STATE OF WISCONSIN
Town of ________
________ County
We, ________ ________ and ________ ________, the remaining supervisors, ________ ________, clerk, and ________ ________, treasurer of the Town of ________, ________ County, Wisconsin, hereby appoint ________ ________ to fill one of the vacancies in the town board.
Dated this ______ day of ________, 20__.
[Signatures of supervisors and town clerk]
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