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SPL-1

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This document is a 2008 Model Form for Wisconsin Legislators to make an Internal Revenue Code Section 162(h) election. It provides instructions for legislators to calculate their per diem expenses for living expenses incurred due to working as a state legislator. The form includes fields for the legislator's name, address, social security number, number of legislative days, and mileage from their district residence to the capitol building. It provides the per diem rates for 2008 and instructions for allocating the expenses to meals and other living costs to report on a federal tax form.

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2008 Model Form – Wisconsin Legislators (For Making Internal Revenue Code Section 162(h) Election) Name Residence within Address Legislative District Social Security Number For the tax year 2008 I have elected my district home as my tax home and I am now applying section 162(h) of the Internal Revenue Code which allows a per diem expense for living expenses attributable to my work as a state legislator for every legislative day. The number of miles between my residence within my legislative district and the capitol building is . The number of my legislative days for tax year 2008 includes: Session days (including recesses of four consecutive days or less) Committee meeting days Total legislative days The per diem rate I am using is $143 for the period January 1, 2008, through September 30, 2008, and $144 for the period October 1, 2008 through December 31, 2008. These are the federal employee per diem rates which were in effect for Madison for 2008. My per diem expense is computed as follows: Legislative days at $143 per day = Legislative days at $144 per day = Total per diem expense Portion of per diem expense allocated to meals Fill in here and include on line 5 of federal Form 2106 (Total per diem expense x .3560) . . . . . . . . . . . . . . . . . . . . . . Portion allocated to other living expenses Fill in here and include on line 3 of federal Form 2106 (Total per diem expense minus portion allocated to meals) The total per diem reimbursement which I received from the State of Wisconsin for 2008 is . . . . . . . . . . . . . . . . . . Portion of per diem reimbursement allocated to meals To line 7, Column B of (Total per diem reimbursement x .3560) . . . . . . . . . . . . . . . federal Form 2106 Portion of per diem reimbursement allocated to other living expenses To line 7, Column A of (Total per diem reimbursement minus portion allocated to meals) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . federal Form 2106 SPL-01 (R. 9-08) Wisconsin Department of Revenue

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SPL-1

  • 1. 2008 Model Form – Wisconsin Legislators (For Making Internal Revenue Code Section 162(h) Election) Name Residence within Address Legislative District Social Security Number For the tax year 2008 I have elected my district home as my tax home and I am now applying section 162(h) of the Internal Revenue Code which allows a per diem expense for living expenses attributable to my work as a state legislator for every legislative day. The number of miles between my residence within my legislative district and the capitol building is . The number of my legislative days for tax year 2008 includes: Session days (including recesses of four consecutive days or less) Committee meeting days Total legislative days The per diem rate I am using is $143 for the period January 1, 2008, through September 30, 2008, and $144 for the period October 1, 2008 through December 31, 2008. These are the federal employee per diem rates which were in effect for Madison for 2008. My per diem expense is computed as follows: Legislative days at $143 per day = Legislative days at $144 per day = Total per diem expense Portion of per diem expense allocated to meals Fill in here and include on line 5 of federal Form 2106 (Total per diem expense x .3560) . . . . . . . . . . . . . . . . . . . . . . Portion allocated to other living expenses Fill in here and include on line 3 of federal Form 2106 (Total per diem expense minus portion allocated to meals) The total per diem reimbursement which I received from the State of Wisconsin for 2008 is . . . . . . . . . . . . . . . . . . Portion of per diem reimbursement allocated to meals To line 7, Column B of (Total per diem reimbursement x .3560) . . . . . . . . . . . . . . . federal Form 2106 Portion of per diem reimbursement allocated to other living expenses To line 7, Column A of (Total per diem reimbursement minus portion allocated to meals) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . federal Form 2106 SPL-01 (R. 9-08) Wisconsin Department of Revenue