Wis. Admin. Code § EL 19.02
(3) A judicial officer or judicial candidate seeking to maintain a private address under s. 8.10 (8) (a), Stats., shall file the certification of residence form currently prescribed by the commission for that purpose. A sufficient form must contain all of the following:
(h) The following certification language: “I hereby certify that I am currently or formerly a judicial officer, or that I intend to be a candidate for filling the office of a judicial officer, as defined by Wis. Stat. § 757.07(1)(e). This form constitutes my written request to the Wisconsin Elections Commission to confidentially maintain my address unless I consent to disclosure under Wis. Stat. § 757.07(4)(e).
I certify that the residential address that I provided is the place where my habitation is fixed, without any present intent to move, and to which, when absent, I intend to return. I certify that the accompanying proof of residence submitted with this application accurately reflects my current legal name and residential address.
I certify that the information I provided in this application is true and correct. I understand that falsifying any portion of this application could result in prosecution and penalties, including, but not limited to, Wis. Stat. §§ 12.13(1)(b) and 12.13(3)(a).
I understand that I will need to submit a new request for certification of residence if there is any material change in the information presented on this application, including a change in address or election date.
I understand on what date I am required to be a resident of the jurisdiction for the office sought and that I may be required to move to qualify for the office.
I understand that if I am a judicial officer, I may place “Residence Certified with WEC” on my own nomination papers and Declaration of Candidacy for the office of a judicial officer in lieu of providing my residential address and, as a signatory or circulator, on the nomination papers of other nonpartisan candidates, notwithstanding s. EL 2.05(12).
I understand that if I am only a candidate for filling the office of a judicial officer, I may place “Residence Certified with WEC” on my own nomination papers and Declaration of Candidacy for that office in lieu of providing my residential address.
I understand that a filing officer may contact me in writing to confirm that my residential address is still accurate or to request an updated form, and that I must confirm the accuracy of my residence or provide an updated form if requested.
I understand that the Wisconsin Elections Commission will maintain the confidentiality of my certification of residence and share it only with my filing officer unless compelled to release the information by a court or other lawful authority, or unless I consent to its release.”
(i) A notarization or an unsworn declaration.
Note: The form referred to under this subsection can be obtained by contacting the commission at elections@wi.gov.
History: CR 25-031: cr. Register December 2025 No. 840, eff. 1-1-26; correction in (3) (e) made under ss. 13.92 (4) (b) 3. and 35.17, Stats., and renum. (4) to (3) (Note) under s. 13.92 (4) (b) 1. and correction made under s. 35.17, Stats., Register December 2025 No. 840.