Parcel Identification Number (PIN)
STATE OF WISCONSIN )
__________________ COUNTY )
Personally came before me on _________________, _______
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:
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
class mail to all parties to the
transaction that was the subject of the conveyance at their last known addresses.
(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.
* Type name below signatures.
FORM NO. 00-2011
STATE BAR OF WISCONSIN
State Bar of Wisconsin Form 00-2011
Under Wis. Stat. § 706.085
ame and Return Address