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AB68-SSA1,1406,44 TITLE: MEMBER STATE BAR OF WISCONSIN
AB68-SSA1,1406,55 (If not, .... authorized by s. 706.06, Wis. Stats.)
AB68-SSA1,1406,6 6Acknowledgment
AB68-SSA1,1406,77 STATE OF WISCONSIN   )
AB68-SSA1,1406,88 )   ss.
AB68-SSA1,1406,99 .... County   )
AB68-SSA1,1406,1210 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.
AB68-SSA1,1406,1414 Notary Public ...., .... County, Wisconsin.
AB68-SSA1,1406,1515 My Commission is permanent.
AB68-SSA1,1406,1616 (If not, state expiration date: ...., .... (year))
AB68-SSA1,1406,1717 (Signatures may be authenticated or
AB68-SSA1,1406,1818 acknowledged. Both are not necessary.)
AB68-SSA1,1406,1919 *Names of persons signing in any capacity should be
AB68-SSA1,1406,2020 typed or printed below their signatures.
AB68-SSA1,1406,2121 Signature of Other Spouse: ....
AB68-SSA1,1406,2222 Date: ....
AB68-SSA1,1406,2323 Print Name Here: ....
AB68-SSA1,1406,2424 Residence Address: ....
AB68-SSA1,1406,2525 (Make Sure Your Signature is Authenticated or Acknowledged Below.)
AB68-SSA1,1407,1
1Authentication
AB68-SSA1,1407,22 Signature .... authenticated this .... day of ...., .... (year)
AB68-SSA1,1407,44 TITLE: MEMBER STATE BAR OF WISCONSIN
AB68-SSA1,1407,55 (If not, .... authorized by s. 706.06, Wis. Stats.)
AB68-SSA1,1407,6 6Acknowledgment
AB68-SSA1,1407,77 STATE OF WISCONSIN   )
AB68-SSA1,1407,88 )   ss.
AB68-SSA1,1407,99 .... County   )
AB68-SSA1,1407,1210 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.
AB68-SSA1,1407,1414 Notary Public ...., .... County, Wisconsin.
AB68-SSA1,1407,1515 My Commission is permanent.
AB68-SSA1,1407,1616 (If not, state expiration date: ...., .... (year))
AB68-SSA1,1407,1717 (Signatures may be authenticated or
AB68-SSA1,1407,1818 acknowledged. Both are not necessary.)
AB68-SSA1,1407,1919 *Names of persons signing in any capacity should
AB68-SSA1,1407,2020 be typed or printed below their signatures.
AB68-SSA1,1407,21 21Termination of
AB68-SSA1,1407,22 22Statutory terminable individual
AB68-SSA1,1407,23 23Property classification agreement
AB68-SSA1,1407,2424 I UNDERSTAND THAT:
AB68-SSA1,1408,3
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.
AB68-SSA1,1408,84 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.
AB68-SSA1,1408,119 3. IN GENERAL, THIS TERMINATION IS NOT BINDING ON CREDITORS
10UNLESS THEY ARE PROVIDED A COPY OF THE TERMINATION BEFORE
11CREDIT IS EXTENDED.
AB68-SSA1,1408,1412 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.
AB68-SSA1,1408,1515 Signature: ....
AB68-SSA1,1408,1616 Date: ....
AB68-SSA1,1408,1717 Print Name Here: ....
AB68-SSA1,1408,1818 Residence Address: ....
AB68-SSA1,1408,19 19Schedule “A"
AB68-SSA1,1408,20 20Financial Disclosure
AB68-SSA1,1408,2421 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.
AB68-SSA1,1408,25 25Husband   Wife   Spouse (Name)   Spouse (Name)   Both Names
AB68-SSA1,1409,1
1I.   Assets:
AB68-SSA1,1409,22 A.   Real estate (gross value)
AB68-SSA1,1409,33 B.   Stocks, bonds and mutual funds
AB68-SSA1,1409,54 C.   Accounts at and certificates and other
5instruments issued by financial institutions
AB68-SSA1,1409,76 D.   Mortgages, land contracts, promissory notes
7and cash
AB68-SSA1,1409,88 E.   Partnership interests
AB68-SSA1,1409,99 EL.   Limited liability company interests
AB68-SSA1,1409,1010 F.   Trust interests
AB68-SSA1,1409,1111 G.   Livestock, farm products, crops
AB68-SSA1,1409,1212 H.   Automobiles and other vehicles
AB68-SSA1,1409,1313 I.   Jewelry and personal effects
AB68-SSA1,1409,1414 J.   Household furnishings
AB68-SSA1,1409,1515 K.   Life insurance and annuities:
AB68-SSA1,1409,1616 1.   Face value
AB68-SSA1,1409,1717 2.   Cash surrender value
AB68-SSA1,1409,1818 L.   Retirement benefits (include value):
AB68-SSA1,1409,1919 1.   Pension plans
AB68-SSA1,1409,2020 2.   Profit sharing plans
AB68-SSA1,1409,2121 3.   HR-10 KEOGH plans
AB68-SSA1,1409,2222 4.   IRAs
AB68-SSA1,1409,2323 5.   Deferred compensation plans
AB68-SSA1,1409,2424 M.   Other assets not listed elsewhere
AB68-SSA1,1409,2525 II.   Obligations (total outstanding balance):
AB68-SSA1,1410,1
1A.   Mortgages and liens
AB68-SSA1,1410,22 B.   Credit cards
AB68-SSA1,1410,33 C.   Other obligations to financial institutions
AB68-SSA1,1410,54 D.   Alimony, maintenance and child support (per
5month)
AB68-SSA1,1410,86 E.   Other obligations (such as other obligations
7to individuals, guarantees, contingent
8liabilities)
AB68-SSA1,1410,99 III.   Annual compensation for services:
AB68-SSA1,1410,1110 (for example, wages and income from
11self-employment; also include social security,
AB68-SSA1,1410,1212 disability and similar income here)
AB68-SSA1,1410,1313 (IF YOU NEED ADDITIONAL SPACE,
AB68-SSA1,1410,1414 ADD ADDITIONAL SHEETS.)
AB68-SSA1,3049 15Section 3049 . 767.215 (2) (b) of the statutes is amended to read:
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