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22 Date: ....
23 Print Name Here: ....
24 Residence Address: ....
25 (Make Sure Your Signature is Authenticated or Acknowledged Below.)
1Authentication
2 Signature .... authenticated this .... day of ...., .... (year)
3 *....
4 TITLE: MEMBER STATE BAR OF WISCONSIN
5 (If not, .... authorized by s. 706.06, Wis. Stats.)
6Acknowledgment
7 STATE OF WISCONSIN   )
8 )   ss.
9 .... County   )
10 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.
13 *....
14 Notary Public ...., .... County, Wisconsin.
15 My Commission is permanent.
16 (If not, state expiration date: ...., .... (year))
17 (Signatures may be authenticated or
18 acknowledged. Both are not necessary.)
19 *Names of persons signing in any capacity should be
20 typed or printed below their signatures.
21 Signature of Other Spouse: ....
22 Date: ....
23 Print Name Here: ....
24 Residence Address: ....
25 (Make Sure Your Signature is Authenticated or Acknowledged Below.)
1Authentication
2 Signature .... authenticated this .... day of ...., .... (year)
3 *....
4 TITLE: MEMBER STATE BAR OF WISCONSIN
5 (If not, .... authorized by s. 706.06, Wis. Stats.)
6Acknowledgment
7 STATE OF WISCONSIN   )
8 )   ss.
9 .... County   )
10 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.
13 *....
14 Notary Public ...., .... County, Wisconsin.
15 My Commission is permanent.
16 (If not, state expiration date: ...., .... (year))
17 (Signatures may be authenticated or
18 acknowledged. Both are not necessary.)
19 *Names of persons signing in any capacity should
20 be typed or printed below their signatures.
21Termination of
22Statutory terminable individual
23Property classification agreement
24 I UNDERSTAND THAT:
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.
4 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.
9 3. IN GENERAL, THIS TERMINATION IS NOT BINDING ON CREDITORS
10UNLESS THEY ARE PROVIDED A COPY OF THE TERMINATION BEFORE
11CREDIT IS EXTENDED.
12 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.
15 Signature: ....
16 Date: ....
17 Print Name Here: ....
18 Residence Address: ....
19Schedule “A"
20Financial Disclosure
21 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.
25Husband   Wife   Spouse (Name)   Spouse (Name)   Both Names
1I.   Assets:
2 A.   Real estate (gross value)
3 B.   Stocks, bonds and mutual funds
4 C.   Accounts at and certificates and other
5instruments issued by financial institutions
6 D.   Mortgages, land contracts, promissory notes
7and cash
8 E.   Partnership interests
9 EL.   Limited liability company interests
10 F.   Trust interests
11 G.   Livestock, farm products, crops
12 H.   Automobiles and other vehicles
13 I.   Jewelry and personal effects
14 J.   Household furnishings
15 K.   Life insurance and annuities:
16 1.   Face value
17 2.   Cash surrender value
18 L.   Retirement benefits (include value):
19 1.   Pension plans
20 2.   Profit sharing plans
21 3.   HR-10 KEOGH plans
22 4.   IRAs
23 5.   Deferred compensation plans
24 M.   Other assets not listed elsewhere
25 II.   Obligations (total outstanding balance):
1A.   Mortgages and liens
2 B.   Credit cards
3 C.   Other obligations to financial institutions
4 D.   Alimony, maintenance and child support (per
5month)
6 E.   Other obligations (such as other obligations
7to individuals, guarantees, contingent
8liabilities)
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