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Form                                                                                                    Tax Account Number
       UT-5
Wisconsin Department
     of Revenue                                        Consumer Use Tax Return                          Period Begin Date (MM DD YYYY)
Use BLACK INK Only           Tab to navigate throughout form.
Name                                                                                                 Period End Date (MM DD YYYY)

Address  (number and street)                                                                         Social Security Number

City                                                                       State    Zip Code         Federal Employer Identification No.

Part A   Computation of Use Tax
                                                                                                        Tax                Tax
         Line 2 will autofill from line 11, Page 3.                                 Purchases           Rate        (Purchases x Tax Rate)

     1  Purchases subject to 5% state use tax ...........                        1a                  x  .05   =  1b
C    2  Enter total from Schedule CT
O        (line 11, Page 3) ...............................                       2a                  x  .005 =  2b
U
N    3  Purchases after 2023           subject to 0.9%
T
Y        Milwaukee County use tax  ....................                          3a                  x  .009 =  3b
         Purchases before 2024         subject to 0.5%
         Milwaukee County use tax  ....................                          3c                  x  .005 =  3d
C    4   Purchases after 2023          subject to 2% city of
I        Milwaukee use tax . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a                  x  .02   =   4b
T
Y        Caution: Baseball stadium tax ended.
     5   Purchases prior to April 1, 2020           subject to
         0.1% baseball stadium tax.  ....................                        5a                  x  .001 =  5b
     6   Total use tax (add lines 1b, 2b, 3b, 3d, 4b, and 5b)   ................................                  6 
     7  Credit for state and/or local sales or use tax paid to another state on purchases included on
         lines 1a-5a (see instructions)  .................................................                        7
     8  Net use tax (line 6 minus line 7)  ...............................................                        8
     9  Interest and penalty (see instructions)  ..........................................                       9
  10 Total Amount Due         (add lines 8 and 9)  .........................................                      10

Part B   County Information for Purchases Subject to County Use Tax
Complete Schedule CT (pages 2 and 3).

Mail to:
Wisconsin Department of Revenue
PO Box 8946
Madison WI  53708-8946

I hereby certify that this return, including any accompanying schedules and statements, has been examined by me and to the best of 
my knowledge and belief is a true, correct, and complete return.
 Contact Name  (please print clearly)                  Signature           Remember to sign your     Phone Number          Date
                                                                               return after printing.
SU-050 (R. 1-24)



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2023 Form UT-5   Name                    Tax Account No.                              Page 2 of 3 

Schedule CT – County Sales and Use Tax                   Reporting Period (mm dd yyyy)
                                                         Beg Date:

                                         USE BLACK       End Date:
                                         INK ONLY

                 Effective      Column 1                 Column 2
County           Date      Code                    Purchases Subject to County Use Tax     Code

Adams  ........ 01-94  01                                                              01
Ashland  ....... 04-88  02                                                             02
Barron  ........ 04-86  03                                                             03
Bayfield  ....... 04-91  04                                                            04
Brown  ........ 01-18  05                                                              05
Buffalo  ........ 04-87  06                                                            06
Burnett   ....... 04-89  07                                                            07
Calumet   ...... 04-18  08                                                             08
Chippewa  ..... 04-91  09                                                              09
Clark  ......... 01-09  10                                                             10
Columbia  ...... 04-89  11                                                             11
Crawford  ...... 04-91  12                                                             12
Dane  ......... 04-91  13                                                              13
Dodge  ........ 04-94  14                                                              14
Door  ......... 04-88  15                                                              15
Douglas  ....... 04-91  16                                                             16
Dunn  ......... 04-86  17                                                              17
Eau Claire  ..... 01-99  18                                                            18
Florence  ...... 07-06  19                                                             19
Fond du Lac  ... 04-10  20                                                             20
Forest  ........ 04-95  21                                                             21
Grant  ......... 04-02  22                                                             22
Green  ........ 01-03  23                                                              23
Green Lake  .... 07-99  24                                                             24
Iowa   ......... 04-87  25                                                             25
Iron  .......... 04-91  26                                                             26
Jackson  ....... 04-87  27                                                             27
Jefferson  ...... 04-91  28                                                            28
Juneau  ....... 04-92  29                                                              29
Kenosha  ...... 04-91  30                                                              30
Kewaunee ..... 04-17  31                                                               31
La Crosse  ..... 04-90  32                                                             32
Lafayette ...... 04-01  33                                                             33
Langlade ...... 04-88  34                                                              34
Lincoln ......... 04-87    35                                                          35

S-012CT (R. 1-24)



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2023 Form UT-5                                                                                                                                                         Page 3 of 3 

                     Effective      Column 1                                                        Column 2
County               Date      Code                                                                 Purchases Subject to County Use Tax                                  Code
Manitowoc ..........           36   NoNo CountyCounty TaxaxT                                        NoNo CountyCounty TaxTax                                           36
Marathon ....... 04-87         37                                                                                                                                      37
Marinette ....... 10-01        38                                                                                                                                      38
Marquette  ...... 04-89        39                                                                                                                                      39
Menominee ..... 04-20          72                                                                                                                                      72
Milwaukee ..........           40   Enter sales on line 10, Page 1Enter sales on line 10, Page 1    Enter purchases on line 3, Page 1Enter purchases on line 3, Page 1 40
Monroe  ........ 04-90         41                                                                                                                                      41
Oconto ......... 07-94         42                                                                                                                                      42
Oneida ......... 04-87         43                                                                                                                                      43
Outagamie ...... 01-20         44                                                                                                                                      44
Ozaukee  ....... 04-91         45                                                                                                                                      45
Pepin .......... 04-91         46                                                                                                                                      46
Pierce  ......... 04-88        47                                                                                                                                      47
Polk ........... 04-88         48                                                                                                                                      48
Portage ........ 04-89         49                                                                                                                                      49
Price  .......... 01-93        50                                                                                                                                      50
Racine .............           51   NoNo CountyCounty TaxaxT                                        NoNo CountyCounty TaxTax                                           51
Richland. . . . . . . . 04-89  52                                                                                                                                      52
Rock  .......... 04-07         53                                                                                                                                      53
Rusk  .......... 04-87         54                                                                                                                                      54
St. Croix ........ 04-87       55                                                                                                                                      55
Sauk  .......... 04-92         56                                                                                                                                      56
Sawyer. . . . . . . . . 04-87  57                                                                                                                                      57
Shawano ....... 04-90          58                                                                                                                                      58
Sheboygan  ..... 01-17         59                                                                                                                                      59
Taylor .......... 07-99        60                                                                                                                                      60
Trempealeau .... 10-95         61                                                                                                                                      61
Vernon ......... 01-97         62                                                                                                                                      62
Vilas ........... 04-88        63                                                                                                                                      63
Walworth ....... 04-87         64                                                                                                                                      64
Washburn  ...... 04-91         65                                                                                                                                      65
Washington ..... 01-99         66                                                                                                                                      66
Waukesha ..........            67   NoNo CountyCounty TaxaxT                                        NoNo CountyCounty TaxTax                                           67
Waupaca ....... 04-89          68                                                                                                                                      68
Waushara  ...... 04-90         69                                                                                                                                      69
Winnebago  .........           70   NoNo CountyCounty TaxaxT                                        NoNo CountyCounty TaxTax                                           70
Wood .......... 01-04          71                                                                                                                                      71

                                                                                                 11.
                                                                                                    Total PURCHASES Subject to County Use Tax
                                                                                                    Add Column 2 amounts on pages 2 and 3.
                                                                                                    Enter above and on line 2 of page 1.
S-012CT (R. 1-24)






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