STATE OF WISCONSIN
Town of ________
________ County
To the clerk of ________ County, Wisconsin:
I, ________ ________, clerk of the Town of ________, ________ County, Wisconsin, certify that a majority of the votes cast at the last annual town meeting upon the question of dissolution of the town were in favor of dissolution.
In witness whereof I have hereto set my hand this ____ of April, 20__.
[Signature of town clerk]
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