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

General Information

• 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.

Form Information

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
• Note: Do 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 lgs@wisconsin.gov.