Schedule
Y
Name of Payer Corporation
Wisconsin Deductible Dividends
File with Wisconsin Form 4, 4I, or 5
Read instructions before filling in this schedule
Federal Employer ID Number
Wisconsin Department of Revenue Name
2008
Dividend Received
Date Acquired
Percent Owned
1a b c d e f g h i j k l m n o p q r s t u v w x y z 2 3 4 Add lines 1a through 1z . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enter foreign taxes paid on dividends included on line 2 . . . . . . . . . . . . . . . . . . . . . . . . 2 3
Subtract line 3 from line 2 . This is total deductible dividends (enter on Schedule W, line 1) 4
.00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00
IC-025i
*C1SY08991*