TO:
FROM:
ADDRESS:
CITY/ STATE/ ZIP:
TODAY'S DATE

It is my intention to move from the above stated address on:

Please regard this as my written 28 day notice to move as required under the State of Wisconsin Statutes.

 

X                                              
Signature of Tenant
                                        
Date Signed
 
X                                                
Signature of Owner/Landlord
                                        
Date Received
 

(Please print one copy of this for the tenant and one copy for the owner/landlord)