Fill Out a Valid Wisconsin Tax A 771 Template Edit Form Online

Fill Out a Valid Wisconsin Tax A 771 Template

The Wisconsin Tax A 771 form is an Installment Agreement Request that allows taxpayers to propose a payment plan for their tax liabilities. By filling out this form, individuals can formally request to pay their outstanding taxes in manageable installments while complying with state regulations. For those facing financial difficulties, this form offers a structured way to address tax obligations.

Start the process of filling out the Wisconsin Tax A 771 form by clicking the button below.

Edit Form Online
Article Structure

When navigating the complexities of tax obligations, the Wisconsin Tax A 771 form serves as a crucial tool for individuals seeking to establish a manageable payment plan with the Wisconsin Department of Revenue. This form is specifically designed for those who may find themselves in a position of financial strain, allowing them to propose an installment agreement for settling outstanding tax liabilities. As you fill out the A 771, you'll provide essential personal information, including your name, Social Security number, and details about your income and expenses. The form also requires you to outline your proposed payment plan, specifying how much you can afford to pay and the frequency of those payments—whether monthly, bi-weekly, or weekly. It's important to note that a processing fee accompanies the acceptance of your installment agreement, and the Department retains the right to adjust the terms based on your financial situation. Furthermore, while entering into this agreement can alleviate immediate pressures, it does not prevent the filing of delinquent tax warrants, which could impact your credit rating. Understanding these aspects is vital for anyone considering this option, as it ensures you are making informed decisions about your financial future.

Listed Questions and Answers

  1. What is the Wisconsin Tax A 771 form?

    The Wisconsin Tax A 771 form is an Installment Agreement Request form. It allows taxpayers who owe taxes to request a payment plan with the Wisconsin Department of Revenue. This form is essential for individuals who cannot pay their tax liability in full and need to propose a manageable payment schedule.

  2. What information do I need to provide on the form?

    You will need to provide personal information, including your name, Social Security number, date of birth, address, and contact details. Additionally, you must include details about your employment, income, dependents, and financial assets and liabilities. Accurate information is crucial, as it will determine your eligibility for an installment agreement.

  3. Is there a fee associated with the installment agreement?

    Yes, there is a processing fee of $20. This fee will be added to your balance when your installment agreement is accepted by the Wisconsin Department of Revenue. Be aware that this fee is non-refundable, even if you decide to withdraw your request later.

  4. What happens if my installment agreement is approved?

    If your request is approved, the department will send you an installment agreement outlining the terms. You will be required to adhere to these terms, including making payments on time. Failure to comply may result in the agreement being voided.

  5. Can I still file my tax returns while in an installment agreement?

    Yes, you must continue to file and pay all taxes as they become due, even while you are in an installment agreement. Your tax refunds will also be applied to your unpaid tax liability and will not count as installment payments.

  6. What if I provide inaccurate information on the form?

    If it is determined that the information provided is false or inaccurate, the Wisconsin Department of Revenue reserves the right to void the installment agreement. This could lead to further penalties or collection actions against you.

  7. How will my credit rating be affected?

    Entering into an installment agreement does not prevent the filing of a delinquent tax warrant. These warrants are public records and can negatively impact your credit rating. It is important to be aware of this when considering an installment agreement.

  8. What types of payments can I propose?

    You can propose various payment frequencies, such as monthly, bi-weekly, or semi-monthly. When completing the form, you will need to specify the amount you wish to pay and the date of your first payment. Automatic withdrawals can also be arranged to ensure timely payments.

Key takeaways

Here are some key takeaways about filling out and using the Wisconsin Tax A 771 form:

  • Complete Both Sides: Ensure that you fill out both sides of the form. Missing information can delay your request.
  • Processing Fee: A fee of $20.00 will be added to your balance if your installment agreement is accepted.
  • Payment Options: You can choose from various payment frequencies, including monthly or bi-weekly, and set up automatic withdrawals.
  • Impact on Credit: An installment agreement does not stop the filing of a delinquent tax warrant, which can affect your credit rating.
  • Refunds Applied: Any Wisconsin and Federal tax refunds will go toward reducing your unpaid tax liability and will not count as installment payments.
  • Accurate Information Required: The Wisconsin Department of Revenue can void your agreement if it is based on false information or if your financial situation changes significantly.
  • Signature Required: Both you and your spouse (if applicable) must sign the form, confirming that the information provided is true and correct.

Document Overview

Fact Name Details
Form Purpose The Wisconsin Tax A 771 form is used to request an installment agreement for unpaid taxes.
Processing Fee A processing fee of $20.00 is added to your balance when the installment agreement is accepted.
Approval Notification The Department of Revenue will inform you if your request is approved or if more information is needed.
Tax Warrant Impact Entering an installment agreement does not prevent the filing of a delinquent tax warrant, which can affect your credit.
Refund Application Wisconsin and Federal tax refunds will be applied to your unpaid tax liability, not counted as installment payments.
Required Information Both sides of the form must be completed, providing personal and financial information.
Governing Laws This form is governed by Wisconsin Statutes Chapter 71 and related tax laws.
Signature Requirement Both you and your spouse must sign the form, confirming the accuracy of the information provided.
Financial Disclosure You must list all assets and expenses, including accounts, vehicles, and real estate.

Browse Other Documents

Misconceptions

Misconceptions about the Wisconsin Tax A 771 form can lead to confusion and potentially costly errors. Below are six common misconceptions along with clarifications to help individuals understand the form better.

  • Misconception 1: The form is only for individuals who cannot pay their taxes in full.
  • This form is specifically for those seeking an installment agreement, but it can also be used by individuals who wish to manage their tax payments more effectively, even if they have the means to pay in full.

  • Misconception 2: Submitting the form guarantees approval of the installment agreement.
  • Approval is not automatic. The Wisconsin Department of Revenue reviews each request and may require additional information or adjustments to the proposed payment plan before granting approval.

  • Misconception 3: The $20 processing fee is a one-time charge.
  • While the fee is charged upon acceptance of the agreement, additional fees may apply if the agreement is violated or if tax warrants are filed against the individual.

  • Misconception 4: Entering into an installment agreement prevents the filing of a delinquent tax warrant.
  • This is incorrect. The filing of a tax warrant can still occur, and it may affect credit ratings, regardless of the installment agreement.

  • Misconception 5: Tax refunds will be applied to the installment agreement payments.
  • Tax refunds will not count as payments toward the installment agreement. Instead, they will be applied to reduce the overall tax liability.

  • Misconception 6: The form does not require accurate financial information.
  • Providing false or inaccurate information can lead to the voiding of the agreement. It is essential to ensure that all information submitted is truthful and complete.

Form Sample

STATE OF WISCONSIN  DEPARTMENT OF REVENUE

2135 RIMROCK ROAD PO BOX 8901 MADISON WI 53708-8901 Phone (608) 266-7879 FAX (608) 261-8978 delnqtax@revenue.wi.gov

Installment Agreement Request – Processing Fee Required

The department will inform you if your installment request is approved or if additional information is needed. If approved as proposed, an installment agreement will be forwarded to you. If it is determined that larger payments are necessary or additional information is required, someone from the department will contact you. Be sure to complete both sides of this form.

YOUR INFORMATION

Name

Social Security Number

Date of Birth

Address

City, State, Zip

 

Phone (

)

Name(s) and ages of dependent(s)

Place of Employment

Company

Address

City, State, Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone (

)

 

 

 

 

 

 

 

 

 

 

 

 

Job Title /Position

 

 

 

 

 

 

 

 

 

 

Gross Income

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net Income

 

 

 

Weekly

 

Bi-weekly

Monthly

Other Income

 

 

 

 

$

 

 

 

 

 

 

 

 

 

General Assistance

 

$

 

 

 

 

 

AFDC

 

 

 

 

$

 

 

Social Security /SSI

 

$

 

 

 

 

 

Other (specify)

 

 

 

 

$

 

 

 

 

 

 

 

 

SPOUSE INFORMATION

Name

Social Security Number

Date of Birth

Address

City, State, Zip

 

Phone (

)

Name(s) and ages of dependent(s)

Place of Employment

Company

Address

City, State, Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone (

)

 

 

 

 

 

 

 

 

 

 

 

 

Job Title /Position

 

 

 

 

 

 

 

 

 

 

Gross Income

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net Income

 

 

 

Weekly

 

Bi-weekly

Monthly

Other Income

 

 

 

 

$

 

 

 

 

 

 

 

 

 

General Assistance

 

$

 

 

 

 

 

AFDC

 

 

 

 

$

 

 

Social Security /SSI

 

$

 

 

 

 

 

Other (specify)

 

 

 

 

$

 

 

 

 

 

 

 

 

PROPOSED INSTALLMENT AGREEMENT

$

/ /

(mo/day/yr)

{

Monthly OR

Semi-monthly

Bi-weekly

Weekly

 

Monthly Automatic Withdrawal

(check withdrawal date)

First Payment / Withdrawal Date

 

 

5th

15th

25th

INSTALLMENT AGREEMENT TERMS:

1.A $20.00 fee will be added to your balance when an installment agreement is accepted by the department.

2.An installment agreement will not prevent the iling of a delinquent tax warrant. These warrants are liens against your property and, as public records, may affect your credit rating. The iling of these tax warrants will add additional charges to your balance.

3.Your Wisconsin and Federal tax refunds will be used to reduce the unpaid tax liability and will not be considered installment payments on your agree- ment.

4.All returns and taxes must be iled and paid as they become due.

5.The Wisconsin Department of Revenue reserves the right to void any agreement if it is determined that it was made based on false or inaccurate infor- mation or if there is a material change in your inancial condition.

I/ We have read and understand the terms listed above and wish to enter into an installment agreement with the Wisconsin Department of Revenue. I/ We also attest that the information furnished on this form is true and correct to the best of my/our knowledge.

Your Signature

Date

Spouse Signature

Date

A-771 (R. 4-12)

Please indicate both separate and combined assets and expenses.

Financial Institutions

Balance

Name and address of institution

 

Checking Account

$

 

 

 

 

 

 

 

 

 

 

Savings Account

$

 

 

 

 

 

 

 

 

 

 

Other (IRA, CD,

$

 

 

 

 

 

 

 

 

 

 

Money Market, etc.)

 

 

 

 

 

 

 

 

 

 

 

Life Insurance Policies

 

 

 

 

 

 

 

 

Cash

Balance Due

Company

 

 

 

 

Beneiciary

Amount

Value

on Loan

 

 

 

 

 

 

 

$

 

$

 

$

 

 

 

 

 

 

 

$

 

$

 

$

 

 

 

 

 

 

 

$

 

$

 

$

Yes

No

Have premiums been paid to date?

Motor Vehicles

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Make

 

 

 

 

 

 

Model

 

 

 

 

 

 

 

Year

 

 

Fair Market Value $

 

 

 

Balance Due $

 

License Plate #

 

 

 

 

 

Lien Holder

 

 

 

 

 

Address

 

 

 

 

 

Make

 

 

 

 

 

 

Model

 

 

 

 

 

 

 

Year

 

 

Fair Market Value $

 

 

 

Balance Due $

 

License Plate #

 

 

 

Lien Holder

 

 

 

 

 

Address

 

 

 

 

 

Other personal property (boat, motorcycle, snowmobile, etc.):

 

 

 

 

 

 

 

 

 

 

Real Estate (If you rent, list name and address of landlord)

 

 

 

 

 

 

 

 

 

 

Location

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fair Market Value $

 

 

 

Balance Due $

 

Mortgage Holder

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

Expenses

 

 

 

 

 

 

 

 

 

 

 

 

 

Monthly

 

 

 

 

 

 

 

Please note any payments you

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Payment

 

 

Balance Due

 

 

are behind in and by how much

Mortgage or Rent

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Property tax escrow

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Auto payments

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gasoline/oil

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Utilities: Home Heating

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Electrical

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

Telephone

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Water

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cable / internet access

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Loans (list)

1.

 

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Credit Cards

. . . . . . . . . Is card still in use?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VISA

No

Yes

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MasterCard

No

Yes

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Discover

No

Yes

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

Other:

 

 

 

 

 

 

No

Yes

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entertainment

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

Insurance (all)

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IRS – Delinquent Payment

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other (list)

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

Total Monthly Expenses. . . . . . . . . . . . . . . . . . . .$

Total Net Monthly Income . . . . . . . . . . . . . . . . . .$

Net Difference . . . . . . . . . . . . . . . . . . . . . . . . . . .$