AB610,11,43 TO GRANT ONE OR MORE OF THE FOLLOWING POWERS, INITIAL THE
4LINE IN FRONT OF EACH POWER YOU ARE GRANTING.
AB610,11,65 TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT.
6YOU MAY, BUT NEED NOT, CROSS OUT EACH POWER WITHHELD.
AB610,11,77 handling my money and property
AB610,11,8 8Initials
AB610,11,109 _____ 1. PAYMENTS OF BILLS: My agent may make payments that are
10necessary or appropriate in connection with the administration of my affairs.
AB610,11,1611 _____ 2. BANKING: My agent may conduct business with financial
12institutions, including endorsing all checks and drafts made payable to my order and
13collecting the proceeds; signing in my name checks or orders on all accounts in my
14name or for my benefit; withdrawing funds from accounts in my name; opening
15accounts in my name; and entering into and removing articles from my safe deposit
16box.
AB610,11,1917 _____ 3. INSURANCE: My agent may obtain insurance of all types, as
18considered necessary or appropriate, settle and adjust insurance claims and borrow
19from insurers and 3rd parties using insurance policies as collateral.
AB610,11,2220 _____ 4. ACCOUNTS: My agent may ask for, collect and receive money,
21dividends, interest, legacies and property due or that may become due and owing to
22me and give receipt for those payments.
AB610,12,223 _____ 5. REAL ESTATE: My agent may manage real property; sell, convey and
24mortgage realty for prices and on terms as considered advisable; foreclose mortgages

1and take title to property in my name; and execute deeds, mortgages, releases,
2satisfactions and other instruments relating to realty.
AB610,12,43 _____ 6. BORROWING: My agent may borrow money and encumber my assets
4for loans as considered necessary.
AB610,12,85 _____ 7. SECURITIES: My agent may buy, sell, pledge and exchange securities
6of all kinds in my name; sign and deliver in my name transfers and assignments of
7securities; and consent in my name to reorganizations, mergers or exchange of
8securities for new securities.
AB610,12,129 _____ 8. INCOME TAXES: My agent may make and sign tax returns; represent
10me in all income tax matters before any federal, state, or local tax collecting agency;
11and receive confidential information and perform any acts that I may perform,
12including receiving refund checks and the signing of returns.
AB610,12,1413 _____ 9. TRUSTS: My agent may transfer at any time any of my property to
14a living trust that has been established by me before the execution of this document.
AB610,12,1515 Professional and technical assistance
AB610,12,16 16Initials
AB610,12,2017 _____ 10. LEGAL ACTIONS: My agent may retain attorneys on my behalf;
18appear for me in all actions and proceedings to which I may be a party; commence
19actions and proceedings in my name; and sign in my name all documents or pleadings
20of every description.
AB610,12,2321 _____ 11. PROFESSIONAL ASSISTANCE: My agent may hire accountants,
22attorneys, clerks, workers and others for the management, preservation and
23protection of my property and estate.
AB610,12,2424 General Authority
AB610,12,25 25Initials
AB610,13,7
1_____ 12. GENERAL: My agent may do any act or thing that I could do in my
2own proper person if personally present, including managing or selling tangible
3assets, disclaiming a probate or nonprobate inheritance and providing support for
4a minor child or dependent adult. The specifically enumerated powers of the basic
5power of attorney for finances and property are not a limitation of this intended
6broad general power except that my agent may not take any action prohibited by law
7and my agent under this document may not:
AB610,13,88 a. Make medical or health care decisions for me.
AB610,13,99 b. Make, modify or revoke a will for me.
AB610,13,1210 c. Other than a burial trust agreement under section 445.125, Wisconsin
11Statutes, enter into a trust agreement on my behalf or amend or revoke a trust
12agreement, entered into by me.
AB610,13,1613 d. Change any beneficiary designation of any life insurance policy, qualified
14retirement plan, individual retirement account or payable on death account or the
15like whether directly or by canceling and replacing the policy or roll over to another
16plan or account.
AB610,13,1817 e. Forgive debts owed to me or disclaim or waive benefits payable to me, except
18a probate or nonprobate inheritance.
AB610,13,1919 f. Appoint a substitute or successor agent for me.
AB610,13,2020 g. Make gifts.
AB610,13,2121 COMPENSATION TO AGENT FROM PRINCIPAL'S FUNDS
AB610,13,22 22Initials
AB610,13,2523 _____ 13. compensation. My agent may receive compensation only in an
24amount not greater than that usual for the services to be performed if expressly
25authorized in the special instructions portion of this document.
AB610,14,1
1accounting
AB610,14,2 2Initials
AB610,14,63 _____ 14. accounting. My agent shall render an accounting (monthly)
4(quarterly) (annually) (CIRCLE ONE) to me or to .... (insert name and address)
5during my lifetime and a final accounting to the personal representative of my estate,
6if any is appointed, after my death.
AB610,14,77 Nomination of guardian
AB610,14,8 8Initials
AB610,14,119 _____ 15. GUARDIAN: If necessary, I nominate .... (name) of .... (address) as
10guardian of my person and I nominate .... (name) of .... (address) as guardian of my
11estate.
AB610,14,1212 special instructions
AB610,14,13 13Initials
AB610,14,1414 _____ 16. SPECIAL INSTRUCTIONS:
AB610,14,1615 ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS
16REGARDING THE POWERS GRANTED TO YOUR AGENT.
AB610,15,117 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AB610,15,73 TO ESTABLISH WHEN, AND FOR HOW LONG, THE BASIC POWER OF
4ATTORNEY FOR FINANCES AND PROPERTY IS IN EFFECT, YOU MUST
5INITIAL ONLY ONE OF THE FOLLOWING 3 OPTIONS. IF YOU DO NOT
6INITIAL ONE, OR IF YOU INITIAL MORE THAN ONE, THIS BASIC POWER OF
7ATTORNEY FOR FINANCES AND PROPERTY WILL NOT TAKE EFFECT.
AB610,15,8 8Initials
AB610,15,119 _____ This basic power of attorney for finances and property becomes effective
10when I sign it and will continue in effect as a durable power of attorney under section
11243.07, Wisconsin Statutes, if I become disabled or incapacitated.
AB610,15,1312 _____ This basic power of attorney for finances and property becomes effective
13only when both of the following apply:
AB610,15,1414 a. I have signed it; and
AB610,15,1515 b. I become disabled or incapacitated.
AB610,15,1816 _____ This basic power of attorney for finances and property becomes effective
17when I sign it but will cease to be effective if I become disabled
18or incapacitated
.
AB610,15,2319 I agree that any 3rd party who receives a copy of this document may act under
20it. Revocation of this basic power of attorney is not effective as to a 3rd party until
21the 3rd party learns of the revocation. I agree to reimburse the 3rd party for any loss
22resulting from claims that arise against the 3rd party because of reliance on this
23basic power of attorney.
AB610,15,2424 Signed this .... day of ...., (year)
AB610,15,2525 ....
AB610,16,1
1(Your Signature)
AB610,16,22 ....
AB610,16,33 (Your Social Security Number)
AB610,16,104 By signing as a witness, I am acknowledging the signature of the principal who
5signed in my presence and the presence of the other witness, and the fact that he or
6she has stated that this power of attorney reflects his or her wishes and is being
7executed voluntarily. I believe him or her to be of sound mind and capable of creating
8this power of attorney. I am not related to him or her by blood or, marriage or
9adoption
, and, to the best of my knowledge, I am not entitled to any portion of his or
10her estate under his or her will.
AB610,16,1111 Witness: ....
AB610,16,1212 Dated: ....
AB610,16,1313 By: ....
AB610,16,1414 Print Name: .....
AB610,16,1515 Address: ....
AB610,16,1616 Witness: ....
AB610,16,1717 Dated: ....
AB610,16,1818 By: ....
AB610,16,1919 Print Name: .....
AB610,16,2020 Address: ....
AB610,16,2121 State of ....
AB610,16,2222 County of ....
AB610,16,2423 This document was acknowledged before me on .... (date) by .... (name of
24principal).
AB610,16,2525 ....
AB610,17,1
1(Signature of Notarial Officer)
AB610,17,22 (Seal, if any)
AB610,17,33 (Title)
AB610,17,44 [My commission is permanent or expires: .... ]
AB610,17,75 BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT
6ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES AND
7LIABILITIES OF AN AGENT.
AB610,17,88 ....
AB610,17,99 (Name of Agent)
AB610,17,1010 ....
AB610,17,1111 (Signature of Agent)
AB610,17,1312 This document was drafted by .... (signature of person preparing the
13document).
AB610, s. 18 14Section 18. 252.15 (1) (eg) of the statutes is amended to read:
AB610,17,1815 252.15 (1) (eg) "Relative" means a spouse, parent, grandparent, stepparent,
16brother, sister, first cousin, nephew or niece; or uncle or aunt within the 3rd degree
17of kinship as computed under s. 852.03 (2), 1995 stats. This relationship may be by
18consanguinity or direct affinity blood, marriage or adoption.
AB610, s. 19 19Section 19. 421.301 (32) (c) of the statutes is amended to read:
AB610,17,2120 421.301 (32) (c) An ancestor or lineal descendant, by blood or adoption, of the
21natural person or that person's spouse; and
AB610, s. 20 22Section 20. 421.301 (32) (d) of the statutes is amended to read:
AB610,17,2523 421.301 (32) (d) Any other relative, by blood or, marriage or adoption, of the
24natural person or that person's spouse who shares the same home with the natural
25person.
AB610, s. 21
1Section 21. 421.301 (33) (d) of the statutes is amended to read:
AB610,18,32 421.301 (33) (d) A relative by blood or , marriage or adoption of a person related
3to the organization who shares the same home with that person.
AB610, s. 22 4Section 22. 615.03 (1) (c) of the statutes is amended to read:
AB610,18,75 615.03 (1) (c) A natural person who issues such an annuity to a relative by blood
6or, marriage or adoption within the 3rd degree of kinship as computed according to
7s. 852.03 (2), 1995 stats.
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