I, ________ ________, clerk of the Town of ________, ________ County, Wisconsin, certify that the attached is a certified copy of the account of the Commissioner of Noxious Weeds for the Town of ________, that the sum of $________ is justly chargeable to ________ [insert name of railroad] as a proper charge under
s. 66.0517, Wis. stats., for the expense of destroying noxious weeds on the grounds belonging to ________ [insert name of railroad] in the Town of ________, for the year 20__, by the Commissioner of Noxious Weeds for the Town of ________. You are requested to collect the sum of $________ from ________ [insert name of railroad] and return the amount collected to the Town of ________.
