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Print Name Here: ....
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Residence Address: ....
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(Make Sure Your Signature is Authenticated or Acknowledged Below.)
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1Authentication
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Signature .... authenticated this .... day of ...., .... (year)
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TITLE: MEMBER STATE BAR OF WISCONSIN
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(If not, .... authorized by s. 706.06, Wis. Stats.)
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6Acknowledgment
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STATE OF WISCONSIN
)
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.... County
)
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Personally came before me this .... day of ...., .... (year) the above named .... to
11me known to be the person who executed the foregoing instrument and acknowledge
12the same.
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Notary Public ...., .... County, Wisconsin.
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My Commission is permanent.
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(If not, state expiration date: ...., .... (year))
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(Signatures may be authenticated or
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acknowledged. Both are not necessary.)
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*Names of persons signing in any capacity should be
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typed or printed below their signatures.
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Signature of Other Spouse: ....
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Print Name Here: ....
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Residence Address: ....
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(Make Sure Your Signature is Authenticated or Acknowledged Below.)
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1Authentication
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Signature .... authenticated this .... day of ...., .... (year)
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TITLE: MEMBER STATE BAR OF WISCONSIN
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(If not, .... authorized by s. 706.06, Wis. Stats.)
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6Acknowledgment
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STATE OF WISCONSIN
)
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.... County
)
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Personally came before me this .... day of ...., .... (year) the above named .... to
11me known to be the person who executed the foregoing instrument and acknowledge
12the same.
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Notary Public ...., .... County, Wisconsin.
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My Commission is permanent.
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(If not, state expiration date: ...., .... (year))
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(Signatures may be authenticated or
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acknowledged. Both are not necessary.)
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*Names of persons signing in any capacity should
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be typed or printed below their signatures.
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21Termination of
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22Statutory terminable individual
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23Property classification agreement
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I UNDERSTAND THAT:
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11. THIS TERMINATION TAKES EFFECT 30 DAYS AFTER MY SPOUSE IS
2NOTIFIED OF THE TERMINATION, AS PROVIDED UNDER SECTION 766.589
3(4) OF THE WISCONSIN STATUTES.
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2. THIS TERMINATION IS PROSPECTIVE; IT DOES NOT AFFECT THE
5CLASSIFICATION OF PROPERTY ACQUIRED BEFORE THE TERMINATION
6BECOMES EFFECTIVE. PROPERTY ACQUIRED AFTER THE TERMINATION
7BECOMES EFFECTIVE IS CLASSIFIED AS PROVIDED UNDER THE MARITAL
8PROPERTY LAW.
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3. IN GENERAL, THIS TERMINATION IS NOT BINDING ON CREDITORS
10UNLESS THEY ARE PROVIDED A COPY OF THE TERMINATION BEFORE
11CREDIT IS EXTENDED.
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The undersigned terminates the statutory terminable individual property
13classification agreement entered into by me and my spouse on .... (date last spouse
14signed the agreement) under section 766.589 of the Wisconsin Statutes.
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Signature: ....
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Print Name Here: ....
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Residence Address: ....
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19Schedule “A"
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20Financial Disclosure
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The following general categories of assets and liabilities are not all inclusive
22and if other assets or liabilities exist they should be listed. Assets should be listed
23according to which spouse has title (including assets owned by a spouse or the
24spouses with one or more third parties) and at their approximate market value.
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25Husband Wife
Spouse (Name) Spouse (Name)
Both Names
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A.
Real estate (gross value)
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B.
Stocks, bonds and mutual funds
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C.
Accounts at and certificates and other
5instruments issued by financial institutions
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D.
Mortgages, land contracts, promissory notes
7and cash
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E.
Partnership interests
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EL.
Limited liability company interests
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F.
Trust interests
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G.
Livestock, farm products, crops
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H.
Automobiles and other vehicles
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I.
Jewelry and personal effects
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J.
Household furnishings
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K.
Life insurance and annuities:
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1.
Face value
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2.
Cash surrender value
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L.
Retirement benefits (include value):
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1.
Pension plans
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2.
Profit sharing plans
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3.
HR-10 KEOGH plans
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5.
Deferred compensation plans
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M.
Other assets not listed elsewhere
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II.
Obligations (total outstanding balance):
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1A.
Mortgages and liens
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B.
Credit cards
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C.
Other obligations to financial institutions
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D.
Alimony, maintenance and child support (per
5month)
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E.
Other obligations (such as other obligations
7to individuals
, guarantees, contingent
8liabilities)
