For Official Use STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Oath and Consent to Serve as Special Prosecutor The appointment dated regarding . I accept this appointment as Special Prosecutor and (swear) or (affirm) that I will support the constitutions of the United States and the State of Wisconsin, and will faithfully discharge the duties of this office to the best of my ability. State of: County of: Subscribed and sworn to before me on: Notary Public, State of Wisconsin Signature of Attorney Telephone Number Name Printed or Typed Bar Number Address of Principal Office Name Printed or Typed My commission expires: CR-210C, 02/16 Oath and Consent to Serve This form shall not be modified. It may be supplemented with additional material. Page 1 of 1 §978.045, Wisconsin Statutes American LegalNet, Inc. www.FormsWorkFlow.com