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The parties (have) (have not) (strike one) completed Schedule “A", “
Financial
8Disclosure", attached to this agreement. If Schedule “A" has not been completed, the
9duration of this agreement is 3 years after both parties have signed the agreement.
10If Schedule “A" has been completed, the duration of this agreement is not limited to
113 years after it is signed.
AB68-SSA1,1405,2012
IF THE DURATION OF THIS AGREEMENT IS NOT TO BE LIMITED TO 3
13YEARS, MAKE SURE THAT SCHEDULE “A", “FINANCIAL DISCLOSURE", IS
14COMPLETED AND THAT YOU HAVE REVIEWED THE SCHEDULE BEFORE
15SIGNING THE AGREEMENT. IF YOU AND YOUR SPOUSE HAVE PREVIOUSLY
16ENTERED INTO A STATUTORY TERMINABLE INDIVIDUAL PROPERTY
17CLASSIFICATION AGREEMENT WITH EACH OTHER WHICH WAS
18EFFECTIVE DURING YOUR PRESENT MARRIAGE AND YOU AND YOUR
19SPOUSE DID NOT COMPLETE SCHEDULE “A", YOU MAY NOT EXECUTE THIS
20AGREEMENT IF YOU DO NOT COMPLETE SCHEDULE “A".
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Signature of One Spouse: ....
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Print Name Here: ....
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Residence Address: ....
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(Make Sure Your Signature is Authenticated or Acknowledged Below.)
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1Authentication
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Signature .... authenticated this .... day of ...., .... (year)
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TITLE: MEMBER STATE BAR OF WISCONSIN
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(If not, .... authorized by s. 706.06, Wis. Stats.)
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6Acknowledgment
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STATE OF WISCONSIN
)
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Personally came before me this .... day of ...., .... (year) the above named .... to
11me known to be the person who executed the foregoing instrument and acknowledge
12the same.
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Notary Public ...., .... County, Wisconsin.
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My Commission is permanent.
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(If not, state expiration date: ...., .... (year))
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(Signatures may be authenticated or
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acknowledged. Both are not necessary.)
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*Names of persons signing in any capacity should be
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typed or printed below their signatures.
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Signature of Other Spouse: ....
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Print Name Here: ....
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Residence Address: ....
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(Make Sure Your Signature is Authenticated or Acknowledged Below.)
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1Authentication
AB68-SSA1,1407,22
Signature .... authenticated this .... day of ...., .... (year)
AB68-SSA1,1407,44
TITLE: MEMBER STATE BAR OF WISCONSIN
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(If not, .... authorized by s. 706.06, Wis. Stats.)
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6Acknowledgment
AB68-SSA1,1407,77
STATE OF WISCONSIN
)
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Personally came before me this .... day of ...., .... (year) the above named .... to
11me known to be the person who executed the foregoing instrument and acknowledge
12the same.
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Notary Public ...., .... County, Wisconsin.
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My Commission is permanent.
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(If not, state expiration date: ...., .... (year))
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(Signatures may be authenticated or
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acknowledged. Both are not necessary.)
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*Names of persons signing in any capacity should
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be typed or printed below their signatures.
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21Termination of
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22Statutory terminable individual
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23Property classification agreement
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I UNDERSTAND THAT:
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11. THIS TERMINATION TAKES EFFECT 30 DAYS AFTER MY SPOUSE IS
2NOTIFIED OF THE TERMINATION, AS PROVIDED UNDER SECTION 766.589
3(4) OF THE WISCONSIN STATUTES.
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2. THIS TERMINATION IS PROSPECTIVE; IT DOES NOT AFFECT THE
5CLASSIFICATION OF PROPERTY ACQUIRED BEFORE THE TERMINATION
6BECOMES EFFECTIVE. PROPERTY ACQUIRED AFTER THE TERMINATION
7BECOMES EFFECTIVE IS CLASSIFIED AS PROVIDED UNDER THE MARITAL
8PROPERTY LAW.
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3. IN GENERAL, THIS TERMINATION IS NOT BINDING ON CREDITORS
10UNLESS THEY ARE PROVIDED A COPY OF THE TERMINATION BEFORE
11CREDIT IS EXTENDED.
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The undersigned terminates the statutory terminable individual property
13classification agreement entered into by me and my spouse on .... (date last spouse
14signed the agreement) under section 766.589 of the Wisconsin Statutes.
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Signature: ....
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Print Name Here: ....
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Residence Address: ....
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20Financial Disclosure
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The following general categories of assets and liabilities are not all inclusive
22and if other assets or liabilities exist they should be listed. Assets should be listed
23according to which spouse has title (including assets owned by a spouse or the
24spouses with one or more third parties) and at their approximate market value.
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25Husband Wife
Spouse (Name) Spouse (Name) Both Names
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A.
Real estate (gross value)
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B.
Stocks, bonds and mutual funds
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C.
Accounts at and certificates and other
5instruments issued by financial institutions
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D.
Mortgages, land contracts, promissory notes
7and cash
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E.
Partnership interests
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EL.
Limited liability company interests
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F.
Trust interests
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G.
Livestock, farm products, crops
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H.
Automobiles and other vehicles
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I.
Jewelry and personal effects
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J.
Household furnishings
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K.
Life insurance and annuities:
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2.
Cash surrender value
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L.
Retirement benefits (include value):
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1.
Pension plans
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2.
Profit sharing plans
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3.
HR-10 KEOGH plans
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5.
Deferred compensation plans
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M.
Other assets not listed elsewhere
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II.
Obligations (total outstanding balance):
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1A.
Mortgages and liens
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B.
Credit cards
