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Get WI DoR A-212 2009

Ld be shown above since the assets are listed at fair market value. 10. Life Insurance Policies Company Beneficiary Is this insurance pledged with banks or other creditors? Amount Yes Cash Surrender Value Balance on Loan Have Premiums Been Paid to Date? (Yes or No) Date Mortgage Recorded Unpaid Interest and Taxes* No 11. Real Estate (include personal residence) Description Cost Fair Market Value Balance Due on Mortgage* *Proof by documentation must accompany this petition. Co.

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