Free DT1783 Vacancy Notice - Wisconsin

File Size: 41.0 kB
Pages: 1
File Format: PDF
State: Wisconsin
Category: Government
Author: WisDOT
Word Count: 107 Words, 719 Characters
Page Size: Letter (8 1/2" x 11")

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DT1783 2/2009 (Replaces RE4021) Ch. 32.19 Wis. Stats.

Wisconsin Department of Transportation


Subject Property Address

Type of Dwelling/Structure Subject Site

Choose One Owner Tenant

New Address

New Phone

E-mail Address Gas Company Electric Company

I have vacated the subject property, removed all personal property and notified the Utility Companies to change the service to WISDOT. Remarks:

Relocatee Signature


Date subject site vacated Date of physical inspection Keys Received Yes All personal property has been removed to the satisfaction of WISDOT. Remarks: No

Real Estate Specialist Project ID County

Date Parcel

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