2013
Page
3 of 4
Schedule FC‑A
Name(s) shown on Schedule FC‑A
Social security number or FEIN
Note: You must include this page as part of Schedule FC‑A if your claim is based on more than one farm.
Enclose additional copies of this page if needed.
QUALIFYING ACRES SCHEDULE
OF
County
Town
Village
City
of
Enter the primary location of the farm
Step 1
For each tax parcel that 1) is part of the farm and 2) has qualifying acres, as described below, enter:
Step 2
Column (A) tax parcel number
Column (B) number of qualifying acres in the parcel subject to an original or modified farmland preservation
agreement entered into after July 1, 2009, and located in a farmland preservation zoning district
Column (C) number of qualifying acres in the parcel located in a farmland preservation zoning district, but not
subject to an original or modified farmland preservation agreement entered into after July 1, 2009
Column (D) number of qualifying acres in the parcel subject to an original or modified farmland preservation
agreement entered into after July 1, 2009, but not located in a farmland preservation zoning district
Number of Acres from Each Category Above
Tax Parcel Number
(A)
(B)
(C)
(D)
Note: If the farm consists of more than 10 parcels, enclose page 4
Using the acres listed in Step 2, compute the qualifying acres on which your claim is based
Step 3
(B)
(C)
(D)
1 Enter the total acres from Columns (B), (C), and (D) above
and, if applicable, page 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Enter in all three columns your ownership percentage of the farm.
Enter as a decimal carried to four places (If 100%, enter “1.0000”) . .
.
.
.
3 Multiply line 1 by line 2, and round result to the nearest acre.
Fill in here and on line 4 of page 2 . . . . . . . . . . . . . . . . . . . . . . . . . .
I‑025bi
Wisconsin Department of Revenue