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Sec. 157.062 Wis. Stats.

State of Wisconsin Department of Financial Institutions Division of Corporate and Consumer Services

CEMETERY ASSOCIATION APPLICATION FOR REGISTRATION
Establishing a Cemetery Association on the records of the Department of Financial Institutions Pursuant to 1989 Wisconsin Act 307, the Department of Financial Institutions is the office of record for the organization documents (certificate of organization) of a Cemetery Association, effective November 1, 1991.

1. The Name of the Association is: 2. The principal office address of the Association is (provide complete mailing address):
Business Address: Street City PO Box State Zip

3. The annual meeting of the Association shall be held each year on: ___________________________. 4. Attached is a certified copy of the Association's CERTIFICATE OF ORGANIZATION (and all amendments) from the county Register of Deeds. 5. We certify that the Association has, within the past three (3) years, held an annual election at its annual meeting, which meeting was held in the place in the county chosen by the Trustees for such meeting, upon public notice as required by the by-laws.

6. The undersigned officers have executed this Application for Registration, in duplicate and in their respective capacities on behalf of the Association on this ________ day of_______________________, 20_______.

______________________________
(Chairperson Printed Name)

________________________________
(Secretary Printed Name)

_______________________________
(Chairperson Signature)

________________________________
(Secretary Signature)

INSTRUCTIONS: (Ref. Sec. 157.062 Wis. Stats. for document content.) Pursuant to 1989 Wisconsin Act 307, the Department of Financial Institutions is the office of record for the organizational documents (certificate of organization) of a Cemetery Association effective November 1, 1991.

NO FILING FEE
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Sec. 157.062 Wis. Stats.

CEMETERY ASSOCIATION APPLICATION FOR REGISTRATION Return filed duplicate to: (Enter your name and return address below.)

Your phone number during the day: (
INSTRUCTIONS - continued

) ________-_____________.

Fee: There is no fee for filing the Cemetery Association Application for Registration. Delivery and Filing Procedure - Submit one original and one exact copy to: Mailing Address: Physical Address: Department of Financial Institutions Department of Financial Institutions Division of Corporate and Consumer Division of Corporate and Consumer Services Services PO Box 7846 345 W. Washington Ave., 3rd Floor Madison WI, 53707-7846 Madison WI 53703

Phone: 608-261-7577 Fax: 608-267-6813 TTY: 608-266-8818

The original will be filed and retained by the Department of Financial Institutions. The stamped duplicate will be returned to the name and return address indicated above. NOTICE: This form may be used to accomplish a filing required or permitted by statute to be made with the department. Information requested may be used for secondary purposes. This document can be made available in alternate formats upon request to qualifying individuals with disabilities. Item 1: Enter the name of the Cemetery Association. Item 2: Enter the principal office address of the Association. Item 3: Enter the date the annual meeting of the Association will be held on each year. Item 4: Obtain a certified copy of the organizational documents (certificate of organization and any amendments) from the records of the county Register of Deeds and submit the certified copy with this application. Item 6: Execution - This document must be signed by the chairperson and secretary of the Association. GENERAL INFORMATION: Annual Report Requirement: Cemetery Associations formed under sec. 157.062, Wis. Stats., are required to file an annual report with the Department of Financial Institutions. The report is due March 1st of each year. Report forms will be mailed about January 1st to the Association at its principal office address on record with the Department of Financial Institutions. Report forms may also be requested from the Department of Financial Institutions by contacting the Division Of Corporate and Consumer Services at (608)261-7577. EXCERPT ­ 1991 WISCONSIN ACT 269 157.062(9) Exemptions for Certain Nonprofit Cemeteries In lieu of delivering a certification, resolution or copy of proceedings to the Department of Financial Institutions, under sub. (1), (2) or (6)(b), a cemetery association that is not required to be registered under s.440.91(1) and that is not organized or conducted for pecuniary profit shall deliver the certification, resolution or copy of proceedings to the office of the register of deeds of the county in which the cemetery is located. Particulars on registration requirements under s.440.91(1) may be obtained from Department of Regulation and Licensing, Attn: Cemetery Regulation, PO Box 8935, Madison, WI 53707.
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