AB68-SSA1,1399,1818 Residence Address: ....
AB68-SSA1,1399,1919 (Make Sure Your Signature is Authenticated or Acknowledged Below.)
AB68-SSA1,1399,20 20Authentication
AB68-SSA1,1399,2121 Signature .... authenticated this .... day of ...., .... (year)
AB68-SSA1,1399,2222 *....
AB68-SSA1,1399,2323 TITLE: MEMBER STATE BAR OF WISCONSIN
AB68-SSA1,1399,2424 (If not, .... authorized by s. 706.06, Wis. Stats.)
AB68-SSA1,1399,25 25Acknowledgment
AB68-SSA1,1400,1
1STATE OF WISCONSIN   )
AB68-SSA1,1400,22 )   ss.
AB68-SSA1,1400,33 .... County   )
AB68-SSA1,1400,64 Personally came before me this .... day of ...., .... (year) the above named .... to
5me known to be the person who executed the foregoing instrument and acknowledge
6the same.
AB68-SSA1,1400,77 *....
AB68-SSA1,1400,88 Notary Public ...., .... County, Wisconsin.
AB68-SSA1,1400,99 My Commission is permanent.
AB68-SSA1,1400,1010 (If not, state expiration date: ...., .... (year))
AB68-SSA1,1400,1111 (Signatures may be authenticated or
AB68-SSA1,1400,1212 acknowledged. Both are not necessary.)
AB68-SSA1,1400,1313 *Names of persons signing in any capacity should be
AB68-SSA1,1400,1414 typed or printed below their signatures.
AB68-SSA1,1400,1515 Signature of Other Spouse: ....
AB68-SSA1,1400,1616 Date: ....
AB68-SSA1,1400,1717 Print Name Here: ....
AB68-SSA1,1400,1818 Residence Address: ....
AB68-SSA1,1400,1919 (Make Sure Your Signature is Authenticated or Acknowledged Below.)
AB68-SSA1,1400,20 20Authentication
AB68-SSA1,1400,2121 Signature .... authenticated this .... day of ...., .... (year)
AB68-SSA1,1400,2222 *....
AB68-SSA1,1400,2323 TITLE: MEMBER STATE BAR OF WISCONSIN