Protected Early Lease-Termination Notice - Wisconsin

PROTECTED EARLY LEASE-TERMINATION NOTICE

State: Wisconsin

Safety first. Do not use an account, device, mailing address, or delivery method the adverse person can monitor. Call emergency services if there is immediate danger. This notice requests only information needed for the statutory route; do not add a detailed history of abuse.

1. Tenant, Landlord, and Lease

2. Notice of Protected Termination

I notify the Landlord that I am using the protected early-termination route described in Section 10. I or a person covered through me meets the state-specific eligibility rule, and I reasonably request release from future obligations as provided by that rule.

I am not providing a perpetrator's name or incident narrative in this notice. Any state-required identifying or incident information appears only in the permitted supporting document and is redacted or limited as Section 10 directs.

3. Date and Deadline Calculator

Do not use the requested date until Section 10 has been applied to the actual delivery method, rent interval, and documentation date.

4. Supporting Document

Attach only a document allowed by Section 10:

☐ Protection / no-contact order
☐ Law-enforcement or court record
☐ Qualified-third-party document
☐ Health-care or victim-services document expressly allowed by state law
☐ Other state-enumerated document: [________________________________]

Document date: [__/__/____]

Redactions completed: ☐ Yes ☐ Not permitted/needed

No medical record, diagnosis, therapy notes, full police file, or extra incident narrative is included unless the state-specific rule expressly requires it and counsel confirms the scope.

5. Vacancy, Rent, Deposit, and Property

I will surrender possession as required by the state route. I request a written ledger showing:

• rent through the lawful termination or release date;
• credits and prepaid rent;
• any security-deposit accounting;
• separately identified pre-termination balances; and
• no lease-break fee or future rent beyond what the state route permits.

Personal property left behind:

☐ None expected
☐ Instructions attached
☐ State-specific property instructions in Section 10 apply

6. Cotenants, Occupants, and Guarantors

Other tenants / occupants: [________________________________]

Guarantor, if any: [________________________________]

This notice does not guess whether another tenant, occupant, or guarantor is released. Apply the exact state rule and obtain a written account of who remains liable. Do not send this notice to an adverse cotenant unless the state rule or a court requires it and a safety plan is in place.

7. Safe Communications and Forwarding Address

Safe contact method:

☐ Email: [________________________________]
☐ Phone / text: [________________________________]
☐ Advocate or attorney: [________________________________]
☐ Mail to safe address: [________________________________]

Forwarding-address choice:

☐ Use the safe address above only for deposit/accounting mail.
☐ I will provide a forwarding address later.
☐ Send statutory financial notices through my attorney/advocate.
☐ Do not disclose my relocation address to any cotenant, occupant, adverse party, reference caller, or third party except with my written consent or as law requires.

8. Confidential Handling Request

Mark this notice and every attachment CONFIDENTIAL — RESTRICTED ACCESS. Limit access to personnel who must process the request. Do not place protected information in ordinary maintenance notes, tenant-screening comments, shared databases, or reference responses.

Return or securely destroy excess copies after the retention period required by law or counsel. These instructions supplement, and do not narrow, any mandatory state confidentiality rule.

9. Delivery Record

Method used:

☐ Hand delivery
☐ First-class mail
☐ Certified or tracked mail
☐ State-authorized electronic method
☐ Court-directed or other method: [________________________________]

Delivered to: [________________________________]

Delivery address / account: [________________________________]

Tracking, witness, receipt, or screenshot retained: ☐ Yes

10. Wisconsin Route — Statutes § 704.16

For the imminent-harm route, the tenant or the tenant's child must face an imminent threat of serious physical harm if the tenant remains. For the separate sexual-assault route, follow § 704.16(1m).

Give notice using a method authorized by § 704.21 and attach a certified copy of a qualifying injunction, no-contact condition of release, or criminal complaint listed in § 704.16(1)(b) or (1m). This form is not a substitute for the certified court or criminal document.

After the tenant removes and supplies compliant notice/documentation, rent liability ends after the end of the month following the month in which notice is given or removal occurs, whichever is later, subject to the landlord's mitigation duty under § 704.29(2).

Because this is a document-specific route, do not attach an advocate letter, medical record, self-attestation, or informal police narrative unless Wisconsin counsel confirms that it is one of the statute's enumerated certified documents.

11. Tenant Signature

I certify that the statements I made in this notice are true to the best of my knowledge. I understand that the attached documentation and state-specific route control the effective date and financial result.

Tenant signature: ________________________________

Printed name: [________________________________]

Date: [__/__/____]

SOURCES AND REFERENCES

• Wisconsin Legislature — Wis. Stat. § 704.16
• Wisconsin Legislature — Wis. Stat. § 704.21