Financial responsibility forms for waste management facilities
All owner financial responsibility forms and official correspondence must include the appropriate signatures and be mailed to the following address.
For USPS:
WI Dept of Natural Resources
Dustin Sholly – WA/5
PO Box 7921
Madison, WI 53707-7921
For any other carrier:
WI Dept of Natural Resources
Dustin Sholly – WA/5
2421 Darwin Rd
Madison, WI 53704
If convenient, please email Dustin Sholly and include electronic copies of any submissions that have been or will be mailed to the DNR.
The following forms are fillable PDFs. If you have trouble opening them in your browser, right-click the link and select the option to save to your device, then open using Adobe Acrobat Reader version 10 or later.
Solid waste
Landfills
- Long-Term Care Performance Bond [PDF] (Form 4400-064)
- Closure Performance Bond [PDF] (Form 4400-065)
- Long-Term Care Irrevocable Trust Agreement [PDF] (Form 4400-069)
- Closure Irrevocable Trust Agreement [PDF] (Form 4400-068)
- Long-Term Care Irrevocable Escrow Agreement [PDF] (Form 4400-071)
- Closure Irrevocable Escrow Agreement [PDF] (Form 4400-072)
- Long-Term Care Irrevocable Letter of Credit [PDF] (Form 4400-080)
- Closure Irrevocable Letter of Credit [PDF] (Form 4400-081)
Non-landfill solid waste facilities
- Closure Performance Bond [PDF] (Form 4400-192)
- Irrevocable Letter of Credit [PDF] (Form 4400-254)
Guidance for non-landfill solid waste facilities
Learn more about how to calculate closure costs and the process for establishing owner financial responsibility.
Hazardous waste
Hazardous waste
- Trust Agreement [PDF] (Form 4430-022)
- Financial Guarantee Bond [PDF] (Form 4430-023)
- Performance Bond [PDF] (Form 4430-024)
- Irrevocable Letter of Credit [PDF] (Form 4430-025)
- Certificate of Insurance for Closure or Long-term Care [PDF] (Form 4430-026)
- Escrow Agreement [PDF] (Form 4430-027)
- Deposit with the Department [PDF] (Form 4430-028)
- Corrective Action Performance Bond [PDF] (Form 4400-186)
- Corrective Action Irrevocable Letter of Credit [PDF] (Form 4400-187)
Inflation factors
Inflation factors
The Waste and Materials Management Program provides the following factors for use when calculating the amount of owner financial responsibility (OFR), as required in ss. NR 520.07(5), NR 664.0142(2), and NR 664.0144(2), Wis. Adm. Code. The information is updated annually around March.
Contact information
If you have questions or comments regarding the inflation factors, contact:
Dustin Sholly
Waste & Materials Management
608-866-0154