May 11, 2020
To: County Clerks and Treasurers, Municipal Clerks and Treasurers
The Wisconsin Department of Revenue (DOR) would like to remind you the following forms must be electronically filed (e-filed) with DOR by
today, Monday, May 11, 2020. Both are available in
My DOR Government Account (MyDORGov).
- SL-320C – County Fallen Protective Services Insurance Report
- SL-320M – Municipal Fallen Protective Services Insurance Report
Under state law (2019 WI Act 19), counties and municipalities must submit this form (SL-320C or SL-320M) if they:
- Had a police officer, emergency medical services practitioner, or firefighter die in the line of duty
- Paid hospital, surgical or other health insurance premiums for the surviving spouse and dependent children during 2019
- County/Municipal Clerk must e-file this report
- The reported values are used to calculate the 2021 adjustment to County and Municipal Aid.
A county/municipality will not be eligible for this aid adjustment if the form is not submitted timely.
Each county/municipality must report:
- Number of eligible deceased personnel
- Number of surviving spouses/dependents and their age as of January 1, 2019
- Premiums paid during 2019
not report, or attach, any personally identifiable information for the deceased personnel or their family members (ex: full name, social security number, mailing address)
If you have questions, contact us at email@example.com.