Fill and Sign the Wisconsin Notice State Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use IN THE MATTER OF       Amended Notice to State Election Board       Date of Birth Case No.       TO: STATE ELECTIONS BOARD Attn: Statewide Voter Registration Service P. O. Box 2973 Madison, Wisconsin 53701-2973 This is to notify you that a circuit court declared on (date)       that: Party/full name:       Party/primary address:       Party/second address:       Party/city Party/State Party/zip:       Date of birth:       is not competent to exercise the right to register to vote or to vote in an election. has been restored the right to register to vote and to vote in an election. Signature of Register in Probate       Name Printed or Typed       Street Address       City, State, ZipName of Attorney       Address             Date Telephone Number       Bar Number             Telephone Number GN-3180, 04/07 Notice to State Election Board §§54.25(2)(c)(1)(g) and 54.64(2) ,Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material.