AB68-SSA1,1408,14 The undersigned terminates the statutory terminable individual property classification agreement entered into by me and my spouse on .... (date last spouse signed the agreement) under section 766.589 of the Wisconsin Statutes.

AB68-SSA1,1408,15 Signature: ....

AB68-SSA1,1408,16 Date: ....

AB68-SSA1,1408,17 Print Name Here: ....

AB68-SSA1,1408,18 Residence Address: ....

AB68-SSA1,1408,19 Schedule “A"

AB68-SSA1,1408,20 Financial Disclosure

AB68-SSA1,1408,24 The following general categories of assets and liabilities are not all inclusive and if other assets or liabilities exist they should be listed. Assets should be listed according to which spouse has title (including assets owned by a spouse or the spouses with one or more third parties) and at their approximate market value.

AB68-SSA1,1408,25 Husband   Wife   Spouse (Name)   Spouse (Name)   Both Names

AB68-SSA1,1409,1 I.   Assets:

AB68-SSA1,1409,2 A.   Real estate (gross value)

AB68-SSA1,1409,3 B.   Stocks, bonds and mutual funds

AB68-SSA1,1409,5 C.   Accounts at and certificates and other instruments issued by financial institutions

AB68-SSA1,1409,7 D.   Mortgages, land contracts, promissory notes and cash

AB68-SSA1,1409,8 E.   Partnership interests

AB68-SSA1,1409,9 EL.   Limited liability company interests

AB68-SSA1,1409,10 F.   Trust interests

AB68-SSA1,1409,11 G.   Livestock, farm products, crops

AB68-SSA1,1409,12 H.   Automobiles and other vehicles

AB68-SSA1,1409,13 I.   Jewelry and personal effects

AB68-SSA1,1409,14 J.   Household furnishings

AB68-SSA1,1409,15 K.   Life insurance and annuities:

AB68-SSA1,1409,16 1.   Face value

AB68-SSA1,1409,17 2.   Cash surrender value

AB68-SSA1,1409,18 L.   Retirement benefits (include value):

AB68-SSA1,1409,19 1.   Pension plans

AB68-SSA1,1409,20 2.   Profit sharing plans

AB68-SSA1,1409,21 3.   HR-10 KEOGH plans

AB68-SSA1,1409,22 4.   IRAs