AB305,11,3 23(8) Authorization for final disposition. (a) An individual who is of sound
24mind and has attained age 18 may voluntarily execute an authorization for final
25disposition, which shall take effect on the date of execution. An individual for whom

1an adjudication of incompetence and appointment of a guardian of the person is in
2effect under ch. 880 is presumed not to be of sound mind for purposes of this
3subsection.
AB305,11,64 (b) An authorization for final disposition may express the declarant's special
5directions, instructions concerning religious observances, and suggestions
6concerning any of the following:
AB305,11,77 1. Arrangements for a viewing.
AB305,11,88 2. Funeral ceremony, memorial service, graveside service, or other last rite.
AB305,11,109 3. Burial, cremation and burial, or other disposition, or donation of the
10declarant's body after death.
AB305,11,1611 (c) An authorization for final disposition requires a representative and one or
12more named successor representatives to carry out the directions, instructions, and
13suggestions of the declarant, as expressed in the declarant's authorization for final
14disposition, unless the directions, instructions, and suggestions exceed available
15resources from the decedent's estate or are unlawful or unless there is no realistic
16possibility of compliance.
AB305,11,1817 (d) An authorization for final disposition shall meet all of the following
18requirements:
AB305,11,2219 1. List the name and last-known address, as of the date of execution of the
20authorization for final disposition, of each representative and each successor
21representative named, and be signed by each representative and each successor
22representative named.
AB305,12,423 2. Be signed and dated by the declarant, with the signature witnessed by 2
24witnesses who each have attained age 18 and who are not related by blood, marriage,
25or adoption to the declarant, or acknowledged before a notary public. If the declarant

1is physically unable to sign an authorization for final disposition, the authorization
2shall be signed in the declarant's name by an individual at the declarant's express
3direction and in his or her presence; such a proxy signing shall take place or be
4acknowledged by the declarant in the presence of 2 witnesses or a notary public.
AB305,12,75 (e) Unless any of the following is related to the declarant by blood, marriage,
6or adoption, that person may not serve as a representative under the requirements
7of this subsection:
AB305,12,88 1. A funeral director.
AB305,12,99 2. A crematory authority.
AB305,12,1010 3. A cemetery authority.
AB305,12,1211 4. An employee of a funeral director, crematory authority, or cemetery
12authority.
AB305,12,1313 5. A member of the clergy.
AB305,12,1414 6. A health care provider.
AB305,12,1515 7. A hospice worker.
AB305,12,1616 8. A social worker.
AB305,13,217 (f) The department shall prepare and provide copies of the authorization for
18final disposition form and accompanying information for distribution in quantities
19to funeral directors, crematory authorities, cemetery authorities, hospitals, nursing
20homes, county clerks, and local bar associations and individually to private persons.
21The department shall include, in information accompanying the authorization for
22final disposition form, at least the statutory definitions of terms used in the form, and
23an instruction to potential declarants to read and understand the information before
24completing the form. The department may charge a reasonable fee for the cost of
25preparation and distribution. The authorization for final disposition form

1distributed by the department shall be easy to read, in not less than 10-point type,
2and in the following form:
authorization for final disposition
AB305,13,93 I, .... (print name and address), being of sound mind, willfully and voluntarily
4make known by this document my desire that, upon my death, the final disposition
5of my remains be under the control of my representative under the requirements of
6section 154.30, Wisconsin statutes, and, with respect to that final disposition only,
7I hereby appoint the representative and any successor representative named in this
8document. All decisions made by my representative or any successor representative
9with respect to the final disposition of my remains are binding.
AB305,13,1010 Name of representative.........................................................................................
AB305,13,1111 Address..................................................................................................................
AB305,13,1212 Telephone number.................................................................................................
AB305,13,1713 If my representative dies, becomes incapacitated, resigns, refuses to act, ceases
14to be qualified, or cannot be located within the time necessary to control the final
15disposition of my remains, I hereby appoint the following individuals, each to act
16alone and successively, in the order specified, to serve as my successor
17representative:
AB305,13,1818 1. Name of first successor representative..............................................................
AB305,13,1919 Address..............................................................................................................
AB305,13,2020 Telephone number.............................................................................................
AB305,13,2121 2. Name of second successor representative.........................................................
AB305,13,2222 Address..............................................................................................................
AB305,13,2323 Telephone number............................................................................................
AB305,13,24 24Suggested special directions............................................................
AB305,14,2
1Suggested instructions concerning religious
2observances
............................................................................................................
AB305,14,4 3Suggested source of funds for implementing final disposition directions and
4instructions
................................................
AB305,14,55 This authorization becomes effective upon my death.
AB305,14,76 I hereby revoke any prior authorization for final disposition that I may have
7signed before the date that this document is signed.
AB305,14,148 I hereby agree that any funeral director, crematory authority, or cemetery
9authority that receives a copy of this document may act under it. Any modification
10or revocation of this document is not effective as to a funeral director, crematory
11authority, or cemetery authority until the funeral director, crematory authority, or
12cemetery authority receives actual notice of the modification or revocation. No
13funeral director, crematory authority, or cemetery authority may be liable because
14of reliance on a copy of this document.
AB305,14,1715 The representative and any successor representative, by accepting
16appointment under this document, assume the powers and duties specified for a
17representative under section 154.30, Wisconsin statutes.
AB305,14,1818 Signed this .............................day of .................................
AB305,14,1919 Signature of declarant...........................................................................................
AB305,14,2120 I hereby accept appointment as representative for the control of final
21disposition of the declarant's remains.
AB305,14,2222 Signed this .............................day of .................................
AB305,14,2323 Signature of representative...................................................................................
AB305,14,2524 I hereby accept appointment as successor representative for the control of final
25disposition of the declarant's remains.
AB305,15,1
1Signed this .............................day of .................................
AB305,15,22 Signature of first successor representative...........................................................
AB305,15,33 Signed this .............................day of .................................
AB305,15,44 Signature of second successor representative.......................................................
AB305,15,116 I attest that the declarant signed or acknowledged this authorization for final
7disposition in my presence and that the declarant appears to be of sound mind and
8not subject to duress, fraud, or undue influence. I further attest that I am not the
9representative or the successor representative appointed under this document, that
10I am aged at least 18, and that I am not related to the declarant by blood, marriage,
11or adoption.
AB305,15,1212 Witness (print name).............................................................................................
AB305,15,1313 Signature..........................................................................................................
AB305,15,1414 Address.............................................................................................................
AB305,15,1515 Date..................................................................................................................
AB305,15,1717 Witness (print name).............................................................................................
AB305,15,1818 Signature..........................................................................................................
AB305,15,1919 Address.............................................................................................................
AB305,15,2020 Date..................................................................................................................
AB305,15,2222 State of Wisconsin
AB305,15,2323 County of .................................
AB305,16,424 On (date)............................................................., before me personally appeared
25(name of declarant).................................................................., known to me or

1satisfactorily proven to be the individual whose name is specified in this document
2as the declarant and who has acknowledged that he or she executed the document
3for the purposes expressed in it. I attest that the declarant appears to be of sound
4mind and not subject to duress, fraud, or undue influence.
AB305,16,55 Notary public.........................................................................................................
AB305,16,66 My commission expires..........................................................................................
AB305,16,9 7(9) Revocation of authorization for final disposition. A declarant may
8revoke an authorization for final disposition at any time by any of the following
9methods:
AB305,16,1510 (a) Cancelling, defacing, obliterating, burning, tearing, or otherwise destroying
11the authorization for final disposition or directing some other person to cancel,
12deface, obliterate, burn, tear, or otherwise destroy the authorization for final
13disposition in the presence of the declarant. In this paragraph, "cancelling" includes
14a declarant's writing on a declaration of final disposition, "I hereby revoke this
15declaration of final disposition," and signing and dating that statement.
AB305,16,1716 (b) Revoking in writing the authorization for final disposition. The declarant
17shall sign and date any written revocation under this subsection.
AB305,16,1818 (c) Executing a subsequent authorization for final disposition.
AB305,16,22 19(10) Penalty. Any person who intentionally conceals, cancels, defaces,
20obliterates, or damages the authorization for final disposition of another without the
21declarant's consent may be fined not more than $500 or imprisoned not more than
2230 days or both.
AB305,16,2323 (End)
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