AB43,1652,1919 *....
AB43,1652,2020 TITLE: MEMBER STATE BAR OF WISCONSIN
AB43,1652,2121 (If not, .... authorized by s. 706.06, Wis. Stats.)
AB43,1652,22 22Acknowledgment
AB43,1652,2323 STATE OF WISCONSIN   )
AB43,1652,2424 )   ss.
AB43,1652,2525 .... County   )
AB43,1653,3
1Personally came before me this .... day of ...., .... (year) the above named .... to
2me known to be the person who executed the foregoing instrument and acknowledge
3the same.
AB43,1653,44 *....
AB43,1653,55 Notary Public ...., .... County, Wisconsin.
AB43,1653,66 My Commission is permanent.
AB43,1653,77 (If not, state expiration date: ...., .... (year))
AB43,1653,88 (Signatures may be authenticated or
AB43,1653,99 acknowledged. Both are not necessary.)
AB43,1653,1010 *Names of persons signing in any capacity should be
AB43,1653,1111 typed or printed below their signatures.
AB43,1653,1212 Signature of Other Spouse: ....
AB43,1653,1313 Date: ....
AB43,1653,1414 Print Name Here: ....
AB43,1653,1515 Residence Address: ....
AB43,1653,1616 (Make Sure Your Signature is Authenticated or Acknowledged Below.)
AB43,1653,17 17Authentication
AB43,1653,1818 Signature .... authenticated this .... day of ...., .... (year)
AB43,1653,1919 *....
AB43,1653,2020 TITLE: MEMBER STATE BAR OF WISCONSIN
AB43,1653,2121 (If not, .... authorized by s. 706.06, Wis. Stats.)
AB43,1653,22 22Acknowledgment
AB43,1653,2323 STATE OF WISCONSIN   )
AB43,1653,2424 )   ss.
AB43,1653,2525 .... County   )
AB43,1654,3
1Personally came before me this .... day of ...., .... (year) the above named .... to
2me known to be the person who executed the foregoing instrument and acknowledge
3the same.
AB43,1654,44 *....
AB43,1654,55 Notary Public ...., .... County, Wisconsin.
AB43,1654,66 My Commission is permanent.
AB43,1654,77 (If not, state expiration date: ...., .... (year))
AB43,1654,88 (Signatures may be authenticated or
AB43,1654,99 acknowledged. Both are not necessary.)
AB43,1654,1010 *Names of persons signing in any capacity should
AB43,1654,1111 be typed or printed below their signatures.
AB43,1654,12 12Termination of
AB43,1654,13 13Statutory terminable individual
AB43,1654,14 14Property classification agreement
AB43,1654,1515 I UNDERSTAND THAT:
AB43,1654,1816 1. THIS TERMINATION TAKES EFFECT 30 DAYS AFTER MY SPOUSE IS
17NOTIFIED OF THE TERMINATION, AS PROVIDED UNDER SECTION 766.589
18(4) OF THE WISCONSIN STATUTES.
AB43,1654,2319 2. THIS TERMINATION IS PROSPECTIVE; IT DOES NOT AFFECT THE
20CLASSIFICATION OF PROPERTY ACQUIRED BEFORE THE TERMINATION
21BECOMES EFFECTIVE. PROPERTY ACQUIRED AFTER THE TERMINATION
22BECOMES EFFECTIVE IS CLASSIFIED AS PROVIDED UNDER THE MARITAL
23PROPERTY LAW.
AB43,1655,3
13. IN GENERAL, THIS TERMINATION IS NOT BINDING ON CREDITORS
2UNLESS THEY ARE PROVIDED A COPY OF THE TERMINATION BEFORE
3CREDIT IS EXTENDED.
AB43,1655,64 The undersigned terminates the statutory terminable individual property
5classification agreement entered into by me and my spouse on .... (date last spouse
6signed the agreement) under section 766.589 of the Wisconsin Statutes.
AB43,1655,77 Signature: ....
AB43,1655,88 Date: ....
AB43,1655,99 Print Name Here: ....
AB43,1655,1010 Residence Address: ....
AB43,1655,11 11Schedule “A"
AB43,1655,12 12Financial Disclosure
AB43,1655,1613 The following general categories of assets and liabilities are not all inclusive
14and if other assets or liabilities exist they should be listed. Assets should be listed
15according to which spouse has title (including assets owned by a spouse or the
16spouses with one or more third parties) and at their approximate market value.
AB43,1655,17 17Husband   Wife   Spouse (Name)   Spouse (Name)   Both Names
AB43,1655,1818 I.   Assets:
AB43,1655,1919 A.   Real estate (gross value)
AB43,1655,2020 B.   Stocks, bonds and mutual funds
AB43,1655,2221 C.   Accounts at and certificates and other
22instruments issued by financial institutions
AB43,1655,2423 D.   Mortgages, land contracts, promissory notes
24and cash
AB43,1655,2525 E.   Partnership interests
AB43,1656,1
1EL.   Limited liability company interests
AB43,1656,22 F.   Trust interests
AB43,1656,33 G.   Livestock, farm products, crops
AB43,1656,44 H.   Automobiles and other vehicles
AB43,1656,55 I.   Jewelry and personal effects
AB43,1656,66 J.   Household furnishings
AB43,1656,77 K.   Life insurance and annuities:
AB43,1656,88 1.   Face value
AB43,1656,99 2.   Cash surrender value
AB43,1656,1010 L.   Retirement benefits (include value):
AB43,1656,1111 1.   Pension plans
AB43,1656,1212 2.   Profit sharing plans
AB43,1656,1313 3.   HR-10 KEOGH plans
AB43,1656,1414 4.   IRAs
AB43,1656,1515 5.   Deferred compensation plans
AB43,1656,1616 M.   Other assets not listed elsewhere
AB43,1656,1717 II.   Obligations (total outstanding balance):
AB43,1656,1818 A.   Mortgages and liens
AB43,1656,1919 B.   Credit cards
AB43,1656,2020 C.   Other obligations to financial institutions
AB43,1656,2221 D.   Alimony, maintenance and child support (per
22month)
AB43,1656,2523 E.   Other obligations (such as other obligations
24to individuals, guarantees, contingent
25liabilities)
AB43,1657,1
1III.   Annual compensation for services:
AB43,1657,32 (for example, wages and income from
3self-employment; also include social security,
AB43,1657,44 disability and similar income here)
AB43,1657,55 (IF YOU NEED ADDITIONAL SPACE,
AB43,1657,66 ADD ADDITIONAL SHEETS.)
AB43,3164 7Section 3164 . 767.215 (2) (b) of the statutes is amended to read:
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