State of Wisconsin         l    DEPARTMENT OF REVENUE
                                                           2135 RIMROCK ROAD        l MAIL STOP 3-164        l PO BOX 8966         MADISONlWI  53708-8966
                                                                                                               FAX (608) 264-6884        lwww.revenue.wi.gov

You may also make your 2024 prepayment online via electronic funds transfer. Click                                    here for our electronic 
payment application. The tax type should be Individual Income Tax. The payment type should be W-200 
Prepayment.

If you wish to prepay 100% of your 2024 income tax by mail, complete the voucher below and mail the voucher 
postmarked by December 31, 2023, with your prepayment to:

                                                Mail Stop 3‑164
                                   Wisconsin Department of Revenue
                                                Exceptions Review Unit
                                                PO Box 8966
                                                Madison WI  53708‑8966

A Form W-200,       Certificate of Exemption from Withholding, will automatically be mailed to you when your 
payment has been processed.  You will receive 2 copies of this form.  If your spouse also needs an exemption 
certificate, you must send separate payments for you and your spouse.

2024 PREPAYMENT                                                                                  ESTIMATED TAX
Last name                                       First name                                       Social security number

Home address (number and street or rural route)                                                  Telephone number

City or post office                                                                        State Zip code

                                                           Prepayment Amount                                 $
A-115 (R. 08-23)