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                    Wisconsin Department of Revenue
                    PO Box 8946                                                  PREMIER                              Tab to continue
                    Madison WI  53708-8946
                                                                     RESORT AREA
                                                                                                                  SSN or FEIN
                                                       TAX RETURN  (PRA‑012)
Enter Complete form using BLACK INK
15-digit Tax Account Number  (020  XXXXXXXXXX  XX) Period Begin Date (MM DD YYYY) Period End Date  (MM DD YYYY)   Due Date  (MM DD YYYY)
Tax 
Account 
Number                                                               To enter dates above, use the following format: MM DD YYYY

         Enter name and address. Hit "Enter" to start                                                 Check if this is an AMENDED return
         each new line of the name and/or address.

                                                                                                      Check if name/address change
                                                                                                      (Note changes on the back of the form)

                                                                                                      Check if business discontinued
                                                                                                      (Note changes on the back of the form)

      For periods beginning on or after 07‑01‑2014
                                                   Premier Resort Area Taxable Sales                                 Tax Calculation

         BAYFIELD                         1a                                              x  .005  =  1b

         EAGLE RIVER                      2a                                              x  .005  =  2b

         EPHRAIM                          3a                                              x  .005  =  3b
             (Effective 01-01-2022)
         RHINELANDER                      4a                                              x  .005  =  4b
             (Effective 01-01-2017)
         SISTER BAY                       5a                                              x  .005  =  5b
         (Effective 07-01-2018)
         STOCKHOLM                        6a                                              x  .005  =  6b
         (Effective 10-01-2014)
         LAKE DELTON                      7a                                              x  .0125  = 7b

         WISCONSIN DELLS                  8a                                              x  .0125  = 8b

             9Total premier resort tax (add lines 1b - 8b)  .........................                 9

             10Retailer’s discount   (see instructions)   ............................. 10

             11Net premier resort tax (subtract line 10 from line 9)  ..................              11

             12Interest and penalty  ..........................................                       12

             13TOTAL DUE (add lines 11 and 12)   ...............................                      13

         Contact Name (please print)               Signature                              Date                  Phone
                                                                                                                (    )

      Mail return and remittance to:                                              Contact information:
         Wisconsin Department of Revenue                                          Phone:    608-266-2776
         PO Box 8946                                                              Email:    DORBusinessTax@wisconsin.gov
         Madison WI  53708-8946                                                   Website:  revenue.wi.gov

      PRA-012 (R. 1-22)
                                                                                                                                        To Page 2

                              Taxpayer Information Changes                   Page 2 of 2

Business Discontinued Date:
                           MM DD           YYYY

Please indicate reason for discontinuation:

Deceased                   Merger with                        Partner added

Formed LLC                 Business did not materialize       Partner dropped

Incorporated               No taxable activity                Sold to

Other (please explain)

Name Change
New Legal Name

New Business Name

Mailing Address Change
Street Address or PO Box

City                                                    State Zip code

Business Location Change
Street Address

City                                                    State Zip code

PRA-012 (R. 1-22)