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DEPARTMENT OF HEALTH SERVICES
Division of Public Health
F00124 (Rev. 07/15)STATE OF WISCONSIN
Chapter 69.21 Wis.Stats.
Page 1 of 2WISCONSIN TERMINATION OF DOMESTIC PARTNERSHIP APPLICATIONTYPE or PRINT.(for
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Penalties can be imposed on any person who fails to comply with certain regulations or laws.
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Any person or entity that is mandated by law to report or pay penalties is required to file penalties.
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To fill out penalties, the person or entity must provide all relevant information accurately and completely.
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The purpose of penalties is to enforce compliance with regulations and laws, and to deter individuals from committing violations.
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Information such as the nature of the violation, the date it occurred, and any relevant details must be reported on penalties.
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