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Get WI ET-2815 2022-2024

Count, please provide your date of birth, name, and your Social Security number or ETF ID. Sign at the bottom of the page; unsigned forms will be rejected. If you are a representative signing on behalf of the member, the Department of Employee Trust Funds must have a copy of your approved power of attorney on file. ETF will not accept this form from any unauthorized third party. 1. Information About You Your name (first, middle, last) Birth date (MM/DD/YYYY) (For Beneficiaries only: original.

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