To all to whom these presents shall come, greeting:

Whereas, …., treasurer of the county of …., has deposited in the office of the county clerk of the county of …., in the state of Wisconsin, a tax certificate of said county, whereby it appears, as the fact is, that the following described piece (or pieces) or parcel (or parcels) of land lying and being situated in the county of …., to wit: (Here describe the lands) was (or were) included in the tax certificate issued to the county of …. on …. …., …. (date), for the nonpayment of real property taxes, special assessments, special charges or special taxes, in the amount of …. dollars and …. cents, in the whole, which sum was the amount assessed and due and unpaid on said tract (or several tracts) of land, and whereas it further appears, as the fact is, that the owner (or owners) or claimant (or claimants) of said land has (or have) not redeemed from said certificate the lands which were included as aforesaid, and said lands continue to remain unredeemed, whereby said described lands have become forfeited and the said county is entitled to a conveyance thereof:

Now, therefore, know all by these presents that the county of …., in said state, and the state of Wisconsin, in conformity to law, have given and hereby do give, grant and convey the tract (or several tracts) of land above described, together with the hereditaments and appurtenances, to the said county of …. and its assigns, to their sole use and benefit forever.

In testimony whereof, I, …., the clerk of the county of …., have executed this deed pursuant to and in virtue of the authority in me vested by the statutes of the state of Wisconsin, and for and on behalf of said state and the county of …. aforesaid, and have hereunto subscribed my name officially and affixed the seal of the said …. (name it), at …. in said county of …., this …. day of …., …. (year)

[L. S.]

A. B.

(Here give official designation.)

Done in presence of

….

….