STATE OF WISCONSIN
Town of ________
________ County
To the clerk of [name of the applicable taxation district]:
The undersigned, clerk of the Town of ________, ________ County, Wisconsin, certifies as follows:
1.
The State of Wisconsin, Department of Revenue has certified to the Town of ________ that ________ ________ [name of landowner] has failed to complete a forestry practice [or practices] during the period of time required under an applicable management plan adopted under
s. 77.82 (3), Wis. stats.
2.
The certificate of the Department of Revenue directs the Town of ________ to impose a noncompliance assessment of $________ against ________ ________ [name of landowner], and a copy of the certificate was mailed by the Department of Revenue to ________ ________ [name of landowner] in accordance with
s. 77.876 (4), Wis. stats., on ________ ___, 20__.
3. The assessment was not paid on or before August 31, 20__ [
the last day of the August following the mailing of the certificate].
4. A true and correct copy of the certificate of the Department of Revenue is attached.
Pursuant to
s. 77.876 (4), Wis. stats., you are directed to enter the delinquent assessment in the amount of $________, together with interest at the rate of 12% per year from ________ ___, 20__, being the last day of the month following the date the certificate was mailed to ________ ________ [name of landowner] on the property tax roll as a special charge.
Dated this ______ day of ________, 20__.
[Signature of clerk of town]
Note: Although not specifically required by
s. 77.876, Wis. stats., mail a copy of this certificate to the delinquent landowner.
