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Residence Address: ....
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(Make Sure Your Signature is Authenticated or Acknowledged Below.)
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17Authentication
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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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22Acknowledgment
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STATE OF WISCONSIN
)
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.... County
)
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1Personally came before me this .... day of ...., .... (year) the above named .... to
2me known to be the person who executed the foregoing instrument and acknowledge
3the 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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Date: ....
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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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17Authentication
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Signature .... authenticated this .... day of ...., .... (year)
SB111,1600,2020
TITLE: MEMBER STATE BAR OF WISCONSIN
SB111,1600,2121
(If not, .... authorized by s. 706.06, Wis. Stats.)
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22Acknowledgment
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STATE OF WISCONSIN
)
SB111,1600,2525
.... County
)
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1Personally came before me this .... day of ...., .... (year) the above named .... to
2me known to be the person who executed the foregoing instrument and acknowledge
3the same.
SB111,1601,55
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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12Termination of
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13Statutory terminable individual
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14Property classification agreement
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I UNDERSTAND THAT:
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1. THIS TERMINATION TAKES EFFECT 30 DAYS AFTER MY SPOUSE IS
17NOTIFIED OF THE TERMINATION, AS PROVIDED UNDER SECTION 766.589
18(4) OF THE WISCONSIN STATUTES.
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2. THIS TERMINATION IS PROSPECTIVE; IT DOES NOT AFFECT THE
20CLASSIFICATION OF PROPERTY ACQUIRED BEFORE THE TERMINATION
21BECOMES EFFECTIVE. PROPERTY ACQUIRED AFTER THE TERMINATION
22BECOMES EFFECTIVE IS CLASSIFIED AS PROVIDED UNDER THE MARITAL
23PROPERTY LAW.
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13. IN GENERAL, THIS TERMINATION IS NOT BINDING ON CREDITORS
2UNLESS THEY ARE PROVIDED A COPY OF THE TERMINATION BEFORE
3CREDIT IS EXTENDED.
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The undersigned terminates the statutory terminable individual property
5classification agreement entered into by me and my spouse on .... (date last spouse
6signed 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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11Schedule “A"
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12Financial Disclosure
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The following general categories of assets and liabilities are not all inclusive
14and if other assets or liabilities exist they should be listed. Assets should be listed
15according to which spouse has title (including assets owned by a spouse or the
16spouses with one or more third parties) and at their approximate market value.
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17Husband Wife
Spouse (Name) Spouse (Name) Both Names
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I.
Assets:
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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
22instruments issued by financial institutions
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D.
Mortgages, land contracts, promissory notes
24and cash
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E.
Partnership interests
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1EL.
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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1.
Face value
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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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A.
Mortgages and liens
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B.
Credit cards
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C.
Other obligations to financial institutions
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D.
Alimony, maintenance and child support (per
22month)
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E.
Other obligations (such as other obligations
24to individuals
, guarantees, contingent
25liabilities)
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1III.
Annual compensation for services:
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(for example, wages and income from
3self-employment; also include social security,
