Wisconsin Power of Attorney
Effective Date: ____/____/______
I,
[Legal Name]
A resident of
[City], Wisconsin
Located at
[Address]
[City], Wisconsin [Zip Code]
Hereby Appoint,
[Legal Name]
A resident of
[City], Wisconsin
Located at
[Address]
[City], Wisconsin [Zip Code]
As my attorney-in-fact.
My attorney-in-fact may act on my behalf for the following purpose(s):
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