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Get Form 4500-113 - Wisconsin Department Of Natural Resources - Dnr Wi

NR 406.04, 410.05 and 447.07, Wis. Adm. Code. Penalties for failure to provide complete information requested include forfeitures of $10 to $25,000, fines of up to $25,000 and imprisonment for up to six months s. 285.87, Wis. Stats. . This form may be used to meet the notification requirements for the Department of Health Services, ch. DHS 159, Wis. Adm. Code. Personal information collected will be used for administrative purposes and may be provided to requesters to the extent required by Wisc.

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