Wisconsin Tax Form A-771 – Fill Out and Use This PDF

The Wisconsin Tax A 771 form, known as the Installment Agreement Request, is designed for individuals who seek to set up a payment plan for outstanding taxes owed to the State of Wisconsin. This process requires a processing fee and involves the Department of Revenue reviewing the request for approval. If you find yourself unable to pay your tax debt in full, completing this form can be a critical step towards managing your obligations in a structured manner.

To begin the process of establishing your installment agreement, click the button below.

Get Form Now Download PDF

Wisconsin Tax Form A-771 PDF Details

In navigating the complexities of tax obligations, residents of Wisconsin facing financial hardship have access to a vital avenue for relief through the Wisconsin Tax A 771 form—an Installment Agreement Request processed by the State of Wisconsin Department of Revenue. This form, requiring a processing fee, plays a pivotal role for individuals seeking to manage their delinquent tax liabilities in a more manageable manner by proposing a structured payment plan that fits their financial situation. The department reviews these requests thoroughly, analyzing the taxpayer's financial information, including income, expenses, assets, and dependence information, before approving an installment plan that may necessitate adjustments based on the individual's or family's fiscal capability. Importantly, while such an agreement enables taxpayers to mitigate the immediate financial burden by distributing payments over time, it includes conditions like the non-prevention of delinquent tax warrant filings—actions that may affect one’s credit rating and add to the balance due through additional charges. Moreover, any Wisconsin and Federal tax refunds received during this period are allocated towards reducing the unpaid tax balance rather than counting towards the installment payments. Being well-informed about these facets and adhering to the specified installment agreement terms—such as ensuring all returns and taxes are filed and paid promptly and maintaining accurate and truthful information—is crucial for taxpayers aiming to utilize this option effectively while avoiding potential pitfalls that could lead to the agreement’s nullification.

Question	Answer
Form Name	Wisconsin Tax Form A-771
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	gggoverment form a771irs, a771, wisconsin department of revenue form a771, state of wisconsin a771 form

Form Preview Example

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
City, State, Zip
Phone (	)
Phone (	)
Job Title /Position
Job Title /Position
Gross Income
Gross Income
Net Income		Weekly		Bi-weekly	Monthly
Other Income			$
Other Income
General Assistance			$
General Assistance			$
AFDC			$
Social Security /SSI			$
Social Security /SSI			$
Other (specify)			$
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
City, State, Zip
Phone (	)
Phone (	)
Job Title /Position
Job Title /Position
Gross Income
Gross Income
Net Income		Weekly		Bi-weekly	Monthly
Other Income			$
Other Income
General Assistance			$
General Assistance			$
AFDC			$
Social Security /SSI			$
Social Security /SSI			$
Other (specify)			$
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					$		$
Mortgage or Rent					$		$
Property tax escrow					$		$
Property tax escrow					$		$
Auto payments					$		$
Auto payments					$		$
Gasoline/oil					$		$
Gasoline/oil					$		$
Utilities: Home Heating					$		$
Utilities: Home Heating					$		$
	Electrical				$		$
	Telephone				$		$
	Telephone				$		$
	Water				$		$
	Water				$		$
	Cable / internet access				$		$
	Cable / internet access				$		$
Loans (list)		1.			$		$
Loans (list)		1.			$		$
		2.			$		$
		2.			$		$
		3.			$		$
		3.			$		$
Credit Cards		. . . . . . . . . Is card still in use?
VISA			No	Yes	$		$
VISA			No	Yes	$		$
MasterCard			No	Yes	$		$
MasterCard			No	Yes	$		$
Discover			No	Yes	$		$
Other:			No	Yes	$		$
Other:			No	Yes	$		$
Food					$		$
Food					$		$
Entertainment					$		$
Insurance (all)					$		$
Insurance (all)					$		$
IRS – Delinquent Payment					$		$
IRS – Delinquent Payment					$		$
Other (list)					$		$

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

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

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

How to Edit Wisconsin Tax Form A-771 Online for Free

You'll be able to fill out gggoverment form a771irs effortlessly by using our PDFinity® editor. FormsPal professional team is continuously endeavoring to improve the tool and insure that it is much better for clients with its many features. Bring your experience one stage further with constantly growing and great options we offer! Should you be looking to get going, here's what it requires:

Step 1: Hit the orange "Get Form" button above. It will open up our tool so that you can begin completing your form.

Step 2: Once you start the online editor, you'll notice the document prepared to be completed. Besides filling in various blanks, you can also do some other actions with the PDF, particularly putting on custom words, modifying the original textual content, adding illustrations or photos, signing the form, and a lot more.

It will be easy to fill out the form using out practical guide! Here's what you have to do:

1. Complete your gggoverment form a771irs with a selection of necessary blanks. Consider all of the necessary information and be sure nothing is neglected!

2. Now that this array of fields is completed, you're ready add the essential particulars in Other Income General Assistance, Other Income General Assistance, PROPOSED INSTALLMENT AGREEMENT, modayyr, Monthly, Semimonthly, Biweekly, Weekly, Monthly Automatic Withdrawal check, First Payment Withdrawal Date, INSTALLMENT AGREEMENT TERMS A, may affect your credit rating The, Your Wisconsin and Federal tax, ment, and All returns and taxes must be so you can proceed further.

The right way to prepare wi dor a771 step 2

3. The following segment is mostly about Financial Institutions, Balance, Name and address of institution, Checking Account Savings Account, Beneiciary, Amount, Cash Value, Balance Due, on Loan, Yes, Have premiums been paid to date, Motor Vehicles, Make License Plate, Make License Plate, and Model - type in all these blank fields.

The way to prepare wi dor a771 portion 3

You can easily make a mistake when filling out your Yes, for that reason ensure that you take a second look prior to deciding to finalize the form.

4. This next section requires some additional information. Ensure you complete all the necessary fields - Expenses, Monthly Payment, Balance Due, Please note any payments you are, Yes Yes Yes Yes, Electrical Telephone Water Cable, and Mortgage or Rent Property tax - to proceed further in your process!

wi dor a771 completion process clarified (stage 4)

5. Lastly, the following last segment is what you'll have to complete prior to submitting the PDF. The blanks in this case are the next: Mortgage or Rent Property tax, and Net Difference.

Step 3: When you've reviewed the details you given, click on "Done" to complete your form. Right after setting up afree trial account at FormsPal, it will be possible to download gggoverment form a771irs or email it without delay. The form will also be readily accessible from your personal account menu with your each and every edit. At FormsPal.com, we do everything we can to be sure that all your information is maintained private.

Wisconsin Tax Form A-771 – Fill Out and Use This PDF

Wisconsin Tax Form A-771 PDF Details

Form Preview Example

How to Edit Wisconsin Tax Form A-771 Online for Free

Wisconsin Tax Form A-771 isn’t the one you’re looking for?

Related Documents