Lac La Belle Management District
P.O. Box 511
Oconomowoc, Wisconsin 53066
www.llbmd.org           info@llbmd.org

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Goose Roundup Opt in Form - 2010
The LLBMD does have my permission to enter my property to catch geese.

By this submission, my signature is inferred

Please complete the following:
First Name:  Last Name:
Lake Address:  City: State: Zip:
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