____________________________
Parcel Identification Number (PIN)
_________________________________________________(SEAL)
*_________________________________________________
ACKNOWLEDGMENT
STATE OF WISCONSIN )
) ss
__________________ COUNTY )
Personally came before me on _________________, _______
the above-named____________________________________
to me known to be the person who executed the foregoing
instrument and acknowledged the same.
__________________________________________________
*_________________________________________________
Notary Public, State of Wisconsin
My Commission (is permanent) (expires:________________)
.
Undersigned hereby states that a certain document (“conveyance”) titled as
________________________________________________ (type of document), and
executed between ______________________________________, Grantor, and
______________________________, Grantee, was recorded in ________________
County, Wisconsin, on _____________, _____, in volume ______________, page
_______, as document number ___________, and contained the following error:
Undersigned makes this Correction Instrument for the purpose of correcting the
conveyance as follows:
AUTHENTICATION
Signature of _____________________________________
_________________________________________________
authenticated on ___________________________________,
_________________________________________________
*________________________________________________
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, _____________________
authorized by Wis. Stat. §706.06)
THIS INSTRUMENT DRAFTED BY:
_________________________________________________
_________________________________________________
The basis for Undersigned’s personal knowledge is (check one):
□ Undersigned is the Grantor/Grantee of the property described in the conveyance.
□ Undersigned is the drafter of the conveyance that is the subject of the Correction Instrument
□ Undersigned is the settlement agent in the transaction that is the subject of this Correction Instrument
□ Other (Explain):
A copy of the conveyance (in part or whole)
□ is □ is not attached to this Correction Instrument (if a copy of the conveyance is not
attached, attach the legal description).
Undersigned has sent notice of the execution and recording of this Correction Instrument by 1
st
class mail to all parties to the
transaction that was the subject of the conveyance at their last known addresses.
Dated _____________________________.
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
CORRECTION INSTRUMENT
* Type name below signatures.
FORM NO. 00-2011
STATE BAR OF WISCONSIN
State Bar of Wisconsin Form 00-2011
CORRECTION INSTRUMENT
Under Wis. Stat. § 706.085
Recording Area
ame and Return Address
Document Name
Document Number
