AB1000,94,2323
TITLE: MEMBER STATE BAR OF WISCONSIN
AB1000,94,2424
(If not, .... authorized by s. 706.06, Wis. Stats.)
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25Acknowledgment
AB1000,95,1
1STATE OF WISCONSIN
)
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.... County
)
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Personally came before me this .... day of ...., .... (year) the above named .... to
5me known to be the person who executed the foregoing instrument and acknowledge
6the 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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Date: ....
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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.)
AB1000,95,20
20Authentication
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Signature .... authenticated this .... day of ...., .... (year)
AB1000,95,2323
TITLE: MEMBER STATE BAR OF WISCONSIN
AB1000,95,2424
(If not, .... authorized by s. 706.06, Wis. Stats.)
AB1000,95,25
25Acknowledgment
AB1000,96,1
1STATE OF WISCONSIN
)
AB1000,96,33
.... County
)
AB1000,96,64
Personally came before me this .... day of ...., .... (year) the above named .... to
5me known to be the person who executed the foregoing instrument and acknowledge
6the same.
AB1000,96,88
Notary Public ...., .... County, Wisconsin.
AB1000,96,99
My Commission is permanent.
AB1000,96,1010
(If not, state expiration date: ...., .... (year))
AB1000,96,1111
(Signatures may be authenticated or
AB1000,96,1212
acknowledged. Both are not necessary.)
AB1000,96,1313
*Names of persons signing in any capacity should
AB1000,96,1414
be typed or printed below their signatures.
AB1000,96,15
15Termination of
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16statutory terminable individual
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17property classification agreement
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I UNDERSTAND THAT:
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1. THIS TERMINATION TAKES EFFECT 30 DAYS AFTER MY SPOUSE IS
20NOTIFIED OF THE TERMINATION, AS PROVIDED UNDER SECTION 766.589
21(4) OF THE WISCONSIN STATUTES.
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2. THIS TERMINATION IS PROSPECTIVE; IT DOES NOT AFFECT THE
23CLASSIFICATION OF PROPERTY ACQUIRED BEFORE THE TERMINATION
24BECOMES EFFECTIVE. PROPERTY ACQUIRED AFTER THE TERMINATION
1BECOMES EFFECTIVE IS CLASSIFIED AS PROVIDED UNDER THE MARITAL
2PROPERTY LAW.
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3. IN GENERAL, THIS TERMINATION IS NOT BINDING ON CREDITORS
4UNLESS THEY ARE PROVIDED A COPY OF THE TERMINATION BEFORE
5CREDIT IS EXTENDED.
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The undersigned terminates the statutory terminable individual property
7classification agreement entered into by me and my spouse on .... (date last spouse
8signed the agreement) under section 766.589 of the Wisconsin Statutes.
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Signature: ....
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Date: ....
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Print Name Here: ....
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Residence Address: ....
AB1000,97,13
13Schedule “a"
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14Financial Disclosure
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The following general categories of assets and liabilities are not all inclusive
16and if other assets or liabilities exist they should be listed. Assets should be listed
17according to which spouse has title (including assets owned by a spouse or the
18spouses with one or more third parties) and at their approximate market value.
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19Husband Wife
Spouse (Name) Spouse (Name)
Both Names
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I.
Assets:
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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
24instruments issued by financial institutions
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1D.
Mortgages, land contracts, promissory notes
2and 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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A.
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
25month)
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1E.
Other obligations (such as other obligations
2to individuals
, guarantees, contingent
3liabilities)
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III.
Annual compensation for services:
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(for example, wages and income from
6self-employment; also include social security,
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disability and similar income here)
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(IF YOU NEED ADDITIONAL SPACE,
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ADD ADDITIONAL SHEETS.)
AB1000,230
10Section
230. 767.001 (1m) of the statutes is amended to read:
