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Petition_for_change_of_town_name 60.065: Petition for change of town name

The following statutes affect this form: s. 60.065, Wis. stats.

Petition

To ________ ________, clerk of the Town of ________, ________ County, Wisconsin:

We, the undersigned, electors of the Town of ________, ________ County, Wisconsin, pursuant to s. 60.065, Wis. stats., petition that the attached resolution [attach resolution that the name of the town be changed and stating the proposed new name] be referred to a vote of the electors of the town for the purpose of determining whether the name of the Town of ________ shall be changed to the “Town of ________.”

In the event of any impropriety or insufficiency in this petition or the attached resolution, contact ________ ________, whose mailing address is _________, ________ and telephone number is (____) ____-________.

Affidavit

STATE OF WISCONSIN
________ County

________ ________, of ________ ________ [insert address of residence with street and number], being duly sworn, says that I personally circulated the petition and personally obtained each of the signatures; that I know that the signers are electors of the jurisdiction or district in which the petition is circulated; that I know that the signers signed the paper with full knowledge of its content; that I know the signers’ respective residences given; that I know that each signer signed on the date stated opposite his or her name; that I reside within the jurisdiction or district in which the petition is circulated; and that I am aware that falsifying the affidavit is punishable under ss. 12.13 (3) (a) and 946.32 (1) (a), Wis. stats.

[Signature of affiant]

Subscribed and sworn to before me this ____ of ________, 20__.

[Signature of officer administering oath]