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DO NOT STAPLE

PAPER CLIP withholding statements here

1NPR

2021

Nonresident & part-year resident

For the year Jan. 1-Dec. 31, 2021, or other tax year

Wisconsin income tax

beginning

, 2021 ending

, 20

Check here if this is an amended return

Complete form using BLACK INK

Your legal last name

Legal first name

M.I.

Your social security number

If a joint return, spouse’s legal last name

Spouse’s legal first name

M.I.

Spouse’s social security number

Home address (number and street). If you have a PO Box, see page 12

Apt. no.

Tax district

Check below then fill in either the name of the Wisconsin

city, village, or town, and the county in which you

City or post office

State

Zip code

lived at the end of 2021 or before leaving Wisconsin

(nonresidents leave blank).

Foreign Country

Foreign

province/state/county

City

Village

Town

City, village,

Filing status

Foreign postal code

or town

Single

County of

Married filing joint return

(even if only one had income)

Legal last name

School district number See page 59

Married filing separate return.

Fill in spouse’s SSN above

Legal first name

M.I.

Special

and full name here

conditions

Form 804 filed with return (see page 10)

Head of household, NOT married (see page 13)

Head of household, married (see page 13) If married, fill in spouse’s

Resident status Check the status that applies

SSN above and full name here

You Spouse

Full-year resident of Wisconsin

Nonresident of Wisconsin; state of residence

(2-letter state abbreviation)

Part-year resident of Wisconsin from

Note: Complete residence questionnaire, page 61.

yyyy

mm dd

yyyy

PAPER CLIP check or money order here

I-050i

Income

1 Wages, salaries, tips, etc. (see page 15) . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Taxable interest (see page 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Ordinary dividends (see page 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4Taxable refunds, credits, or offsets of state and local income taxes

(from line 1 of federal Schedule 1 (Form 1040) . . . . . . . . . . . . . . . . . . . 4

5 Alimony received (see page 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 Business income or (loss) (see page 19) . . . . . . . . . . . . . . . . . . . . . . . . 6 7 Capital gain or (loss) (see page 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Other gains or (losses) (see page 20) . . . . . . . . . . . . . . . . . . . . . . . . . . 8 9 IRA distributions (see page 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

10 Pensions and annuities (see page 21) . . . . . . . . . . . . . . . . . . . . . . . . . . 10

11Rental real estate, royalties, partnerships, S corporations, trusts, etc.

	(see page 22)	11
12	Farm income or (loss) (see page 24)	12
13	Unemployment compensation (see page 24)	13
14	Social security benefits (see page 25)	14
15	Other income (see page 25). Enclose Schedule M if line 15b has an amount	15
16	Combine lines 1 through 15	16

A. Federal column B. Wisconsin column

.00	.00
.00	.00
.00	.00
.00	Not taxable
.00	.00
.00	.00
.00	.00
.00	.00
.00	.00
.00	.00
.00	.00
.00	.00
.00	.00
.00	Not taxable
.00	.00
.00	.00

2021 Form 1NPR

Name

SSN

Page 2 of 4

	Adjustments to Income			A. Federal column				B. Wisconsin column
17		Educator expenses (see page 26)	17			.00			.00
18		Certain business expenses of reservists, performing artists, and				.00			.00
		fee-basis government officials (see page 26)	18			.00			.00
19		Health savings account deduction (see page 26)	19			.00			.00
20		Moving expenses for members of the Armed Forces (see page 26) . . .	20			.00			.00
21		Deductible part of self-employment tax (see page 27)	21			.00			.00
22		Self-employed SEP, SIMPLE, and qualified plans (see page 27)	22			.00			.00
23		Self-employed health insurance deduction (see page 28)	23			.00			.00
24		Penalty on early withdrawal of savings (see page 29)	24			.00			.00
25		Alimony paid (see page 29)	25			.00			.00
26		IRA deduction (see page 29)	26			.00			.00
27		Student loan interest deduction (see page 30)	27			.00			.00
28		Other adjustments (see page 30). Enclose Schedule M if line 28b has an amount 28				.00			.00
29		Total adjustments to income. Add lines 17 through 28	29			.00			.00
	Adjusted Gross Income
30		Wisconsin income. Subtract line 29, column B from line 16, column B .	30						.00
31		Federal income. Subtract line 29, column A from line 16, column A . . .	31			.00
32		Divide line 30 by line 31. Carry the decimal to four places. If amount
		on line 30 is more than amount on line 31, fill in 1.0000. (See page 31) .	32			.

	Tax Computation
33		Fill in the larger of Wisconsin income from line 30, column B or federal income from line 31,							.00
		column A. But, if Wisconsin income from line 30 is zero or less, fill in 0 (zero)				. 33. .			.00
	34a If you (or your spouse) can be claimed as a dependent on anyone else’s return, check here
		. . . .and see the “Exception” in the instructions for line 34c on page 31	. . . . . . . . . . . .		. . . .		. . 34a
	. . . . . . . . .34b Aliens (see page 31 to determine if you must check line 34b)		. . . . . . . . . . . .		. . . .		. . 34b
	34c Find the standard deduction for amount on line 31 using table on page 50						. . 34c		.00
35		Subtract line 34c from line 33. If line 34c is more than line 33, fill in 0 (zero)				. 35. .			.00

36Exemptions (Caution: see page 32)

	a Fill in exemptions allowed	. . . . .	. . . . . . . . . . . . .			x	$700 . .	36a		.00
	b Check if 65 or older	You +		Spouse =		x	$250 . .	36b		.00		.00
	c Add lines 36a and 36b			. . . . . . . . . .	. . . . . . . .		. . . . . . .	. . .	. . . . . . . . . . . . . . .		. 36c	.00
37	Subtract line 36c from line 35. If line 36c is more than line 35, fill in 0 (zero)									. . . . . . . . . . . . . . 37.		.00
38	Tax (see table on page 52)	. . . . . . . . .		. . . . . . . . . .	. . . . . . . .		. . . . . . .	. . .	.	. . . . . . . . . . . . . . 38.		.00
39	. . . .Itemized deduction credit. Complete Schedule 1 (page 4, Form 1NPR)							39		.00

40School property tax credits (part-year and full-year residents only)

a Rent paid in 2021–heat included	.00	Find credit from		.00
Rent paid in 2021–heat not included	.00}	. . . .table page 35	40a
		Find credit from		.00
b Property taxes paid on home in 2021	.00
		table page 36 . . . .	40b

41	Add credits on lines 39, 40a, and 40b	41	.00
42	Subtract line 41 from line 38. If line 41 is more than line 38, fill in 0 (zero)	42	.00
43	. . . . . . . . . . . . . . . . . .Fill in ratio from line 32	43		.
44	Multiply line 42 by ratio on line 43	44	.00

.00

2021 Form 1NPR					Page 3 of 4
Name(s) shown on Form 1NPR				Your social security number

45	Fill in amount from line 44		.	. . 45	.00
46	. . . . .Working families tax credit. (Full-year Wisconsin residents only) .	46		.00
47	Married couple credit. Complete Schedule 2 (page 4, Form 1NPR) . . . .	47		.00
48	Nonrefundable credits from Schedule CR, line 34. Enclose Schedule CR	48		.00
49	Net income tax paid to another state. Enclose Schedule OS . . .	49		.00	.00
49		49		.00

50	Add lines 46 through 49		.	. . 50
51	Subtract line 50 from line 45. If line 50 is more than line 45, fill in 0 (zero). This is your net tax . 51				.00
52	Sales and use tax due on internet, mail order, or other out-of-state purchases (see page 39)			. . 52	.00
	. . . . . . . . . . . . . . . . . . . . . . . . . .If you certify that no sales or use tax is due, check here

53Donations (decreases refund or increases amount owed)

a Endangered resources	.00	e	Military family relief	.00
b Cancer research	.00	f	Second Harvest/Feeding Amer.	.00
c Veterans trust fund . . .	.00	g Red Cross WI Disaster Relief		.00
d Multiple sclerosis	.00	h Special Olympics Wisconsin		.00

	Total (add lines a through h) . .			53i	.00
54	Penalties on IRAs, other retirement plans, MSAs, etc. (see page 40)	.00 x .33 =		54	.00
55	Other penalties (see page 41)	. . . . . . . . . . . . . .	. . . . . . .	55	.00
56	Add lines 51 through 55	. . . . . . . . . . . . . .	. . . . . . .	56	.00

Payments and Credits

57 Wisconsin income tax withheld. Enclose readable withholding statements . 57 58 2021 Wisconsin estimated tax paid and amount applied from 2020 return . 58

59Earned income credit. (Full-year Wisconsin residents only) Number of qualifying children


	Federal credit				.00 x		% = 59	.00
	Federal credit	.	. . . . . .		.00 x		% = 59	.00

60	Farmland preservation credit.	a. Schedule FC, line 17					. . . . 60a	.00
		. . . . . . . . .b. Schedule FC-A, line 13					. . . . 60b	.00
61	Repayment credit	.	. . . . . .	. .	. . . . . . . . . . . . . .	. . . . . . . .	. . . . 61	.00
62	Homestead credit. (Full-year Wisconsin residents only)						. . . . 62	.00
63	Eligible veterans and surviving spouses property tax credit						. . . . 63	.00
64	Refundable credits from Schedule CR, line 40						. . . . 64	.00
65	AMENDED RETURN ONLY – amount previously paid (see page 46) .						. . . . 65	.00
66	Add lines 57 through 65	.	. . . . . .	. .	. . . . . . . . . . . . . .	. . . . . . . .	. . . . 66	.00
67	AMENDED RETURN ONLY – amount previously refunded (see page 47) . 67							.00
68	.Subtract line 67 from line 66 .	.	. . . . . .	. . . . . . . . . . . . . . . .		. . . . . . . . . . . . . . . .		. . . . . . . . . . . . . . 68

NOTE: You must use your 2021 earned income (see page 42).

.00

I-050ai

Refund or Amount You Owe
69	If line 68 is more than line 56, subtract line 56 from line 68. This is the AMOUNT OVERPAID	. . 69	.00
70	Amount of line 69 you want REFUNDED TO YOU	. . . 70	.00
71	Amount of line 69 to be APPLIED TO YOUR 2022 ESTIMATED TAX . . . 71	.00

2021 Form 1NPR		Paper clip a copy of your federal income		SSN			Page 4 of 4
2021 Form 1NPR		tax return and schedules to this return.		SSN			Page 4 of 4
72a	If line 68 is less than line 56, subtract line 68 from line 56 . . . This is the AMOUNT YOU OWE 72a					.00
72b	Interest (see page 47)		72b		.00
73	Underpayment interest. Fill in exception code – see Sch. U 		73		.00
	Also include on line 72a (see page 48).

Third Do you want to allow another person to discuss this return with the department (see page 49)?

Yes Complete the following.

Party

Designee’s

Phone

Personal

(

)

identification

Designee name

no.

number (PIN)

Under penalties of law, I declare that this return and all attachments are true, correct, and complete to the best of my knowledge and belief.

Your signature

Date

Wisconsin Identity Protection PIN (7 characters)

Sign

here

Spouse’s signature (if filing jointly, BOTH must sign)

Date

Wisconsin Identity Protection PIN (7 characters)

Sign

here

Mail your return to: Wisconsin Department of Revenue

(if tax is due)

(if refund or no tax due)

PO Box 268

PO Box 59

Madison WI 53790-0001

Madison WI 53785-0001

Schedule 1 – Wisconsin Itemized Deduction Credit (see line 39 instructions)

1Medical and dental expenses from federal Schedule A (Form 1040). See instructions for

exceptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Interest paid from federal Schedule A (Form 1040). See instructions for exceptions . . . . . . . . . . . . 2 3 Gifts to charity from federal Schedule A (Form 1040). See instructions for exceptions . . . . . . . . . . 3 4 Casualty losses from federal Schedule A (Form 1040) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

5	Add lines 1 through 4	5
6	Wisconsin standard deduction from Form 1NPR, line 34c	6
7	Subtract line 6 from line 5. If line 6 is more than line 5, fill in 0 (zero)	7
8	Rate of credit is .05 (5%)	8
9	Multiply line 7 by line 8. Fill in here and on line 39 of Form 1NPR	9

.00

x .05

.00

Schedule 2 – Married Couple Credit May be claimed only when both spouses have earned income taxable by Wisconsin.

1	Wages, salaries, tips, etc., included in column B of line 1 on Form 1NPR.		(A) YOURSELF		(B) YOUR SPOUSE
1
	Do not include deferred compensation (even though reported on a W-2) or		.00	.00

	taxable scholarships or fellowships not reported on a W-2	1
2	Net profit or (loss) from self-employment from federal Schedules C, C-EZ,
	and F (Form 1040), Schedule K-1 (Form 1065), and any other taxable self-		.00		.00

	employment or earned income included in column B on Form 1NPR	2
3	Combine lines 1 and 2. This is your total Wisconsin earned income	3	.00		.00
4	Add amounts on Form 1NPR, lines 18, 22, 26, and 28, column B. Fill in the		.00		.00
	total of these adjustments that apply to your or your spouse’s earned income	4
		4
5	Subtract line 4 from line 3. This is your qualified earned income	5	.00		.00
6	Compare the amount in columns (A) and (B) of line 5. Fill in the			.00
	smaller amount here. If more than $16,000, fill in $16,000	. . . .	. . . . . . 6	.00
7	Rate of credit is .03 (3%)	. . . .	. . . . . . 7	x .03
8	Multiply line 6 by line 7. Round the result and fill in here and on line 47 of Form 1NPR.			.00
	Do not fill in more than $480	. . . .	. . . . . . 8	.00

Question	Answer
Form Name	1Npr Form
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
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