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DEPARTMENT OF HEALTH SERVICES Division of Public Health F05280 (Rev. 07/15) STATE OF WISCONSIN Chapter 69.21 Wis.Stats. Page 1 of 2 WISCONSIN DEATH CERTIFICATE APPLICATION TYPE or PRINT. (for Mail
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Fine of not more is a penalty imposed for certain violations or offenses that do not exceed a specific amount.
Any individual or organization that has committed an offense or violation that falls within the fine of not more category is required to file it.
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The purpose of fine of not more is to enforce compliance with regulations and laws by imposing a monetary penalty on offenders.
The information that must be reported on fine of not more includes details of the violation or offense, the amount of the fine, and any supporting documentation.
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2003 WISCONSIN uncertified Taylor pre-2003 F-05280 YYYY BIRTHDATE Medford false DECEDENTS III Wis ISSUANCE obtains restricts REFUNDABLE Grandparent informational photocopy fraudulent attest DECEDENT asterisk aforementioned Township willfully Registrar not

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