AB75: Bill Text

AB75,1337,8 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.

AB75,1337,12 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.

AB75,1337,14 e. Forgive debts owed to me or disclaim or waive benefits payable to me, except a probate or nonprobate inheritance.

AB75,1337,15 f. Appoint a substitute or successor agent for me.

AB75,1337,16 g. Make gifts.

AB75,1337,18 COMPENSATION TO AGENT FROM PRINCIPAL'S FUNDS

AB75,1337,19 Initials

AB75,1337,22 _____ 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.

AB75,1337,23 ACCOUNTING

AB75,1337,24 Initials

AB75,1338,4 _____ 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.

AB75,1338,5 NOMINATION OF GUARDIAN

AB75,1338,6 Initials

AB75,1338,9 _____ 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.

AB75,1338,10 SPECIAL INSTRUCTIONS

AB75,1338,11 Initials

AB75,1338,12 _____ 16. SPECIAL INSTRUCTIONS:

AB75,1338,14 ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS REGARDING THE POWERS GRANTED TO YOUR AGENT.

AB75,1339,3 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.

AB75,1339,4 Initials

AB75,1339,7 _____ 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.

AB75,1339,9 _____ This basic power of attorney for finances and property becomes effective only when both of the following apply:

AB75,1339,10 a. I have signed it; and

AB75,1339,11 b. I become disabled or incapacitated.

AB75,1339,14 _____ 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.

AB75,1339,19 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.

AB75,1339,20 Signed this .... day of ...., (year)

AB75,1339,21 ....

AB75,1339,22 (Your Signature)

AB75,1339,24 ....

AB75,1339,25 (Your Social Security Number)

AB75,1340,7 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, marriage or adoption, and, to the best of my knowledge, I am not entitled to any portion of his or her estate under his or her will.

AB75,1340,8 Witness Witness

AB75,1340,9 Dated: ....   Dated: ....

AB75,1340,10 Signature: ....  Signature: ....

AB75,1340,11 Print Name: .... Print Name: ....

AB75,1340,12 Address: .... Address: ....

AB75,1340,13 State of ....

AB75,1340,14 County of ....

AB75,1340,16 This document was acknowledged before me on .... (date) by .... (name of principal).

AB75,1340,18 ....

AB75,1340,19 (Signature of Notarial Officer)

AB75,1340,20 (Seal, if any)

AB75,1340,21 (Title)

AB75,1340,22 [My commission is permanent or expires: .... ]

AB75,1340,25 BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES AND LIABILITIES OF AN AGENT.

AB75,1341,1 ....

AB75,1341,2 (Name of Agent)

AB75,1341,4 ....

AB75,1341,5 (Signature of Agent)

AB75,1341,7 This document was drafted by .... (signature of person preparing the document).

AB75, s. 2506 Section 2506. 243.10 (7) (b) of the statutes is amended to read:

AB75,1341,17 243.10 (7) (b) A principal may revoke a Wisconsin basic power of attorney for finances and property and invalidate it at any time by destroying it, by directing another person to destroy it in the principal's presence or by signing a written and dated statement expressing the principal's intent to revoke. If the agent under the Wisconsin basic power of attorney for finances and property is the principal's spouse and the marriage is annulled, or the agent and principal are divorced, or the agent is the principal's domestic partner under ch. 770 and the domestic partnership is terminated under s. 770.12, after signing the document, the Wisconsin basic power of attorney for finances and property is invalid.

AB75, s. 2507 Section 2507. 250.10 (title) of the statutes is amended to read:

AB75,1341,19 250.10 (title) Grant for dental Dental services.

AB75, s. 2508 Section 2508. 250.10 (intro.) of the statutes is repealed.

AB75, s. 2509 Section 2509. 250.10 (1) of the statutes is renumbered 250.10 (1m) (a) and amended to read:

AB75,1342,5 250.10 (1m) (a) The department shall provide Provide funding in each fiscal year to the Marquette University School of Dentistry for clinical education of Marquette University School of Dentistry students through the provision of dental services by the students and faculty of the Marquette University School of Dentistry in underserved areas and to underserved populations in the state, as determined by the department in conjunction with the Marquette University School of Dentistry; to inmates of correctional centers in Milwaukee County; and in clinics in the city of Milwaukee.

AB75, s. 2510 Section 2510. 250.10 (1m) (intro.) of the statutes is created to read:

AB75,1342,7 250.10 (1m) (intro.) The department shall do all of the following:

AB75, s. 2511 Section 2511. 250.10 (2) of the statutes is renumbered 250.10 (1m) (b) and amended to read:

AB75,1342,13 250.10 (1m) (b) The department shall distribute Award in each fiscal year to qualified applicants grants totaling $25,000 for fluoride supplements, $25,000 for a fluoride mouth-rinse program, and $120,000 for a school-based dental sealant program.

AB75, s. 2512 Section 2512. 250.15 (2) (intro.) of the statutes is created to read:

AB75,1342,16 250.15 (2) (intro.) From the appropriation account under s. 20.435 (1) (fh), the department shall, in each fiscal year, award all of the following as grants:

AB75, s. 2513 Section 2513. 250.15 (2) (a) of the statutes is amended to read:

AB75,1342,20 250.15 (2) (a) From the appropriation under s. 20.435 (5) (fh), the department shall award $50,000 in each fiscal year as a grant to To a community health center in a 1st class city, $50,000.

AB75, s. 2514 Section 2514. 250.15 (2) (b) of the statutes is amended to read:

AB75,1343,5 250.15 (2) (b) From the appropriation under s. 20.435 (5) (fh), the department shall award grants in each fiscal year to To community health centers that receive federal grants under 42 USC 254b (e), (g) or (h). Each grant shall equal the amount that results from multiplying the total amount available for grants under this paragraph in the fiscal year in which the grants are to be awarded by the quotient obtained by dividing the amount that the community health center received under 42 USC 254b (e), (g) or (h) in the most recently concluded federal fiscal year in which those grants were made by the total amount of federal grants under 42 USC 254b (e), (g) and (h) made in that federal fiscal year to community health centers in this state.

AB75, s. 2515 Section 2515. 250.15 (2) (c) of the statutes is amended to read:

AB75,1343,9 250.15 (2) (c) From the appropriation under s. 20.435 (5) (fh), the department shall award $50,000 in each fiscal year as a grant to To HealthNet of Janesville, Inc., $50,000.

AB75, s. 2516 Section 2516. 250.16 (1) of the statutes is amended to read:

AB75,1343,17 250.16 (1) The From the appropriation account under s. 20.435 (1) (gi), the department shall enter into an agreement with the Wisconsin Women's Health Foundation, Inc., to make payments from the appropriation under s. 20.435 (5) (fi) to the Wisconsin Women's Health Foundation, Inc., to be used by the Wisconsin Women's Health Foundation, Inc., to fund its efforts to provide women's health outreach and education programs and support for women's health research that improves the quality of life for women and families in this state.

AB75, s. 2517 Section 2517. 250.17 (1) of the statutes is amended to read:

AB75,1344,2 250.17 (1) The From the appropriation account under s. 20.435 (1) (g), the department shall enter into an agreement with Donate Life Wisconsin to make payments from the appropriation under s. 20.435 (5) (g) to Donate Life Wisconsin, to be used to fund its efforts to encourage organ and tissue donation by providing educational programs, promoting or advancing research and patient services, and, at its the discretion of Donate Life Wisconsin, distributing portions of these payments to any other organ and tissue procurement and donation organization in this state that is exempt from taxation under section 501 (a) of the Internal Revenue Code, to be used for these same purposes.

AB75, s. 2518 Section 2518. 250.20 (3) of the statutes is amended to read:

AB75,1344,12 250.20 (3) From the appropriation account under s. 20.435 (5) (1) (kb), the department shall annually award grants for activities to improve the health status of economically disadvantaged minority group members. A person may apply, in the manner specified by the department, for a grant of up to $50,000 in each fiscal year to conduct these activities. An awardee of a grant under this subsection shall provide, for at least 50% of the grant amount, matching funds that may consist of funding or an in-kind contribution. An applicant that is not a federally qualified health center, as defined under 42 CFR 405.2401 (b) shall receive priority for grants awarded under this subsection.

AB75, s. 2519 Section 2519. 250.20 (4) of the statutes is amended to read: