AB75-ASA1,1336,1310
_____ 7.
SECURITIES: My agent may buy, sell, pledge and exchange securities
11of all kinds in my name; sign and deliver in my name transfers and assignments of
12securities; and consent in my name to reorganizations, mergers or exchange of
13securities for new securities.
AB75-ASA1,1336,1714
_____ 8.
INCOME TAXES: My agent may make and sign tax returns; represent
15me in all income tax matters before any federal, state, or local tax collecting agency;
16and receive confidential information and perform any acts that I may perform,
17including receiving refund checks and the signing of returns.
AB75-ASA1,1336,1918
_____ 9.
TRUSTS: My agent may transfer at any time any of my property to
19a living trust that has been established by me before the execution of this document.
AB75-ASA1,1336,20
20PROFESSIONAL AND TECHNICAL ASSISTANCE
AB75-ASA1,1336,2522
_____ 10.
LEGAL ACTIONS: My agent may retain attorneys on my behalf;
23appear for me in all actions and proceedings to which I may be a party; commence
24actions and proceedings in my name; and sign in my name all documents or pleadings
25of every description.
AB75-ASA1,1337,3
1_____ 11.
PROFESSIONAL ASSISTANCE: My agent may hire accountants,
2attorneys, clerks, workers and others for the management, preservation and
3protection of my property and estate.
AB75-ASA1,1337,4
4GENERAL AUTHORITY
AB75-ASA1,1337,126
_____ 12.
GENERAL: My agent may do any act or thing that I could do in my
7own proper person if personally present, including managing or selling tangible
8assets, disclaiming a probate or nonprobate inheritance and providing support for
9a minor child or dependent adult. The specifically enumerated powers of the basic
10power of attorney for finances and property are not a limitation of this intended
11broad general power except that my agent may not take any action prohibited by law
12and my agent under this document may not:
AB75-ASA1,1337,1313
a. Make medical or health care decisions for me.
AB75-ASA1,1337,1414
b. Make, modify or revoke a will for me.
AB75-ASA1,1337,1715
c. Other than a burial trust agreement under section 445.125, Wisconsin
16Statutes, enter into a trust agreement on my behalf or amend or revoke a trust
17agreement, entered into by me.
AB75-ASA1,1337,2118
d. Change any beneficiary designation of any life insurance policy, qualified
19retirement plan, individual retirement account or payable on death account or the
20like whether directly or by canceling and replacing the policy or rollover to another
21plan or account.
AB75-ASA1,1337,2322
e. Forgive debts owed to me or disclaim or waive benefits payable to me, except
23a probate or nonprobate inheritance.
AB75-ASA1,1337,2424
f. Appoint a substitute or successor agent for me.
AB75-ASA1,1337,2525
g. Make gifts
.
AB75-ASA1,1338,2
1COMPENSATION TO AGENT FROM
2
PRINCIPAL'S FUNDS
AB75-ASA1,1338,64
_____ 13.
compensation. My agent may receive compensation only in an
5amount not greater than that usual for the services to be performed if expressly
6authorized in the special instructions portion of this document.
AB75-ASA1,1338,129
_____ 14.
accounting. My agent shall render an accounting (monthly)
10(quarterly) (annually) (CIRCLE ONE) to me or to .... (insert name and address)
11during my lifetime and a final accounting to the personal representative of my estate,
12if any is appointed, after my death.
AB75-ASA1,1338,13
13NOMINATION OF GUARDIAN
AB75-ASA1,1338,1715
_____ 15.
GUARDIAN: If necessary, I nominate .... (name) of .... (address) as
16guardian of my person and I nominate .... (name) of .... (address) as guardian of my
17estate.
AB75-ASA1,1338,18
18SPECIAL INSTRUCTIONS
AB75-ASA1,1338,2020
_____ 16.
SPECIAL INSTRUCTIONS:
AB75-ASA1,1338,2221
ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS
22REGARDING THE POWERS GRANTED TO YOUR AGENT.
AB75-ASA1,1339,117
TO ESTABLISH WHEN, AND FOR HOW LONG, THE BASIC POWER OF
8ATTORNEY FOR FINANCES AND PROPERTY IS IN EFFECT, YOU MUST
9INITIAL ONLY ONE OF THE FOLLOWING 3 OPTIONS. IF YOU DO NOT
10INITIAL ONE, OR IF YOU INITIAL MORE THAN ONE, THIS BASIC POWER OF
11ATTORNEY FOR FINANCES AND PROPERTY WILL NOT TAKE EFFECT.
AB75-ASA1,1339,1513
_____ This basic power of attorney for finances and property becomes effective
14when I sign it and will continue in effect as a durable power of attorney under section
15243.07, Wisconsin Statutes, if I become disabled or incapacitated.
AB75-ASA1,1339,1716
_____ This basic power of attorney for finances and property becomes effective
17only when both of the following apply:
AB75-ASA1,1339,1818
a. I have signed it; and
AB75-ASA1,1339,1919
b. I become disabled or incapacitated.
AB75-ASA1,1339,2220
_____ This basic power of attorney for finances and property becomes effective
21when I sign it
but will cease to be effective if I become disabled
22or incapacitated.
AB75-ASA1,1340,223
I agree that any 3rd party who receives a copy of this document may act under
24it. Revocation of this basic power of attorney is not effective as to a 3rd party until
25the 3rd party learns of the revocation. I agree to reimburse the 3rd party for any loss
1resulting from claims that arise against the 3rd party because of reliance on this
2basic power of attorney.
AB75-ASA1,1340,33
Signed this .... day of ...., (year)
AB75-ASA1,1340,55
(Your Signature)
AB75-ASA1,1340,88
(Your Social Security Number)
AB75-ASA1,1340,159
By signing as a witness, I am acknowledging the signature of the principal who
10signed in my presence and the presence of the other witness, and the fact that he or
11she has stated that this power of attorney reflects his or her wishes and is being
12executed voluntarily. I believe him or her to be of sound mind and capable of creating
13this power of attorney. I am not related to him or her by blood, marriage or adoption,
14and, to the best of my knowledge, I am not entitled to any portion of his or her estate
15under his or her will.
AB75-ASA1,1340,16
16Witness Witness
AB75-ASA1,1340,1717
Dated: .... Dated: ....
AB75-ASA1,1340,1818
Signature: .... Signature: ....
AB75-ASA1,1340,1919
Print Name: .... Print Name: ....
AB75-ASA1,1340,2020
Address: .... Address: ....
AB75-ASA1,1340,2222
County of ....
AB75-ASA1,1340,2423
This document was acknowledged before me on .... (date) by .... (name of
24principal).
AB75-ASA1,1341,22
(Signature of Notarial Officer)
AB75-ASA1,1341,33
(Seal, if any)
AB75-ASA1,1341,55
[My commission is permanent or expires: .... ]
AB75-ASA1,1341,86
BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT
7ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES AND
8LIABILITIES OF AN AGENT.
AB75-ASA1,1341,1010
(Name of Agent)
AB75-ASA1,1341,1313
(Signature of Agent)
AB75-ASA1,1341,1514
This document was drafted by .... (signature of person preparing the
15document).
AB75-ASA1,1341,2517
243.10
(7) (b) A principal may revoke a Wisconsin basic power of attorney for
18finances and property and invalidate it at any time by destroying it, by directing
19another person to destroy it in the principal's presence or by signing a written and
20dated statement expressing the principal's intent to revoke. If the agent under the
21Wisconsin basic power of attorney for finances and property is the principal's spouse
22and the marriage is annulled, or the agent and principal are divorced,
or the agent
23is the principal's domestic partner under ch. 770 and the domestic partnership is
24terminated under s. 770.12, after signing the document, the Wisconsin basic power
25of attorney for finances and property is invalid.
AB75-ASA1,1342,62
250.03
(3) (b) Biennially, after first consulting with the adjutant general, local
3health departments, health care providers, as defined in s. 146.81 (1)
(a) to (p), and
4law enforcement agencies, as defined in s. 165.77 (1) (b), the department shall submit
5to the legislature under s. 13.172 (2) and to the governor a report on the preparedness
6of the public health system to address public health emergencies.
AB75-ASA1,1342,8
8250.10 (title)
Grant for dental
Dental services.
AB75-ASA1, s. 2509
10Section
2509. 250.10 (1) of the statutes is renumbered 250.10 (1m) (a) and
11amended to read:
AB75-ASA1,1342,1912
250.10
(1m) (a)
The department shall provide Provide funding in each fiscal
13year to the Marquette University School of Dentistry for clinical education of
14Marquette University School of Dentistry students through the provision of dental
15services by the students and faculty of the Marquette University School of Dentistry
16in underserved areas and to underserved populations in the state, as determined by
17the department in conjunction with the Marquette University School of Dentistry;
18to inmates of correctional centers in Milwaukee County; and in clinics in the city of
19Milwaukee.
AB75-ASA1, s. 2510
20Section
2510. 250.10 (1m) (intro.) of the statutes is created to read:
AB75-ASA1,1342,2121
250.10
(1m) (intro.) The department shall do all of the following:
AB75-ASA1, s. 2511
22Section
2511. 250.10 (2) of the statutes is renumbered 250.10 (1m) (b) and
23amended to read:
AB75-ASA1,1343,224
250.10
(1m) (b)
The department shall distribute Award in each fiscal year to
25qualified applicants grants totaling $25,000 for fluoride supplements, $25,000 for a
1fluoride mouth-rinse program, and $120,000 for a school-based dental sealant
2program.
