Application For Satisfaction Due To Discharge In Bankruptcy Page 4

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STATE OF WISCONSIN
CIRCUIT COURT
WAUKESHA COUNTY
______________________________________,
Plaintiff(s),
AFFIDAVIT OF MAILING
CASE NO.: __________________
vs
______________________________________,
Defendant(s).
____________________________, being duly sworn on oath, state that I placed
Your name
an Application for Order of Satisfaction of Judgment Due to Discharge in Bankruptcy
with attachments on the above entitled matter in an envelope with proper postage
affixed and addressed to:
Name:
________________________________________________
Address:
________________________________________________
City, State & Zip
________________________________________________
and on ___________________________________deposited said envelope and the
Date
contents thereof in the U.S. Mail by placing it in a receptacle provided for the deposit of
such mail at the U.S. Post Office in ___________________________________.
City, State
______________________________
Please sign before notary
______________________________
Print or type name & phone number
Subscribed and sworn to before me this
_________ day of ___________________ , _______
__________________________________ _______
Notary Public
State of Wisconsin
My commission expires ________________
M:\CIVIL\FORMS\Affidavit of Mailing Satisfaction due to bankruptcy.doc

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