Wisconsin Income Tax Form - Nonresident And Part-Year Resident Page 4
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4LEGAL RESIDENCE (DOMICILE) QUESTIONNAIRE
Page 4
Your answers to these questions will be used to determine your legal residence. Certain types of income are either taxable or
nontaxable to Wisconsin based upon whether you were a legal resident of Wisconsin at the time you received such income. Form
1NPR may be returned to you or its processing delayed if the questionnaire is not completed. If the questionnaire does not fit your
situation or you want to submit additional information, attach an additional sheet describing your particular circumstances.
NAME(S)
SOCIAL SECURITY NUMBER
Please
one: (If married and checking a different box for husband and wife, indicate (H) or (W) next to the
appropriate box)
Full-year Wisconsin resident; did not change domicile from Wisconsin during 1998.
Changed legal residence from Wisconsin during 1998; have not moved back to Wisconsin.
Changed legal residence from Wisconsin during or before 1998; have moved back to Wisconsin.
Changed legal residence to Wisconsin from (state)
on (date)
during 1998;
no previous Wisconsin residency. If you check this box, do not complete the rest of the questionnaire.
Was a nonresident of Wisconsin for all of 1998. Resident of
(Nonresident alien; please indicate country)
If you changed your legal residence from Wisconsin during 1997 or 1998 and you did not previously complete a questionnaire
for that change, answer the following questions.
1. a. On what date did you move from Wisconsin?
b. When you moved from Wisconsin, did you intend to move back to Wisconsin?
c. If you moved back to Wisconsin, indicate date and explain the circumstances under which you moved back to
Wisconsin
2. Did you establish a legal residence in another state?
If yes, in which state and on what date?
3. After establishing legal residency in the new state, list the dates you were in Wisconsin.
4. When were you physically present in your new state of legal residence (please list dates)?
5. Did your spouse and dependent children (if any) move to your new state of legal residence?
If yes, when?
6. a. On what date did you begin working in your new state of legal residence?
b. If your job is a temporary job, do you intend to return to Wisconsin upon its completion?
7. In your new state of legal residence, referred to in question 2, did you:
a. Register to vote?
If yes, when?
b. Purchase a home?
If yes, when?
c. Obtain a driver’s license?
If yes, when?
d. Register an auto or other vehicle?
If yes, when?
e. File resident income tax returns?
If yes, what years filed?
8. Since changing your legal residence from Wisconsin, have you:
a. Performed services for income in Wisconsin?
If yes, when?
b. Purchased Wisconsin auto license plates?
If yes, when?
c. Renewed a Wisconsin driver’s license?
If yes, when?
d. Voted in Wisconsin, in person or by absentee ballot?
If yes, when?
e. Attended or sent your children to Wisconsin schools?
If yes, when?
f. Purchased a Wisconsin resident hunting, fishing, or trapping license?
If yes, when?
Type of license?
County purchased in?
g. Listed Wisconsin as your state of legal residence for purposes of your auto insurance?
h. Listed Wisconsin as your state of legal residence for purposes of your will?
i. Listed Wisconsin as your state of legal residence for purposes of any legal proceedings?
If yes, when?
j. Obtained or renewed any Wisconsin trade or professional licenses or union memberships?
If yes, when?
9. If you answered “yes” to any of the questions 8a through 8j, please explain why you have taken such action.
10. Did you or your spouse own the real estate you occupied as your home while living in Wisconsin?
If yes, have you disposed of it?
If yes, when?
If no, what use do you make of it and how often?
11. If you established a legal residence in a new state but are using a Wisconsin address on your 1998 tax returns, please
explain.
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