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Wisconsin Form Verification is an online system that allows you to verify the accuracy of Wisconsin tax forms. The system compares the information on your tax form with the information reported to the Department of Revenue by businesses and other taxpayers. You can use Wisconsin Form Verification to check whether: 1) the wage, income or other information on your tax form is correct, and 2) the deductions and credits claimed on your tax form are allowed. You can also use Wisconsin Form Verification to see if your employer filed withholding taxes for you. If you find any discrepancies between the information on your tax form and what is reported in Wisconsin Form Verification, please contact us right away at (608) 266-2772.

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Question	Answer
Form Name	Wisconsin Form Verification
Form Length	2 pages
Fillable?	Yes
Fillable fields	54
Avg. time to fill out	11 min 22 sec
Other names	pi 1613 employment verification, pi 1613 work experience verification, wisconsin employment verification, wi dpi verification online

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	Form		Registration Verification	Wisconsin Department of Revenue

	A-001			Nexus Unit 2‑233
				PO Box 8906
				Madison WI 53708-8906
	Complete this form to document your business’s Wisconsin tax status. If you do not
				Phone: (608) 266‑3969
	verify that your business and its affiliates are registered for Wisconsin sales or use tax
				FAX: (608) 266‑5464
	or that all sales are exempt, Wisconsin state agencies and authorities may not purchase
				website: revenue.wi.gov
	products or services from the business or affiliates.

A. Identification

Case ID:

Legal name (sole proprietors enter your last name, first, MI)

Business name (DBA)

Mailing address

City

State

Zip

Federal Employer Identification Number (FEIN)

SSN required for sole proprietors

Website address

Sole Proprietorship

} Date of incorporation

Corporation



C corp

QSubS corp

 State of incorporation

(mm dd yyyy)

Legal name of owner

Owner SSN or, if owner is a business, enter FEIN

Partnership



General

Limited (LP)

Limited Liability Partnership (LLP)

} Date registered

 State of registration

Limited Liability Company (LLC)

(mm dd yyyy)

LLC classification for

C Corporation

S Corporation

Partnership

 federal income tax



Disregarded entity (LLC activity reported on owner’s income tax return). Enter owner below.

Legal name of owner

Owner SSN or, if owner is a business, enter FEIN

Other (e.g., Governmental unit, nonprofit organization)

If your income year does not end on December 31st, enter the date your fiscal year ends	-

	(mm - dd)

B. Current Wisconsin Registration Status (check appropriate box)

Currently registered to collect and remit Wisconsin sales and use tax. Enter Wisconsin sales and use tax account number.

Registering to collect and remit Wisconsin sales and use tax. Register online at tap.revenue.wi.gov/btr and enter your Business Tax Registration confirmation number.

All sales of products and services in Wisconsin are exempt. Complete and attach Affidavit of Exempt Sales (Form A‑006).

We are not eligible to submit an Affidavit of Exempt Sales and decline to register to collect and remit Wisconsin sales and use tax. (Note: Wisconsin state agencies and authorities may not purchase products or services from your company).

Affiliate Information

Do you have affiliates* selling products or services in Wisconsin?	Yes	No
If Yes, complete and attach Affiliate Registration Verification (Form A‑002).

*“Affiliate” means a person or business that controls, is controlled by, or is under common control with another person or business. “Control” means to own, directly or indirectly, more than 10% of the interest in, or voting securities of, a business.

A-001 (R. 4-18)

Go to Page 2

(see back)

C.Wisconsin Business Activity

1.Describe all products sold, rented or leased to Wisconsin customers.

2.Describe all services sold or provided to Wisconsin customers.

3.	Do you sell products or services in Wisconsin to customers that are not governmental units?	Yes	No
4.	Are all of your sales in Wisconsin exempt from sales and use tax?	Yes	No

Why are all sales exempt? (check all that apply)

Sales to governmental units

Sales for resale

Sales are not taxable. Exemption certificates provided by customers or nontaxable services

Other (describe)

5. Do salespersons or representatives visit Wisconsin for any business purpose?	Yes	No
If yes, explain?

6.	Do you license software or intangible assets, such as trademarks, customer lists, etc., in Wisconsin? .	Yes	No
7.	Do you provide services outside Wisconsin for which the benefits are received in Wisconsin? . . . .	Yes	No
8.	What year did you start selling products/services to Wisconsin customers?

I certify that, to the best of my knowledge, the above information is accurate and complete.

Completed by (type or print)

Signature

( )

Telephone number

Title

Date

Email address

A-001 (R. 4-18)

- 2 -

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example of gaps in dpi verification

You have to fill out the Legal, name, of, owner Limited, LP Date, registered mm, dd, yyyy State, of, registration S, Corporation Partnership, and mm, dd area with the expected information.

Finishing dpi verification step 2

In the section talking about Yes, and see, back you have got to note some essential information.

Entering details in dpi verification part 3

Describe the rights and responsibilities of the sides inside the paragraph Yes, and Yes.

Filling in dpi verification step 4

Finish by reviewing the next areas and filling them in as needed: If, yes, explain Yes, Yes, Yes, Completed, by, type, or, print and Title.

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