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Wisconsin Department of Revenue

 Instructions for Local Appeal for Exemption From State Mandates

  1. Review the General Waiver Review Criteria and Wisconsin Statutes 66.0143.
  2. Gather all documents that will be required to complete the waiver request prior to beginning the process.
  3. Use the PA-050 form or a facsimile.
  4. Please mail the form and the additional material for question 8 to the Department of Revenue.

    Wisconsin Department of Revenue
    Local Government Services Section
    P.O. Box 8971
    Madison WI 53708-8971

  5. If you need additional assistance in completing the requirements, you may contact Bev Maddrell at (608) 264-6892 or our FAX number at (608) 264-6887.

General Waiver Review Criteria

The Wisconsin Department of Revenue (DOR) will use the following general criteria in evaluating Section 66.0143 Wis. Stats. Waiver requests received from municipalities and counties. DOR will request additional information from municipalities and counties, as needed, to make informed decisions regarding unique circumstances and individual situations in which informational needs cannot be fully anticipated in advance.

  1. Cite state statute or administrative rule by statutory reference or administrative code number that creates the state mandate for which relief is requested.

  2. Provide a description of the reason for the request.

  3. Describe how the waiver will enhance the efficiency and effectiveness of municipal or county operations.

  4. What effects, if any, will the requested waiver have on programs or services offered by other municipalities or counties?

  5. State the reason why this waiver is not related to health or safety.

  6. Description of alternative actions if the waiver is not granted.

  7. Estimate savings expected if the waiver is granted. Include a year-by-year projection of expected savings for each year of the waiver, including any capital costs required and how allocated. Include total expenditures in the past year for the program or service to be waived and the overall, total expenditures (tax levy and non- tax levy) for your political entity in the most recent calendar year.

    • Submit a copy of the resolution or ordinance from your legislative body (town board, village board, city council, county board) requesting a mandate waiver. Include the recorded vote of that body.
    • Attach a formal attestation from the Governing Body that the waiver is not related to health or safety.
    • Attach record of public hearing, if a public hearing was held , including any adverse impact on public services offered by other municipalities or counties.
    • Name individuals, businesses, organizations, or other entities that have expressed opposition to or support for the proposed waiver.

Last updated January 5, 2006