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SB70-SSA2-SA2,208,44 TITLE: MEMBER STATE BAR OF WISCONSIN
SB70-SSA2-SA2,208,55 (If not, .... authorized by s. 706.06, Wis. Stats.)
SB70-SSA2-SA2,208,6 6Acknowledgment
SB70-SSA2-SA2,208,77 STATE OF WISCONSIN   )
SB70-SSA2-SA2,208,99 .... County   )
SB70-SSA2-SA2,208,1210 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.
SB70-SSA2-SA2,208,1414 Notary Public ...., .... County, Wisconsin.
SB70-SSA2-SA2,208,1515 My Commission is permanent.
SB70-SSA2-SA2,208,1616 (If not, state expiration date: ...., .... (year))
SB70-SSA2-SA2,208,1717 (Signatures may be authenticated or
SB70-SSA2-SA2,208,1818 acknowledged. Both are not necessary.)
SB70-SSA2-SA2,208,1919 *Names of persons signing in any capacity should be
SB70-SSA2-SA2,208,2020 typed or printed below their signatures.
SB70-SSA2-SA2,208,2121 Signature of Other Spouse: ....
SB70-SSA2-SA2,208,2222 Date: ....
SB70-SSA2-SA2,208,2323 Print Name Here: ....
SB70-SSA2-SA2,208,2424 Residence Address: ....
SB70-SSA2-SA2,208,2525 (Make Sure Your Signature is Authenticated or Acknowledged Below.)
SB70-SSA2-SA2,209,1
1Authentication
SB70-SSA2-SA2,209,22 Signature .... authenticated this .... day of ...., .... (year)
SB70-SSA2-SA2,209,44 TITLE: MEMBER STATE BAR OF WISCONSIN
SB70-SSA2-SA2,209,55 (If not, .... authorized by s. 706.06, Wis. Stats.)
SB70-SSA2-SA2,209,6 6Acknowledgment
SB70-SSA2-SA2,209,77 STATE OF WISCONSIN   )
SB70-SSA2-SA2,209,99 .... County   )
SB70-SSA2-SA2,209,1210 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.
SB70-SSA2-SA2,209,1414 Notary Public ...., .... County, Wisconsin.
SB70-SSA2-SA2,209,1515 My Commission is permanent.
SB70-SSA2-SA2,209,1616 (If not, state expiration date: ...., .... (year))
SB70-SSA2-SA2,209,1717 (Signatures may be authenticated or
SB70-SSA2-SA2,209,1818 acknowledged. Both are not necessary.)
SB70-SSA2-SA2,209,1919 *Names of persons signing in any capacity should
SB70-SSA2-SA2,209,2020 be typed or printed below their signatures.
SB70-SSA2-SA2,209,21 21Termination of
SB70-SSA2-SA2,209,22 22Statutory terminable individual
SB70-SSA2-SA2,209,23 23Property classification agreement
SB70-SSA2-SA2,209,2424 I UNDERSTAND THAT:
SB70-SSA2-SA2,210,3
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.
SB70-SSA2-SA2,210,84 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.
SB70-SSA2-SA2,210,119 3. IN GENERAL, THIS TERMINATION IS NOT BINDING ON CREDITORS
10UNLESS THEY ARE PROVIDED A COPY OF THE TERMINATION BEFORE
11CREDIT IS EXTENDED.
SB70-SSA2-SA2,210,1412 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.
SB70-SSA2-SA2,210,1515 Signature: ....
SB70-SSA2-SA2,210,1616 Date: ....
SB70-SSA2-SA2,210,1717 Print Name Here: ....
SB70-SSA2-SA2,210,1818 Residence Address: ....
SB70-SSA2-SA2,210,19 19Schedule “A"
SB70-SSA2-SA2,210,20 20Financial Disclosure
SB70-SSA2-SA2,210,2421 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.
SB70-SSA2-SA2,210,25 25Husband   Wife   Spouse (Name)   Spouse (Name)   Both Names
SB70-SSA2-SA2,211,1
1I.   Assets:
SB70-SSA2-SA2,211,22 A.   Real estate (gross value)
SB70-SSA2-SA2,211,33 B.   Stocks, bonds and mutual funds
SB70-SSA2-SA2,211,54 C.   Accounts at and certificates and other
5instruments issued by financial institutions
SB70-SSA2-SA2,211,76 D.   Mortgages, land contracts, promissory notes
7and cash
SB70-SSA2-SA2,211,88 E.   Partnership interests
SB70-SSA2-SA2,211,99 EL.   Limited liability company interests
SB70-SSA2-SA2,211,1010 F.   Trust interests
SB70-SSA2-SA2,211,1111 G.   Livestock, farm products, crops
SB70-SSA2-SA2,211,1212 H.   Automobiles and other vehicles
SB70-SSA2-SA2,211,1313 I.   Jewelry and personal effects
SB70-SSA2-SA2,211,1414 J.   Household furnishings
SB70-SSA2-SA2,211,1515 K.   Life insurance and annuities:
SB70-SSA2-SA2,211,1616 1.   Face value
SB70-SSA2-SA2,211,1717 2.   Cash surrender value
SB70-SSA2-SA2,211,1818 L.   Retirement benefits (include value):
SB70-SSA2-SA2,211,1919 1.   Pension plans
SB70-SSA2-SA2,211,2020 2.   Profit sharing plans
SB70-SSA2-SA2,211,2121 3.   HR-10 KEOGH plans
SB70-SSA2-SA2,211,2222 4.   IRAs
SB70-SSA2-SA2,211,2323 5.   Deferred compensation plans
SB70-SSA2-SA2,211,2424 M.   Other assets not listed elsewhere
SB70-SSA2-SA2,211,2525 II.   Obligations (total outstanding balance):
SB70-SSA2-SA2,212,1
1A.   Mortgages and liens
SB70-SSA2-SA2,212,22 B.   Credit cards
SB70-SSA2-SA2,212,33 C.   Other obligations to financial institutions
SB70-SSA2-SA2,212,54 D.   Alimony, maintenance and child support (per
5month)
SB70-SSA2-SA2,212,86 E.   Other obligations (such as other obligations
7to individuals, guarantees, contingent
8liabilities)
SB70-SSA2-SA2,212,99 III.   Annual compensation for services:
SB70-SSA2-SA2,212,1110 (for example, wages and income from
11self-employment; also include social security,
SB70-SSA2-SA2,212,1212 disability and similar income here)
SB70-SSA2-SA2,212,1313 (IF YOU NEED ADDITIONAL SPACE,
SB70-SSA2-SA2,212,1414 ADD ADDITIONAL SHEETS.)
SB70-SSA2-SA2,400 15Section 400. 767.215 (2) (b) of the statutes is amended to read:
SB70-SSA2-SA2,212,1816 767.215 (2) (b) The name and birthdate of each minor child of the parties and
17each other child born to the wife a party during the marriage, and whether the wife
18a party is pregnant.
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