To ________ ________, treasurer, Town of ________, ________ County, Wisconsin:
Set forth below is my account for destruction of weeds as Commissioner of Noxious Weeds [for the Town of ________ or for district No. __, of the town].
One day's work: ________ ___, 20__ $________
[So continue.]
Total $________
The above amounts for labor and services are chargeable to the following pieces or tracts of land, all of which I certify to be correct:
Dated this ______ day of ________, 20__.
[Signature of weed commissioner]
________ ________, being duly sworn on oath, says that as commissioner of noxious weeds for the Town of ________, the above account is a true and correct statement of moneys due for services rendered on the dates above set forth, and that the amounts of money as above set forth are severally chargeable to the several tracts of land therein described.
[Signature of weed commissioner]
Subscribed and sworn to before me this ____ of ________, 20__.
[Signature of town chairperson]
or
[Signature of notary public]
Notary Public, State of Wisconsin
My commission _________.
Chairperson's Approval
I, ________ ________, chairperson of the Town of ________, ________ County, Wisconsin, approve the foregoing account of ________ ________, commissioner of noxious weeds of the town, and direct the treasurer to pay the amount of $________ to ________ ________ and to file the account in the office of the town clerk, who is directed to enter and charge in the next tax roll, in the proper column, all amounts chargeable to each tract of land, as is indicated in the foregoing account.
Dated this ______ day of ________, 20__.
[Signature of chairperson]
