AB967: Bill Text

AB967,48,19 SINCE SOME 3RD PARTIES OR SOME TRANSACTIONS MAY NOT PERMIT USE OF THIS DOCUMENT, IT IS ADVISABLE TO CHECK IN ADVANCE, IF POSSIBLE, FOR ANY SPECIAL REQUIREMENTS THAT MAY BE IMPOSED.

AB967,48,21 YOU SHOULD SIGN THIS FORM ONLY IF THE AGENT YOU NAME IS RELIABLE, TRUSTWORTHY AND COMPETENT TO MANAGE YOUR AFFAIRS.

AB967,49,2 I .... (insert your name and address) appoint .... (insert the name and address of the person appointed) as my agent to act for me in any lawful way with respect to the powers initialed below. If the person appointed is unable or unwilling to act as my agent, I appoint .... (insert name and address of alternate person appointed) to act for me in any lawful way with respect to the powers initialed below.

AB967,49,4 TO GRANT ONE OR MORE OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE GRANTING.

AB967,49,6 TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT. YOU MAY, BUT NEED NOT, CROSS OUT EACH POWER WITHHELD.

AB967,49,7 handling my money and property

AB967,49,8 Initials

AB967,49,10 _____ 1. PAYMENTS OF BILLS: My agent may make payments that are necessary or appropriate in connection with the administration of my affairs.

AB967,49,16 _____ 2. BANKING: My agent may conduct business with financial institutions, including endorsing all checks and drafts made payable to my order and collecting the proceeds; signing in my name checks or orders on all accounts in my name or for my benefit; withdrawing funds from accounts in my name; opening accounts in my name; and entering into and removing articles from my safe deposit box.

AB967,49,19 _____ 3. INSURANCE: My agent may obtain insurance of all types, as considered necessary or appropriate, settle and adjust insurance claims and borrow from insurers and 3rd parties using insurance policies as collateral.

AB967,49,22 _____ 4. ACCOUNTS: My agent may ask for, collect and receive money, dividends, interest, legacies and property due or that may become due and owing to me and give receipt for those payments.

AB967,50,2 _____ 5. REAL ESTATE: My agent may manage real property; sell, convey and mortgage realty for prices and on terms as considered advisable; foreclose mortgages and take title to property in my name; and execute deeds, mortgages, releases, satisfactions and other instruments relating to realty.

AB967,50,4 _____ 6. BORROWING: My agent may borrow money and encumber my assets for loans as considered necessary.

AB967,50,8 _____ 7. SECURITIES: My agent may buy, sell, pledge and exchange securities of all kinds in my name; sign and deliver in my name transfers and assignments of securities; and consent in my name to reorganizations, mergers or exchange of securities for new securities.

AB967,50,12 _____ 8. INCOME TAXES: My agent may make and sign tax returns; represent me in all income tax matters before any federal, state, or local tax collecting agency; and receive confidential information and perform any acts that I may perform, including receiving refund checks and the signing of returns.

AB967,50,14 _____ 9. TRUSTS: My agent may transfer at any time any of my property to a living trust that has been established by me before the execution of this document.

AB967,50,15 Professional and Technical Assistance

AB967,50,16 Initials

AB967,50,20 _____ 10. LEGAL ACTIONS: My agent may retain attorneys on my behalf; appear for me in all actions and proceedings to which I may be a party; commence actions and proceedings in my name; and sign in my name all documents or pleadings of every description.

AB967,50,23 _____ 11. PROFESSIONAL ASSISTANCE: My agent may hire accountants, attorneys, clerks, workers and others for the management, preservation and protection of my property and estate.

AB967,50,24 General Authority

AB967,50,25 Initials

AB967,51,7 _____ 12. GENERAL: My agent may do any act or thing that I could do in my own proper person if personally present, including managing or selling tangible assets, disclaiming a probate or nonprobate inheritance and providing support for a minor child or dependent adult. The specifically enumerated powers of the basic power of attorney for finances and property are not a limitation of this intended broad general power except that my agent may not take any action prohibited by law and my agent under this document may not:

AB967,51,8 a. Make medical or health care decisions for me.

AB967,51,9 b. Make, modify or revoke a will for me.

AB967,51,12 c. Other than a burial trust agreement under section 445.125, Wisconsin Statutes, enter into a trust agreement on my behalf or amend or revoke a trust agreement, entered into by me.

AB967,51,16 d. Change any beneficiary designation of any life insurance policy, qualified retirement plan, individual retirement account or payable on death account or the like whether directly or by canceling and replacing the policy or rollover to another plan or account.

AB967,51,18 e. Forgive debts owed to me or disclaim or waive benefits payable to me, except a probate or nonprobate inheritance.

AB967,51,19 f. Appoint a substitute or successor agent for me.

AB967,51,20 g. Make gifts.

AB967,51,21 COMPENSATION TO AGENT FROM PRINCIPAL'S FUNDS

AB967,51,22 Initials

AB967,51,25 _____ 13. compensation. My agent may receive compensation only in an amount not greater than that usual for the services to be performed if expressly authorized in the special instructions portion of this document.

AB967,52,1 accounting

AB967,52,2 Initials

AB967,52,6 _____ 14. accounting. My agent shall render an accounting (monthly) (quarterly) (annually) (CIRCLE ONE) to me or to .... (insert name and address) during my lifetime and a final accounting to the personal representative of my estate, if any is appointed, after my death.

AB967,52,7 Nomination of Guardian

AB967,52,8 Initials

AB967,52,11 _____ 15. GUARDIAN: If necessary, I nominate .... (name) of .... (address) as guardian of my person and I nominate .... (name) of .... (address) as guardian of my estate.

AB967,52,12 special instructions

AB967,52,13 Initials

AB967,52,14 _____ 16. SPECIAL INSTRUCTIONS:

AB967,52,16 ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS REGARDING THE POWERS GRANTED TO YOUR AGENT.

AB967,53,5 TO ESTABLISH WHEN, AND FOR HOW LONG, THE BASIC POWER OF ATTORNEY FOR FINANCES AND PROPERTY IS IN EFFECT, YOU MUST INITIAL ONLY ONE OF THE FOLLOWING 3 OPTIONS. IF YOU DO NOT INITIAL ONE, OR IF YOU INITIAL MORE THAN ONE, THIS BASIC POWER OF ATTORNEY FOR FINANCES AND PROPERTY WILL NOT TAKE EFFECT.

AB967,53,6 Initials

AB967,53,9 _____ This basic power of attorney for finances and property becomes effective when I sign it and will continue in effect as a durable power of attorney under section 243.07, Wisconsin Statutes, if I become disabled or incapacitated.

AB967,53,11 _____ This basic power of attorney for finances and property becomes effective only when both of the following apply:

AB967,53,12 a. I have signed it; and

AB967,53,13 b. I become disabled or incapacitated.

AB967,53,16 _____ This basic power of attorney for finances and property becomes effective when I sign it but will cease to be effective if I become disabled or incapacitated.

AB967,53,21 I agree that any 3rd party who receives a copy of this document may act under it. Revocation of this basic power of attorney is not effective as to a 3rd party until the 3rd party learns of the revocation. I agree to reimburse the 3rd party for any loss resulting from claims that arise against the 3rd party because of reliance on this basic power of attorney.

AB967,53,22 Signed this .... day of ...., (year)

AB967,53,24 ....

AB967,53,25 (Your Signature)

AB967,54,2 ....

AB967,54,3 (Your Social Security Number)

AB967,54,10 By signing as a witness, I am acknowledging the signature of the principal who signed in my presence and the presence of the other witness, and the fact that he or she has stated that this power of attorney reflects his or her wishes and is being executed voluntarily. I believe him or her to be of sound mind and capable of creating this power of attorney. I am not related to him or her by blood or marriage, and, to the best of my knowledge, I am not entitled to any portion of his or her estate under his or her will.

AB967,54,11 Witness: .... Witness: ....

AB967,54,12 Dated: .... Dated: ...

AB967,54,13 By Signature: .... By Signature: ....

AB967,54,14 Print Name: .... Print Name: ....

AB967,54,15 Address: .... Address: ....

AB967,54,16 State of ....

AB967,54,17 County of ....

AB967,54,19 This document was acknowledged before me on .... (date) by .... (name of principal).

AB967,54,20 ....

AB967,54,21 (Signature of Notarial Officer)

AB967,54,22 (Seal, if any)

AB967,54,23 (Title)

AB967,54,24 [My commission is permanent or expires: .... ]

AB967,55,3 BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES AND LIABILITIES OF AN AGENT.

AB967,55,4 ....

AB967,55,5 (Name of Agent)

AB967,55,6 ....

AB967,55,7 (Signature of Agent)

AB967,55,9 This document was drafted by .... (signature of person preparing the document).

Note: Drafting records for 1997 Wis. Act 253 indicate that the witness portion of this form was not properly formatted in double columns and that "Witness" was to be a heading and was not to be followed by dot leaders. "By" is changed to "Signature" for clarity.

AB967, s. 130 Section 130. 251.02 (1) of the statutes, as affected by 1999 Wisconsin Act 9, is amended to read: