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WISCONSIN DEPARTMENT OF EMPLOYEE TRUST FUNDS P.O. BOX 7931 Madison, Wisconsin 537077931 18775335020 (toll-free)COMPLETE IF APPLICABLEBENEFICIARY DESIGNATION Wis. Stat. 40.02 (8) (a) and 40.74DO NOT
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Take the two-digit month of your birthdate and write it first.
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Write the four-digit year of your birthdate last.
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Always be cautious when providing your birthdate and ensure that it is requested by a legitimate and trustworthy entity.
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