SB111,1600,8 (Signatures may be authenticated or

SB111,1600,9 acknowledged. Both are not necessary.)

SB111,1600,10 *Names of persons signing in any capacity should be

SB111,1600,11 typed or printed below their signatures.

SB111,1600,12 Signature of Other Spouse: ....

SB111,1600,13 Date: ....

SB111,1600,14 Print Name Here: ....

SB111,1600,15 Residence Address: ....

SB111,1600,16 (Make Sure Your Signature is Authenticated or Acknowledged Below.)

SB111,1600,17 Authentication

SB111,1600,18 Signature .... authenticated this .... day of ...., .... (year)

SB111,1600,19 *....

SB111,1600,20 TITLE: MEMBER STATE BAR OF WISCONSIN

SB111,1600,21 (If not, .... authorized by s. 706.06, Wis. Stats.)

SB111,1600,22 Acknowledgment

SB111,1600,23 STATE OF WISCONSIN   )

SB111,1600,24 )   ss.

SB111,1600,25 .... County   )

SB111,1601,3 Personally came before me this .... day of ...., .... (year) the above named .... to me known to be the person who executed the foregoing instrument and acknowledge the same.

SB111,1601,4 *....

SB111,1601,5 Notary Public ...., .... County, Wisconsin.

SB111,1601,6 My Commission is permanent.

SB111,1601,7 (If not, state expiration date: ...., .... (year))

SB111,1601,8 (Signatures may be authenticated or

SB111,1601,9 acknowledged. Both are not necessary.)

SB111,1601,10 *Names of persons signing in any capacity should

SB111,1601,11 be typed or printed below their signatures.

SB111,1601,12 Termination of

SB111,1601,13 Statutory terminable individual