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_____ 15.
accounting. My agent may render an accounting (monthly)
18(quarterly) (annually) (CIRCLE ONE) to me or to .... (insert name and address)
19during my lifetime and a final accounting to the personal representative of my estate,
20if any is appointed, after my death.
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Nomination of Guardian
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_____ 16.
GUARDIAN: If necessary, I nominate .... (name)
of .... (address) as
24guardian of my person and I nominate .... (name) of .... (address) as guardian of my
25estate.
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1special instructions
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_____ 17.
SPECIAL INSTRUCTIONS:
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ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS
5REGARDING THE POWERS GRANTED TO YOUR AGENT.
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TO ESTABLISH WHEN, AND FOR HOW LONG, THE BASIC POWER OF
16ATTORNEY FOR FINANCES AND PROPERTY IS IN EFFECT, YOU MUST
17INITIAL ONLY ONE OF THE FOLLOWING 3 OPTIONS. IF YOU DO NOT
18INITIAL ONE, OR IF YOU INITIAL MORE THAN ONE, THIS BASIC POWER OF
19ATTORNEY FOR FINANCES AND PROPERTY WILL NOT TAKE EFFECT.
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_____ This basic power of attorney for finances and property becomes effective when
22I sign it and will continue in effect as a durable power of attorney under section
23243.07, Wisconsin Statutes, if I become disabled or incapacitated.
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_____ This basic power of attorney for finances and property becomes effective only
25when both of the following apply:
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1a. I have signed it; and
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b. I become disabled or incapacitated.
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_____ This basic power of attorney for finances and property becomes effective when
4I sign it
but will cease to be effective if I become disabled or
5incapacitated.
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I agree that any 3rd party who receives a copy of this document may act under
7it. Revocation of this basic power of attorney is not effective as to a 3rd party until
8the 3rd party learns of the revocation. I agree to reimburse the 3rd party for any loss
9resulting from claims that arise against the 3rd party because of reliance on this
10basic power of attorney.
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Signed this .... day of ...., (year)
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(Your Signature)
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(Your Social Security Number)
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State of ....
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County of ....
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This document was acknowledged before me on .... (date) by .... (name of
19principal).
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(Signature of Notarial Officer)
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(Seal, if any)
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[My commission is permanent or expires: ....]
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1BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT
2ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES AND
3LIABILITIES OF AN AGENT.
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(Name of Agent)
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(Signature of Agent)
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8(2) Requirements. A Wisconsin basic power of attorney for finances and
9property is legally sufficient under this section if the wording of the form complies
10substantially with sub. (1), the form is properly completed, the signature of the
11principal is acknowledged and the signature of the agent is obtained.
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12(3) Copies. A copy of a completed Wisconsin basic power of attorney for finances
13and property form has the same force and effect as the original.
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14(4) Durable power of attorney. A Wisconsin basic power of attorney for
15finances and property that is legally sufficient under this section is durable to the
16extent that durable powers are permitted under s. 243.07 and the basic power of
17attorney for finances and property contains language provided under s. 243.07 (1) (a)
18showing the intent of the principal that the power granted may be exercised
19notwithstanding later disability or incapacity.
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20(5) Distribution of forms. The department of health and family services shall
21prepare and provide copies of the Wisconsin basic power of attorney for finances and
22property form under sub. (1) for distribution in quantities to financial institutions,
23health care professionals, hospitals, nursing homes, multipurpose senior centers,
24county clerks and local bar associations and individually to private persons. The
1department of health and family services may charge a reasonable fee for the cost
2of preparation and distribution of the forms.
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3(6) Relation to power of attorney for health care. The execution of a
4Wisconsin basic power of attorney for finances and property under this section does
5not confer on the agent any of the powers or duties conferred on a health care agent
6by the power of attorney for health care under ch. 155.
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7(7) Revocation and invalidation of basic power of attorney for finances and
8property. A principal may revoke a Wisconsin basic power of attorney for finances
9and property and invalidate it at any time by destroying it, by directing another
10person to destroy it in the principal's presence or by signing a written and dated
11statement expressing the principal's intent to revoke. If the agent under the
12Wisconsin basic power of attorney for finances and property is the principal's spouse
13and the marriage is annulled, or the agent and principal are divorced, after signing
14the document, the Wisconsin basic power of attorney for finances and property is
15invalid.
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16(8) Review of agent's performance. (a) An interested party may petition the
17court assigned to exercise probate jurisdiction for the county where a principal is
18present or the county of the principal's legal residence to review whether the agent
19is performing his or her duties in accordance with the terms of the Wisconsin basic
20power of attorney for finances and property executed by the principal. If the court
21finds after a hearing that the agent has not been performing in accordance with the
22terms of the Wisconsin basic power of attorney for finances and property, the court
23may do any of the following:
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1. Direct the agent to act in accordance with the terms of the principal's
25Wisconsin basic power of attorney for finances and property.
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12. Require the agent to report to the court concerning performance of the
2agent's duties at periods of time established by the court.
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3. Rescind all powers of the agent to act under the power of attorney for finances
4and property.
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(b) If the principal has designated an alternate agent and if the powers of the
6first-designated agent are rescinded under par. (a) 3., the alternate agent is the
7agent and is subject to par. (a).
