To ________ ________, clerk, Town of ________, ________ County, Wisconsin:
The undersigned electors of Town Sanitary District No. ____ of the Town[s] of ________ petition the Town Board of the Town of ________, ________ County, Wisconsin, that the sanitary district commissioners be elected instead of appointed. The commissioners shall first be elected at [a special election or the spring election] as provided in s. 60.74 (4), Wis. stats. Affidavit
STATE OF WISCONSIN
Town of ________
________ County
________ ________, of [insert address of residence with street and number], being duly sworn, says that I personally circulated the petition and personally obtained each of the signatures; that I know that the signers are electors of the jurisdiction or district in which the petition is circulated; that I know that the signers signed the paper with full knowledge of its content; that I know the signers’ respective residences given; that I know that each signer signed on the date stated opposite his or her name; that I reside within the jurisdiction or district in which the petition is circulated; and that I am aware that falsifying this affidavit is punishable under ss. 12.13 (3) (a) and 946.32 (1) (a), Wis. stats. Subscribed and sworn to before me this ____ of ________, 20__.
[Signature of officer administering oath]
Note: The petition must be signed by qualified electors of the districts equal to at least 20% of the votes cast for governor in the district at the last gubernatorial election. See s. 60.74 (4) and (6), Wis. stats. The following statutes affect this form: s. 60.74 (5), Wis. stats. Petition
To ________ ________, clerk, Town of ________, ________ County, Wisconsin:
The undersigned electors of Town Sanitary District ________ of the Town[s] of ________ petition the Town Board of the Town of ________, ________ County, Wisconsin, that the district commissioners be appointed instead of elected.
Affidavit
STATE OF WISCONSIN
________ County
________ ________, of [insert address of residence with street and number], being duly sworn, says that I personally circulated the petition and personally obtained each of the signatures; that I know that the signers are electors of the jurisdiction or district in which the petition is circulated; that I know that the signers signed the paper with full knowledge of its content; that I know the signers’ respective residences given; that I know that each signer signed on the date stated opposite his or her name; that I reside within the jurisdiction or district in which the petition is circulated; and that I am aware that falsifying the affidavit is punishable under ss. 12.13 (3) (a) and 946.32 (1) (a), Wis. stats. [Signature of affiant]
Subscribed and sworn to before me this ____ of ________, 20__.
[Signature of officer administering oath]
Note: For number of required signatures, see the note to 60.74 (4): Petition to elect, instead of appoint, sanitary district commissioners.
Beverages and Tobacco
The following statutes affect this form: s. 66.0433, Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
________ ________, having produced to the undersigned, town clerk of the Town of ________, a receipt showing the payment of $________ to the treasurer of the town, in conformity with an order of the board made on ________ ___, 20__;
This is to certify that in pursuance of the order, a license is granted to ________ ________ to sell at [retail or wholesale] beverages containing less than one-half of one percent of alcohol by volume, on the following described premises: [describe].
This license will expire on ________ ____, 20__, unless sooner revoked.
Dated this ______ day of ________, 20__.
[Signature of town clerk]
The following statutes affect this form: s. 66.0433 (1), Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
Whereas, ________ ________, of the Town of ________, ________ County, Wisconsin, has applied to the town board for a license to sell at [retail or wholesale] beverages containing less than one-half of one percent of alcohol by volume to be consumed [on or off] the premises where sold on the following described premises within the town: [describe premises];
It is ordered as follows:
1. That the application for the license applied for be granted, upon payment of the following license fee: $________;
2. That the town clerk sign and deliver the license to each license applicant, upon producing to the clerk a receipt, showing the payment to the town treasurer of the license fee required under this order.
Dated this ______ day of ________, 20__.
[Signatures of town board]
Attest: [Signature of town clerk]
The following statutes affect this form: ss. 77.61 (11) and 134.65, Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
________ ________, of the Town of ________, ________ County, Wisconsin, having done all of the following:
1. Filed with the undersigned town clerk a complete application for a tobacco products retailer license.
2. Paid the license fee of $_____ [amount may not be less than $5 nor more than $100] to the treasurer of the town.
3. Submitted the proof required under s. 77.61 (11), Wis. stats. And the application having been granted by the town board on __________, _____, 20__;
A tobacco products retailer license is granted to __________ __________ to sell cigarettes, electronic vaping devices, and tobacco products under s. 134.65, Wis. stats., on the following premises in the town: [describe premises]. The license will expire on June 30, 20__, unless sooner revoked.*
Dated this ______ day of ________, 20__.
[Signatures of town board]
Attest: [Signature of town clerk]
*Note: Under s. 134.65 (2) (b), Wis. stats., a town may opt to issue licenses that expire one year from issuance rather than expiring on June 30 of each year. The following statutes affect this form: ch. 125, Wis. stats. Note: Forms related to alcohol beverage licensing are available from the State of Wisconsin, Department of Revenue, Madison, Wisconsin. Electronic copies of many of these forms may be downloaded, and additional information may be obtained at the following website:
The following statutes affect this form: ss. 125.04 (6) (e) and (12) (a) and (b), 125.17 (3) and (5) (c), 125.18 (3), 125.185 (3), 125.25 (4), 125.26 (4) to (6), 125.28 (4), 125.51 (2) (d), (3) (e) 1. to 6., (3m) (e), (9) (b), and (10) (a), Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
SECTION I – TITLE AND PURPOSE
This ordinance is entitled the Town of ________ Alcohol-Related License Fee Ordinance. The purpose of this ordinance is to establish a schedule of the fees for all types of alcohol-related licenses issued by the town.
SECTION II – AUTHORITY
The Town Board of the Town of ________, ________ County, Wisconsin, has the specific authority under those specific sections of ch. 125, Wis. stats., stated next to the name of the license listed in the Schedule of Fees for Alcohol-Related Licenses set forth below to establish fees for alcohol-related licenses issued by the town. SECTION III – ADOPTION OF ORDINANCE
This ordinance, adopted by a majority of the town board on a roll call vote with a quorum present and voting and proper notice having been given, adopts the Schedule of Fees for Alcohol-Related Licenses set forth below and establishes the fees for alcohol-related licenses issued by the town as stated therein.
SECTION IV – SCHEDULE OF FEES
[Type of license] [Statutory fee authorization] [Amount of fee]
SECTION V – SEVERABILITY
If any provision of this ordinance or its application to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of this ordinance that can be given effect without the invalid provision or application, and to this end the provisions of this ordinance are severable.
SECTION VI – EFFECTIVE DATE
This ordinance is effective on publication or posting.
The town clerk shall properly post or publish this ordinance as required under s. 60.80, Wis. stats. Adopted this ________ day of ________ 20__.
[Signatures of town board]
Attest: [Signature of town clerk]
Note: Under s. 66.0628, Wis. stats., any fee must bear a reasonable relationship to the service for which the fee is imposed. Note: If a temporary Class “B” fermented malt beverage license and a temporary “Class B” wine license are issued for the same event, then only one fee may be imposed. See ss. 125.26 (6) and 125.51 (10) (a), Wis. stats. Note: Class “A”, Class “B” and “Class A”, “Class B”, and “Class C” premise licenses issued for less than a year must be prorated for remaining portion of year. See ss. 125.25 (4), 125.26 (4), and 125.51 (9), Wis. stats. The following statutes affect this form: s. 125.04 (12) (a), Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
In consideration of the payment of the $10.00 transfer fee, and on application of ________ ________, of the town, for a transfer of the [intoxicating liquor or fermented malt beverage] license to sell [describe class of license] at [describe premises now covered by the license], and consent of the licensee and the sureties having been given that the license bond shall cover the premises to which transferred, the license of ________ ________ is transferred from the premises now covered to the following described premises within the town: [describe premises to which the license will be transferred].
Dated this ______ day of ________, 20__.
[Signatures of town board]
Attest: [Signature of town clerk]
The following statutes affect this form: s. 125.04 (12) (b), Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
