2015 statement of assessment for richland county

88
STATEMENT OF ASSESSMENT FOR 2015 CO MUN LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53) 52 002 TOWN OF ACCT NO 1374 Check if this is an Amended Return AKAN FOR Town - Village - City Municipality Name County Name RICHLAND COUNTY REMARKS OF Page 1 WHEN COMPLETING THIS DOCUMENT DO NOT WRITE OVER X's OR IN SHADED AREAS Line No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 AGRICULTURAL FOREST - Class 5m TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14) NO. OF ACRES WHOLE NUMBERS ONLY TOTAL VALUE OF LAND AND IMPROVEMENTS LOCALLY ASSESSED MANUFACTURING MERGED REAL ESTATE (See Lines 18 - 22 for other Real Estate) PARCEL COUNT RESIDENTIAL - Class 1 COMMERCIAL - Class 2 MANUFACTURING - Class 3 AGRICULTURAL - Class 4 UNDEVELOPED - Class 5 FOREST LANDS - Class 6 OTHER - Class 7 TOTAL - ALL COLUMNS NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1 MACHINERY,TOOLS AND PATTERNS - Code 2 FURNITURE, FIXTURES AND EQUIPMENT - Code 3 ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F) MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F BOARD OF REVIEW DATE OF FINAL ADJOURNMENT Name of Assessor Telephone # TOTAL LAND Col. A IMPROVEMENTS Col. B Col. C VALUE OF LAND Col. D VALUE OF IMPROVEMENTS Col. E Col. F 150 147 150 1,460,300 10,875,700 12,336,000 7 5 19 117,500 364,900 482,400 615 13,252 1,904,300 1,904,300 337 1,646 1,882,500 1,882,500 146 2,004 2,708,600 2,708,600 85 886 2,393,500 2,393,500 120 120 1,093,400 8,824,100 122 9,917,500 1,460 272 11,560,100 20,064,700 18,079 31,624,800 13 0 22,200 3,600 23,000 48,800 31,673,600 05/22/2015 WORTH SERVICES - WILLIAM HANSON (608) 476-2262 0 0 0 0 0 0 0 0 0 22,200 0 3,600 0 23,000 0 48,800 The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.042330184 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service Commission FINAL - EQUATED

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STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 002

TOWN OF

ACCT NO

1374Check if this is an Amended Return

AKAN FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

150 147 150 1,460,300 10,875,700 12,336,000

7 5 19 117,500 364,900 482,400

615 13,252 1,904,300 1,904,300

337 1,646 1,882,500 1,882,500

146 2,004 2,708,600 2,708,600

85 886 2,393,500 2,393,500

120 120 1,093,400 8,824,100 122 9,917,500

1,460 272 11,560,100 20,064,700 18,079 31,624,800

13

0

22,200

3,600

23,000

48,800

31,673,600

05/22/2015 WORTH SERVICES - WILLIAM HANSON (608) 476-2262

0 0 0 0 0 0

0 0

0 22,200

0 3,600

0 23,000

0 48,800

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.042330184 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 002 1374

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

2 75 202,500

7 115 239,100 137 3,081.18 6,536,000

76 1,675.13 3,509,800

57.5 51.65 47.18

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

002

ACCT NO

1374

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

122016

223850

524851

0077

0140

0314

SCH D OF NORTH CRAWFORD

SCH D OF RIVERDALE (MUSCODA)

SCH D OF RICHLAND

349,800

2,512,600

28,811,200

31,673,600

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 31,673,600

31,673,600

349,800

2,512,600

28,811,200

31,673,600

31,673,600

31,673,600

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 004

TOWN OF

ACCT NO

1375Check if this is an Amended Return

BLOOM FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

181 160 166 1,416,600 11,241,400 12,658,000

9 6 6 52,700 32,400 85,100

702 16,225 2,296,900 2,296,900

383 749 386,900 386,900

309 3,677 4,777,200 4,777,200

23 237 585,600 585,600

169 164 1,621,500 10,907,600 228 12,529,100

1,777 330 11,195,000 22,181,400 21,328 33,376,400

11

0

0

200

12,100

12,300

33,388,700

05/14/2015 WORTH SERVICES (608) 476-2262

1 0 40 57,600 0 57,600

0 0

0 0

0 200

0 12,100

0 12,300

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .992245085 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 004 1375

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

5 92.5 222,300 70 1,441.65 2,318,800

11 260 440,700

30.73 28.24

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

004

ACCT NO

1375

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

524851

622541

625960

0314

0366

0368

SCH D OF RICHLAND

SCH D OF HILLSBORO

SCH D OF KICKAPOO AREA (VIOLA)

8,217,600

4,142,300

20,971,200

33,331,100

000200

000300

0002

0003

WESTERN TECHNICAL COLLEGE LACR

SOUTHWEST WISCONSIN TECH COLLEGE FENN

4,142,300

29,188,800

33,331,100

57,600

8,217,600

4,142,300

21,028,800

57,600 33,388,700

57,600

4,142,300

29,246,400

57,600 33,388,700

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 006

TOWN OF

ACCT NO

1376Check if this is an Amended Return

BUENA VISTA FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

820 656 1,384 13,138,700 66,778,000 79,916,700

31 29 78 496,000 5,178,300 5,674,300

624 13,421 2,350,400 2,350,400

266 1,824 526,800 526,800

203 2,831 3,652,200 3,652,200

70 1,011 2,629,500 2,629,500

93 93 1,209,800 9,396,400 170 10,606,200

2,111 781 24,187,000 82,163,400 20,736 106,350,400

59

0

297,200

244,700

216,900

758,800

107,198,500

06/30/2015 HUGH HARPER (608) 629-5432

4 3 17 183,600 810,700 994,300

0 0

74,800 372,000

5,700 250,400

8,800 225,700

89,300 848,100

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.023130494 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 006 1376

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

2 15 39,000 75 1,816.12 3,963,000

44 1,112.03 2,513,900

2,066.29 133.4 313.68

SEXTONVILLE SANITARY DISTRICT527020 0326 16,430,600

16,430,600

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

006

ACCT NO

1376

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

522660

524851

565523

0313

0314

0336

SCH D OF ITHACA

SCH D OF RICHLAND

SCH D OF RIVER VALLEY (SPRING GREEN)

20,553,700

41,977,400

43,583,800

106,114,900

000300

000400

0003

0004

SOUTHWEST WISCONSIN TECH COLLEGE FENN

MADISON AREA TECHNICAL COLLEGE MADN

62,532,500

43,582,400

106,114,900

1,083,600

20,553,700

43,061,000

43,583,800

1,083,600 107,198,500

1,083,600

63,616,100

43,582,400

1,083,600 107,198,500

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 008

TOWN OF

ACCT NO

1377Check if this is an Amended Return

DAYTON FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

260 240 385 3,185,600 24,797,400 27,983,000

14 11 21 122,400 773,900 896,300

594 10,714 1,561,800 1,561,800

290 1,119 1,232,800 1,232,800

242 3,103 4,032,800 4,032,800

137 1,636 4,269,235 4,269,235

109 104 982,100 7,241,300 150 8,223,400

1,646 355 15,386,735 32,812,600 17,128 48,199,335

26

0

48,400

188,440

148,800

385,640

48,584,975

07/22/2015 HEATHER WOLF (608) 797-9431

0 0 0 0 0 0

0 0

0 48,400

0 188,440

0 148,800

0 385,640

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.023156065 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 008 1377

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

10 194.25 507,800 148 3,232.42 7,263,000

2 45 78,600 62 1,337.36 2,785,500

5.16 240.02 186.31

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

008

ACCT NO

1377

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

524851 0314 SCH D OF RICHLAND 48,584,975

48,584,975

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 48,584,975

48,584,975

48,584,975

48,584,975

48,584,975

48,584,975

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 010

TOWN OF

ACCT NO

1378Check if this is an Amended Return

EAGLE FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

184 169 198 2,865,000 14,019,100 16,884,100

14 6 76 316,500 456,500 773,000

676 15,883 2,425,700 2,425,700

307 1,589 389,200 389,200

83 990 1,140,500 1,140,500

42 661 1,490,000 1,490,000

146 144 1,951,800 13,972,700 243 15,924,500

1,455 321 10,607,200 28,702,900 19,654 39,310,100

20

0

24,500

18,500

10,800

53,800

39,391,800

05/26/2015 WORTH SERVICES (608) 476-2262

3 2 14 28,500 254,600 283,100

0 0

26,500 51,000

900 19,400

500 11,300

27,900 81,700

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.016424226 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 010 1378

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

57 1,177 2,060,200

44 909.65 1,511,000

716.47 12.63 138.45

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

010

ACCT NO

1378

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

223850

524851

0140

0314

SCH D OF RIVERDALE (MUSCODA)

SCH D OF RICHLAND

31,020,100

8,060,700

39,080,800

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 39,080,800

39,080,800

311,000

31,331,100

8,060,700

311,000 39,391,800

311,000 39,391,800

311,000 39,391,800

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 012

TOWN OF

ACCT NO

1379Check if this is an Amended Return

FOREST FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

79 77 94 568,700 6,984,100 7,552,800

0 0 0 0 0 0

572 12,913 1,630,300 1,630,300

149 1,119 1,334,500 1,334,500

210 2,666 3,603,600 3,603,600

87 986 2,663,000 2,663,000

162 159 1,136,000 11,249,900 184 12,385,900

1,263 237 11,037,800 20,058,800 18,011 31,096,600

12

0

1,700

1,900

64,400

68,000

31,906,000

05/23/2015 WORTH SERVICES (608) 476-2262

4 1 49 101,700 1,824,800 1,926,500

0 0

608,100 609,800

117,700 119,600

15,600 80,000

741,400 809,400

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.032134511 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 012 1379

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

13 251 545,700 114 2,658.41 5,407,200

1 40 108,000 61 1,519.32 3,468,900

415.39 34.21 61.21

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

012

ACCT NO

1379

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

622863

625960

0367

0368

SCH D OF LA FARGE

SCH D OF KICKAPOO AREA (VIOLA)

1,391,300

27,846,800

29,238,100

000200

000300

0002

0003

WESTERN TECHNICAL COLLEGE LACR

SOUTHWEST WISCONSIN TECH COLLEGE FENN

1,391,300

27,846,800

29,238,100

2,667,900

1,391,300

30,514,700

2,667,900 31,906,000

2,667,900

1,391,300

30,514,700

2,667,900 31,906,000

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 014

TOWN OF

ACCT NO

1380Check if this is an Amended Return

HENRIETTA FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

222 190 295 2,548,200 11,801,600 14,349,800

3 2 1 8,200 126,700 134,900

577 11,090 1,550,200 1,550,200

335 1,593 1,438,900 1,438,900

200 2,361 2,958,000 2,958,000

70 776 1,921,500 1,921,500

150 149 1,990,500 8,582,500 208 10,573,000

1,557 341 12,415,500 20,510,800 16,324 32,926,300

14

0

1,600

14,700

88,300

104,600

33,030,900

05/11/2015 GARDINER APPRAISAL SERVICE, LLC (608) 943-8009

0 0 0 0 0 0

0 0

0 1,600

0 14,700

0 88,300

0 104,600

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.040559612 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 014 1380

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

15 283.38 633,500 152 3,837.14 9,058,900

85 2,096.05 5,072,900

394.82 28.34 95.33

HUB-ROCK TOWN SANITARY DISTRICT #1527050 0328 1,672,600

1,672,600

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

014

ACCT NO

1380

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

524851

566354

622541

0314

0337

0366

SCH D OF RICHLAND

SCH D OF WESTON (IRONTON)

SCH D OF HILLSBORO

24,161,200

4,886,200

3,983,500

33,030,900

000200

000300

0002

0003

WESTERN TECHNICAL COLLEGE LACR

SOUTHWEST WISCONSIN TECH COLLEGE FENN

3,983,500

29,047,400

33,030,900

24,161,200

4,886,200

3,983,500

33,030,900

3,983,500

29,047,400

33,030,900

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 016

TOWN OF

ACCT NO

1381Check if this is an Amended Return

ITHACA FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

239 215 339 2,430,900 19,611,800 22,042,700

6 6 2 33,600 871,200 904,800

644 12,918 2,040,500 2,040,500

373 1,468 1,298,000 1,298,000

218 2,857 3,716,300 3,716,300

61 715 1,857,700 1,857,700

119 118 1,417,500 10,679,900 211 12,097,400

1,661 339 12,833,700 31,162,900 18,538 43,996,600

20

0

47,300

46,700

91,900

185,900

44,182,500

05/28/2015 GARDINER APPRAISAL SERVICE, LLC (608) 943-8009

1 0 28 39,200 0 39,200

0 0

0 47,300

0 46,700

0 91,900

0 185,900

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .975822888 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 016 1381

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

4 80 180,700 93 2,455.06 4,955,300

3 55 97,500 62 1,316.04 2,762,500

431.01 53.61 84.44

ITHACA SANITARY DISTRICT #1527060 0329 4,433,200

4,433,200

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

016

ACCT NO

1381

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

522660

524851

565523

0313

0314

0336

SCH D OF ITHACA

SCH D OF RICHLAND

SCH D OF RIVER VALLEY (SPRING GREEN)

43,119,700

1,023,600

44,143,300

000300

000400

0003

0004

SOUTHWEST WISCONSIN TECH COLLEGE FENN

MADISON AREA TECHNICAL COLLEGE MADN

43,119,700

1,023,600

44,143,300

39,200

43,158,900

1,023,600

39,200 44,182,500

39,200

43,158,900

1,023,600

39,200 44,182,500

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 018

TOWN OF

ACCT NO

1382Check if this is an Amended Return

MARSHALL FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

212 198 428 2,058,800 18,521,800 20,580,600

3 2 4 19,600 144,200 163,800

550 9,620 1,540,600 1,540,600

405 1,497 1,061,000 1,061,000

268 3,066 3,988,000 3,988,000

114 1,460 3,786,400 3,786,400

119 118 858,400 8,634,700 159 9,493,100

1,672 318 13,490,200 27,300,700 16,275 40,790,900

14

0

386,300

5,100

181,400

572,800

41,363,700

05/26/2015 GARDINER APPRAISAL SERVICE, LLC (608) 943-8009

1 0 41 177,400 0 177,400

0 0

0 386,300

0 5,100

0 181,400

0 572,800

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.019988014 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 018 1382

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

12 352 807,300 195 4,100.96 7,558,600

102 2,377.07 4,666,200

5.61 27.32 30.7

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

018

ACCT NO

1382

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

524851 0314 SCH D OF RICHLAND 41,186,300

41,186,300

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 41,186,300

41,186,300

177,400 41,363,700

177,400 41,363,700

177,400 41,363,700

177,400 41,363,700

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 020

TOWN OF

ACCT NO

1383Check if this is an Amended Return

ORION FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

291 253 312 6,673,100 22,435,300 29,108,400

8 8 11 156,300 2,273,000 2,429,300

606 11,471 1,901,500 1,901,500

225 731 479,000 479,000

245 3,513 3,695,500 3,695,500

85 1,069 2,245,000 2,245,000

120 116 1,316,700 12,836,800 156 14,153,500

1,583 378 16,532,400 37,940,200 17,305 54,472,600

16

9,000

43,400

50,100

22,400

124,900

54,883,600

10/01/2015 WORTH SERVICES (608) 476-2262

3 1 42 65,300 395,100 460,400

0 9,000

284,200 327,600

0 50,100

1,900 24,300

286,100 411,000

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .980760556 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 020 1383

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

3 48 92,500 108 2,695.29 4,453,700

57 1,640.83 2,455,300

1,010.98 66.44 57.03

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

020

ACCT NO

1383

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

223850

522660

524851

0140

0313

0314

SCH D OF RIVERDALE (MUSCODA)

SCH D OF ITHACA

SCH D OF RICHLAND

23,108,600

3,399,400

27,629,100

54,137,100

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 54,137,100

54,137,100

42,300

704,200

23,150,900

3,399,400

28,333,300

746,500 54,883,600

746,500 54,883,600

746,500 54,883,600

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 022

TOWN OF

ACCT NO

1384Check if this is an Amended Return

RICHLAND FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

465 433 792 8,172,000 49,832,700 58,004,700

44 35 150 2,028,900 3,554,000 5,582,900

499 8,258 1,285,200 1,285,200

378 1,226 1,014,900 1,014,900

212 2,481 2,972,600 2,972,600

220 1,865 4,464,200 4,464,200

99 99 990,100 5,569,300 127 6,559,400

1,919 568 21,054,200 59,114,700 14,969 80,168,900

52

0

461,790

177,615

89,797

729,202

80,917,302

07/13/2015 GRETCHEN JELINEK (608) 647-8481

2 1 70 126,300 158,700 285,000

0 0

15,000 476,790

2,100 179,715

2,100 91,897

19,200 748,402

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .941507569 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 022 1384

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

8 110.46 164,300 136 2,885.79 5,787,300

2 15.6 37,400 69 1,444.64 3,092,900

49.98 386.47 135.96

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

022

ACCT NO

1384

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

522660

524851

0313

0314

SCH D OF ITHACA

SCH D OF RICHLAND

7,997,950

72,615,152

80,613,102

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 80,613,102

80,613,102

304,200

7,997,950

72,919,352

304,200 80,917,302

304,200 80,917,302

304,200 80,917,302

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 024

TOWN OF

ACCT NO

1385Check if this is an Amended Return

RICHWOOD FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

274 238 297 2,004,400 17,229,800 19,234,200

6 5 20 45,800 332,900 378,700

662 15,502 2,235,100 2,235,100

319 884 268,200 268,200

198 2,892 2,891,900 2,891,900

55 645 1,289,600 1,289,600

128 127 1,387,400 8,690,700 205 10,078,100

1,645 370 10,197,900 26,253,400 20,500 36,451,300

8

0

19,600

17,200

2,000

38,800

36,490,200

07/06/2015 DON MCGUIRE (608) 875-7327

3 0 55 75,500 0 75,500

0 0

0 19,600

0 17,200

100 2,100

100 38,900

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.001116182 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 024 1385

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

6 172 344,000 65 1,742.48 3,485,000

43 1,150.4 2,300,800

3,094.88 23.88 41.96

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

024

ACCT NO

1385

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

220609

223850

524851

0134

0140

0314

SCH D OF BOSCOBEL AREA

SCH D OF RIVERDALE (MUSCODA)

SCH D OF RICHLAND

1,810,400

34,143,300

460,900

36,414,600

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 36,414,600

36,414,600

75,600

1,810,400

34,218,900

460,900

75,600 36,490,200

75,600 36,490,200

75,600 36,490,200

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 026

TOWN OF

ACCT NO

1386Check if this is an Amended Return

ROCKBRIDGE FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

229 222 436 3,013,800 23,164,200 26,178,000

13 12 6 72,800 284,700 357,500

708 13,721 1,851,100 1,851,100

290 863 223,700 223,700

236 2,869 4,305,000 4,305,000

67 547 1,641,100 1,641,100

158 152 1,538,200 13,976,700 196 15,514,900

1,702 387 12,705,700 37,773,900 18,656 50,479,600

17

0

42,700

4,400

152,900

200,000

50,747,600

05/18/2015 WORTH SERVICES (608) 476-2262

1 1 18 60,000 348,300 408,300

0 0

58,400 101,100

9,400 13,800

200 153,100

68,000 268,000

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.064449738 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 026 1386

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

4 54.43 83,800 91 2,108.33 4,719,900

4 55 132,000 74 1,765.23 4,333,000

291.48 79.92 87.73

HUB-ROCK TOWN SANITARY DISTRICT #1527050 0328 4,117,100

4,117,100

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

026

ACCT NO

1386

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

522660

524851

0313

0314

SCH D OF ITHACA

SCH D OF RICHLAND

1,834,900

48,436,400

50,271,300

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 50,271,300

50,271,300

476,300

1,834,900

48,912,700

476,300 50,747,600

476,300 50,747,600

476,300 50,747,600

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 028

TOWN OF

ACCT NO

1387Check if this is an Amended Return

SYLVAN FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

138 132 161 1,422,500 9,477,500 10,900,000

13 12 18 129,300 1,425,700 1,555,000

644 13,812 2,039,500 2,039,500

336 1,017 981,700 981,700

262 2,539 3,555,200 3,555,200

93 833 2,332,200 2,332,200

162 158 1,704,000 10,302,500 245 12,006,500

1,649 302 12,229,300 21,205,700 18,677 33,435,000

15

0

30,900

0

97,200

128,100

33,622,900

05/12/2015 WORTH SERVICES (608) 476-2262

1 0 52 64,900 0 64,900

0 0

41,300 72,200

17,700 17,700

800 98,000

59,800 187,900

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.051158062 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 028 1387

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

5 69 158,200 115 2,710.65 5,247,700

5 126 330,400 67 1,357.07 2,838,000

190.63 14.29 14.99

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

028

ACCT NO

1387

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

524851

625960

0314

0368

SCH D OF RICHLAND

SCH D OF KICKAPOO AREA (VIOLA)

21,121,300

12,376,900

33,498,200

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 33,498,200

33,498,200

64,900

59,800

21,186,200

12,436,700

124,700 33,622,900

124,700 33,622,900

124,700 33,622,900

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 030

TOWN OF

ACCT NO

1388Check if this is an Amended Return

WESTFORD FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

174 171 347 2,825,000 13,399,800 16,224,800

5 4 13 58,700 216,000 274,700

574 13,094 2,047,500 2,047,500

420 2,110 1,815,800 1,815,800

249 2,771 4,018,100 4,018,100

42 398 1,148,800 1,148,800

118 116 1,522,400 8,318,600 201 9,841,000

1,582 291 13,436,300 21,934,400 18,934 35,370,700

18

0

2,100

6,100

158,200

166,400

35,537,100

06/03/2015 ASSOCIATED APPRAISAL CONSULTANTS, INC. (920) 749-1995

0 0 0 0 0 0

0 0

0 2,100

0 6,100

0 158,200

0 166,400

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.057799752 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 030 1388

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

3 62 181,300 88 2,010.67 5,816,400

1 12 34,800 57 1,142.52 3,034,200

.19 5.49 154.24

GERMANTOWN SANITARY DISTRICT527040 0327 1,494,400

1,494,400

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

030

ACCT NO

1388

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

296713

522660

566354

0175

0313

0337

SCH D OF WONEWOC-UNION CENTER

SCH D OF ITHACA

SCH D OF WESTON (IRONTON)

815,800

97,600

34,623,700

35,537,100

000300

000400

0003

0004

SOUTHWEST WISCONSIN TECH COLLEGE FENN

MADISON AREA TECHNICAL COLLEGE MADN

34,721,300

815,800

35,537,100

815,800

97,600

34,623,700

35,537,100

34,721,300

815,800

35,537,100

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 032

TOWN OF

ACCT NO

1389Check if this is an Amended Return

WILLOW FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

163 153 218 1,637,800 11,711,300 13,349,100

2 2 1 13,000 65,300 78,300

607 13,812 2,283,200 2,283,200

83 1,020 842,600 842,600

177 1,928 1,736,300 1,736,300

109 846 1,523,800 1,523,800

145 142 1,256,400 10,581,600 153 11,838,000

1,286 297 9,293,100 22,358,200 17,978 31,651,300

5

0

0

0

37,300

37,300

31,688,600

05/27/2015 WORTH SERVICES (608) 476-2262

0 0 0 0 0 0

0 0

0 0

0 0

0 37,300

0 37,300

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .948294849 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 032 1389

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

3 52 64,800 112 2,735.08 4,189,600

1 42.48 76,500 59 1,300.4 2,012,500

470.41 380.85

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

032

ACCT NO

1389

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

522660

524851

566354

0313

0314

0337

SCH D OF ITHACA

SCH D OF RICHLAND

SCH D OF WESTON (IRONTON)

27,390,900

200,100

4,097,600

31,688,600

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 31,688,600

31,688,600

27,390,900

200,100

4,097,600

31,688,600

31,688,600

31,688,600

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 106

VILLAGE OF

ACCT NO

1390Check if this is an Amended Return

BOAZ FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

64 58 53 312,100 2,555,300 2,867,400

9 8 9 68,000 592,600 660,600

11 73 12,400 12,400

6 30 41,800 41,800

0 0 0 0

2 12 36,500 36,500

3 3 37,200 189,300 4 226,500

95 69 508,000 3,337,200 181 3,845,200

10

0

2,800

20,200

1,600

24,600

3,869,800

10/06/2015 WORTH SERVICES (608) 476-2262

0 0 0 0 0 0

0 0

0 2,800

0 20,200

0 1,600

0 24,600

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .993351644 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 106 1390

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

1 3.51 10,500

3.28 15.61

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

106

ACCT NO

1390

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

524851 0314 SCH D OF RICHLAND 3,869,800

3,869,800

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 3,869,800

3,869,800

3,869,800

3,869,800

3,869,800

3,869,800

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 111

VILLAGE OF

ACCT NO

1391Check if this is an Amended Return

CAZENOVIA FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

166 144 105 2,796,400 9,065,000 11,861,400

23 19 6 203,800 1,126,700 1,330,500

28 249 53,900 53,900

11 32 22,500 22,500

12 110 107,100 107,100

2 14 27,400 27,400

1 1 5,000 6,000 1 11,000

243 164 3,216,100 10,197,700 517 13,413,800

21

0

38,000

72,000

3,100

113,100

13,526,900

06/29/2015 ASSOCIATED APPRAISAL CONSULTANTS INC (920) 749-1995

0 0 0 0 0 0

0 0

0 38,000

0 72,000

0 3,100

0 113,100

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.004000594 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 111 1391

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

.36 .91 90.06

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

111

ACCT NO

1391

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

566354 0337 SCH D OF WESTON (IRONTON) 13,526,900

13,526,900

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 13,526,900

13,526,900

13,526,900

13,526,900

13,526,900

13,526,900

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 146

VILLAGE OF

ACCT NO

1392Check if this is an Amended Return

LONE ROCK FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

323 287 198 3,596,600 21,338,800 24,935,400

68 50 128 1,988,600 5,005,800 6,994,400

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0 0 0

392 338 5,621,700 26,595,700 336 32,217,400

34

2,200

375,900

120,000

122,500

620,600

32,838,000

09/21/2015 GARDINER APPRAISAL SERVICE, LLC (608) 943-8009

1 1 10 36,500 251,100 287,600

0 2,200

0 375,900

0 120,000

0 122,500

0 620,600

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .999119067 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 146 1392

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

1 39.87 160,000

30.2 79.71

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

146

ACCT NO

1392

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

565523 0336 SCH D OF RIVER VALLEY (SPRING GREEN) 32,550,400

32,550,400

000400 0004 MADISON AREA TECHNICAL COLLEGE MADN 32,550,400

32,550,400

287,600 32,838,000

287,600 32,838,000

287,600 32,838,000

287,600 32,838,000

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 186

VILLAGE OF

ACCT NO

1393Check if this is an Amended Return

VIOLA FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

200 186 83 1,559,700 12,404,100 13,963,800

31 21 10 157,800 1,094,200 1,252,000

3 51 5,000 5,000

1 5 2,800 2,800

0 0 0 0

1 5 10,000 10,000

2 1 13,800 15,700 2 29,500

239 209 1,753,100 13,546,300 156 15,299,400

26

0

27,469

119,577

5,931

152,977

15,453,277

05/28/2015 JERRY KINS (715) 713-0081

1 1 0 4,000 32,300 36,300

0 0

400 27,869

400 119,977

100 6,031

900 153,877

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.063808673 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 186 1393

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

2.04 72.04

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

186

ACCT NO

1393

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

625960 0368 SCH D OF KICKAPOO AREA (VIOLA) 15,416,077

15,416,077

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 15,416,077

15,416,077

37,200 15,453,277

37,200 15,453,277

37,200 15,453,277

37,200 15,453,277

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 196

VILLAGE OF

ACCT NO

1394Check if this is an Amended Return

YUBA FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

31 28 17 230,400 1,339,200 1,569,600

9 8 2 35,100 330,800 365,900

7 118 14,200 14,200

4 6 700 700

0 0 0 0

5 1 3,200 3,200

4 4 40,800 153,900 6 194,700

60 40 324,400 1,823,900 150 2,148,300

7

0

14,900

11,800

900

27,600

2,175,900

05/14/2015 WORTH SERVICES (608) 476-2262

0 0 0 0 0 0

0 0

0 14,900

0 11,800

0 900

0 27,600

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .978636323 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 196 1394

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

6.61

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

196

ACCT NO

1394

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

622541 0366 SCH D OF HILLSBORO 2,175,900

2,175,900

000200 0002 WESTERN TECHNICAL COLLEGE LACR 2,175,900

2,175,900

2,175,900

2,175,900

2,175,900

2,175,900

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

52 276

CITY OF

ACCT NO

1395Check if this is an Amended Return

RICHLAND CENTER FOR

Town - Village - City Municipality Name County Name

RICHLAND COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,758 1,659 630 22,549,600 123,776,700 146,326,300

287 256 331 18,510,000 67,763,000 86,273,000

7 79 10,650 10,650

7 73 21,200 21,200

2 51 45,900 45,900

3 80 184,100 184,100

0 0 0 0 0 0

2,082 1,931 44,032,750 211,783,500 1,322 255,816,250

340

0

1,548,338

5,938,115

1,091,646

8,578,099

277,724,249

07/16/2015 GRETCHEN JELINEK (608) 647-8481

18 16 78 2,711,300 20,243,800 22,955,100

0 0

10,672,400 12,220,738

880,300 6,818,415

1,777,200 2,868,846

13,329,900 21,907,999

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .998058563 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 52 276 1395

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

.27 45.81 193.73 1,100.82

338,140

PARFREY MILL POND DISTRICT528020 0330 241,439,249

36,285,000 277,724,249

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

52MUN

276

ACCT NO

1395

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

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LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

524851 0314 SCH D OF RICHLAND 241,439,249

241,439,249

000300 0003 SOUTHWEST WISCONSIN TECH COLLEGE FENN 241,439,249

241,439,249

36,285,000 277,724,249

36,285,000 277,724,249

36,285,000 277,724,249

36,285,000 277,724,249

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

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LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS