HomeMy WebLinkAboutOFD MOE Form 2024Form Maintenance of Effort Certification Wisconsin
SL-307 Combined Fire/Emergency Medical Services (EMS) I Dept of Revenue
Filing Instructions
• Person in charge of providing, or under contract to provide, combined fire/EMS services for a political subdivision must
complete this certification form (sec. 66.0608(2m), Wis. Stats,)
• Due date —June 15, 2024. Provide this completed form to your municipal or county clerk on or before the due date.
Do not submit this form to the Wisconsin Department of Revenue.
Failure to file — If you do not provide this completed form to your municipal or county clerk by June 15, 2024, they may not
be able to timely file the Maintenance of Effort Report and be charged a penalty under state law.
Questions? Contact us at las(@wisconsin.gov.
Section 1: Municipality or County Information
Co-muni code
70 — 266
Taxation district icheckone)
❑Town QVlllage ❑city ❑County
Municipality or county
City of Oshkosh
County
Winnebago
Section 2: Certifying Person's Information
Name
Title
Michael Stanley 77
Fire Chief
Address
101 Court St
City
State
ZIP
Oshkosh
WI
154901
Email
Phone
mstanley@oshkoshwi.gov
( 920 ) 236 — 5235
Section 3: Certification Questionnaire
Answer each question below by checking "Yes" or "No" If you select yes for either question, do not complete Section 4.
Did the municipality or county listed in Section 1:
• Consolidate its fire protective or emergency medical services with another political subdivision or enter
into a contract with a private entity to provide fire protective or emergency medical services in 2023?.... Yes ❑ No ❑✓
• Newly establish or join a newly established fire protection or emergency medical service agency In 2023? Yes ❑ No 0
Section 4: Certification Details
I certify the following has been maintained at a level equivalent to that provided In the previous year, 2023.
Check all boxes that apply:
❑✓ Political subdivision's expenditures, not including capital expenditures or expenditures of grant moneys received from
the state or federal government, for fire protection and emergency medical services.
❑ Number of full-time equivalent fire fighters and emergency medical services personnel employed by or assigned to
the political subdivision, not including fire fighters and emergency medical services personnel whose positions are
funded by grants received from the state or federal government. For volunteer fire and emergency medical services,
those volunteer fire fighters and emergency medical services personnel who responded to at least 40% of calls to which
volunteer fire protective or emergency medical services responded may be counted as full-time equivalent volunteer
fire fighters and emergency medical services personnel under sec. 66.0608(2m)(b)2.b., Wis. Stats,
0 Level of training of and maintenance of licensure for fire fighters and emergency medical services personnel providing
fire protective and emergency medical services within the political subdivision.
0 Response times for fire protective and emergency medical services throughout the political subdivision, adjusted for
the location of calls for service.
Section 5: Signature
Certifying person's sl ature TDate
05/05/2024
SL-307 (N. 2-24) 1- "� Wsconsin Department of Revenue