AB985,31,1919 State of ....
AB985,31,2020 County of ....
AB985,31,2121 The undersigned, being first duly sworn under oath, states as follows:
AB985,31,2522 This Affidavit of Compliance is executed pursuant to Wis. Stat. § 155.10 (3) to
23document the execution of the power of attorney for health care of [name of principal]
24via remote appearance by 2-way, real-time audiovisual communication technology
25on [date].
AB985,32,1
11. The name and residential address of the principal is ....
AB985,32,22 2. The name and [residential or business] address of remote witness 1 is ....
AB985,32,33 3. The name and [residential or business] address of remote witness 2 is ....
AB985,32,54 4. The address within the state of Wisconsin where the principal was physically
5located at the time the principal signed the power of attorney for health care is ....
AB985,32,86 5. The address within the state of Wisconsin where remote witness 1 was
7physically located at the time the remote witness witnessed the principal's execution
8of the power of attorney for health care is ....
AB985,32,119 6. The address within the state of Wisconsin where remote witness 2 was
10physically located at the time the remote witness witnessed the principal's execution
11of the power of attorney for health care is ....
AB985,32,1512 7. The principal and remote witnesses were all known to each other and to the
13supervising attorney. - OR - The principal and remote witnesses were not all known
14to each other and to the supervising attorney. Each produced the following form of
15photo identification to confirm his or her identity:
AB985,32,1616 ....
AB985,32,1917 8. The principal declared that the principal is 18 years of age or older, that the
18document is the principal's power of attorney for health care, and that the document
19was being executed as the principal's voluntary act.
AB985,32,2320 9. Each of the remote witnesses and the supervising attorney were able to see
21the principal, or an individual 18 years of age or older at the express direction and
22in the physical presence of the principal, sign. The principal appeared to be 18 years
23of age or older and acting voluntarily.
AB985,32,2424 10. The audiovisual technology used for the signing process was ....
AB985,33,10
111. The power of attorney for health care was not signed in counterpart. The
2following methods were used to forward the power of attorney for health care to each
3remote witness for signing and to the supervising attorney after signing. - OR - The
4power of attorney for health care was signed in counterpart. The following methods
5were used to forward each counterpart to the supervising attorney. [If applicable]
6- The supervising attorney physically compiled the signed paper counterparts into
7a single document containing the power of attorney for health care, the signature of
8the principal, and the signatures of the remote witnesses on [date] by [e.g., attaching
9page 7 from each counterpart signed by a remote witness to the back of the power of
10attorney for health care signed by the principal].
AB985,33,1211 12. The name, state bar number, and business or residential address of the
12supervising attorney is ....
AB985,33,1413 13. [Optional] Other information that the supervising attorney considers to be
14material is as follows: ....
AB985,33,1515 .... (signature of supervising attorney)
AB985,33,1716 Subscribed and sworn to before me on .... (date) by .... (name of supervising
17attorney).
AB985,33,1818 .... (signature of notarial officer)
AB985,33,1919 Stamp
AB985,33,2020 .... (Title of office)
AB985,33,2121 [My commission expires: ....]
AB985,7 22Section 7 . 244.05 of the statutes is repealed and recreated to read:
AB985,34,2 23244.05 Execution of power of attorney. (1) To execute a power of attorney,
24the principal must sign the power of attorney, or an individual 18 years of age or older

1at the express direction and in the physical presence of the principal must sign the
2principal's name on the power of attorney.
AB985,34,6 3(2) A signature of the principal, or the signature of an individual signing on
4behalf of the principal, on a power of attorney is presumed to be genuine if the
5principal makes an acknowledgment of the power of attorney before a notarial officer
6authorized under ch. 140 to take acknowledgments.
AB985,34,11 7(3) A signature of the principal, or the signature of an individual signing on
8behalf of the principal, on a power of attorney is presumed to be genuine if the signing
9is witnessed by 2 witnesses via simultaneous remote appearance by 2-way,
10real-time audiovisual communication technology if all of the following conditions are
11satisfied:
AB985,34,1312 (a) The signing is supervised by an attorney in good standing licensed by this
13state. The supervising attorney may serve as one of the remote witnesses.
AB985,34,1514 (b) The principal attests to being physically located in this state during the
152-way, real-time audiovisual communication.
AB985,34,1716 (c) Each remote witness attests to being physically located in this state during
17the 2-way, real-time audiovisual communication.
AB985,34,2118 (d) The principal and each of the remote witnesses identify themselves. If the
19principal and remote witnesses are not personally known to each other and to the
20supervising attorney, the principal and each of the remote witnesses display photo
21identification.
AB985,34,2522 (e) The principal identifies anyone else present in the same physical location
23as the principal and, if possible, the principal makes a visual sweep of the principal's
24physical surroundings so that the supervising attorney and each remote witness can
25confirm the presence of any other person.
AB985,35,4
1(f) The principal displays the power of attorney, confirms the total number of
2pages and the page number of the page on which the principal's signature will be
3affixed, and declares to the remote witnesses and the supervising attorney all of the
4following:
AB985,35,55 1. That the principal is 18 years of age or older.
AB985,35,66 2. That the document is the principal's power of attorney.
AB985,35,77 3. That the document is being executed as a voluntary act.
AB985,35,118 (g) The principal, or another individual 18 years of age or older at the express
9direction and in the physical presence of the principal, signs the power of attorney
10in a manner that allows each of the remote witnesses and the supervising attorney
11to see the execution.
AB985,35,1712 (h) The audiovisual communication technology used allows communication by
13which a person is able to see, hear, and communicate in an interactive way with
14another person in real time using electronic means, except that if the principal, a
15remote witness, or the supervising attorney has an impairment that affects hearing,
16sight, or speech, assistive technology or learned skills may be substituted for audio
17or visual if it allows that person to actively participate in the signing in real time.
AB985,35,1918 (i) The power of attorney indicates that it is being executed pursuant to this
19section.
AB985,35,2020 (j) One of the following occurs:
AB985,36,721 1. The principal, or another person at the direction of the principal, personally
22delivers or transmits by U.S. mail or commercial courier service the entire signed
23original power of attorney to the supervising attorney within a reasonable time after
24execution. The supervising attorney then personally delivers or transmits by U.S.
25mail or commercial courier service the entire signed original power of attorney to the

1remote witnesses within a reasonable time. The first remote witness to receive the
2original power of attorney signs the original power of attorney as a witness and
3forwards the entire signed original power of attorney by personal delivery or U.S.
4mail or commercial courier service within a reasonable time to the 2nd remote
5witness, who signs it as a witness and forwards the entire signed original power of
6attorney by personal delivery or U.S. mail or commercial courier service within a
7reasonable time to the supervising attorney.
AB985,36,228 2. The principal, or another person at the direction of the principal, personally
9delivers or transmits by U.S. mail or commercial courier service the entire signed
10original power of attorney to the supervising attorney within a reasonable time after
11execution and transmits by facsimile or electronic means a legible copy of the entire
12signed power of attorney directly to each remote witness within a reasonable time
13after execution. Each remote witness then signs the transmitted copy of the power
14of attorney as a witness and personally delivers or transmits by U.S. mail or
15commercial courier service the entire signed copy of the power of attorney to the
16supervising attorney within a reasonable time after witnessing. The signed original
17and signed copies together shall constitute one original document, unless the
18supervising attorney, within a reasonable time after receiving the signed original
19and signed copies, compiles the signed original and signed copies into one document
20by attaching the signature pages of each remote witness to the original signed by or
21on behalf of the principal, in which case the compiled document shall constitute the
22original.
AB985,37,623 3. The principal and each of the remote witnesses sign identical copies of the
24original. The principal, or another person at the direction of the principal, and each
25of the remote witnesses personally deliver or transmit by U.S. mail or commercial

1courier service the signed originals to the supervising attorney within a reasonable
2time after execution. All of the signed originals together shall constitute one original
3document, unless the supervising attorney, within a reasonable time after receiving
4all signed originals, compiles the originals into one document by attaching the
5signature pages of each remote witness to the original signed by or on behalf of the
6principal, in which case the compiled document shall constitute the original.
AB985,37,87 (k) The supervising attorney completes an affidavit of compliance that contains
8all of the following information:
AB985,37,99 1. The name and residential address of the principal.
AB985,37,1010 2. The name and residential or business address of each remote witness.
AB985,37,1211 3. The address within this state where the principal was physically located at
12the time the principal signed the power of attorney.
AB985,37,1513 4. The address within this state where each remote witness was physically
14located at the time the remote witness witnessed the principal's execution of the
15power of attorney.
AB985,37,1816 5. A statement that the principal and remote witnesses were all known to each
17other and the supervising attorney or a description of the form of photo identification
18used to confirm the identity of the principal and each remote witness.
AB985,37,2119 6. Confirmation that the principal declared that the principal is 18 years of age
20or older, that the document is the principal's power of attorney, and that the
21document was being executed as the principal's voluntary act.
AB985,37,2522 7. Confirmation that each of the remote witnesses and the supervising attorney
23were able to see the principal, or another individual 18 years of age or older at the
24express direction and in the physical presence of the principal, sign, and that the
25principal appeared to be 18 years of age or older and acting voluntarily.
AB985,38,1
18. A description of the audiovisual technology used for the signing process.
AB985,38,42 9. If the power of attorney was not signed in counterpart, a description of the
3method used to forward the power of attorney to each remote witness for signing and
4to the supervising attorney after signing.
AB985,38,95 10. If the power of attorney was signed in counterpart, a description of the
6method used to forward each counterpart to the supervising attorney and, if
7applicable, how and when the supervising attorney physically compiled the signed
8paper counterparts into a single document containing the power of attorney, the
9signature of the principal, and the signatures of the remote witnesses.
AB985,38,1110 11. The name, state bar number, and business or residential address of the
11supervising attorney.
AB985,38,1512 12. Any other information that the supervising attorney considers to be
13material with respect to the principal's capacity to sign a valid power of attorney, the
14principal's and witnesses' compliance with this section, or any other information that
15the supervising attorney deems relevant to the execution of the power of attorney.
AB985,38,1616 (L) The affidavit of compliance is attached to the power of attorney.
AB985,38,1817 (m) An affidavit of compliance described in this subsection shall be
18substantially in the following form:
AB985,38,1919 AFFIDAVIT OF COMPLIANCE
AB985,38,2020 State of ....
AB985,38,2121 County of ....
AB985,38,2222 The undersigned, being first duly sworn under oath, states as follows:
AB985,38,2523 This Affidavit of Compliance is executed pursuant to Wis. Stat. § 244.05 to
24document the execution of the power of attorney of [name of principal] via remote
25appearance by 2-way, real-time audiovisual communication technology on [date].
AB985,39,1
11. The name and residential address of the principal is ....
AB985,39,22 2. The name and [residential or business] address of remote witness 1 is ....
AB985,39,33 3. The name and [residential or business] address of remote witness 2 is ....
AB985,39,54 4. The address within the state of Wisconsin where the principal was physically
5located at the time the principal signed the power of attorney is ....
AB985,39,86 5. The address within the state of Wisconsin where remote witness 1 was
7physically located at the time the remote witness witnessed the principal's execution
8of the power of attorney is ....
AB985,39,119 6. The address within the state of Wisconsin where remote witness 2 was
10physically located at the time the remote witness witnessed the principal's execution
11of the power of attorney is ....
AB985,39,1512 7. The principal and remote witnesses were all known to each other and to the
13supervising attorney. - OR - The principal and remote witnesses were not all known
14to each other and to the supervising attorney. Each produced the following form of
15photo identification to confirm his or her identity:
AB985,39,1616 ....
AB985,39,1917 8. The principal declared that the principal is 18 years of age or older, that the
18document is the principal's power of attorney, and that the document was being
19executed as the principal's voluntary act.
AB985,39,2320 9. Each of the remote witnesses and the supervising attorney were able to see
21the principal, or another individual 18 years of age or older at the express direction
22and in the physical presence of the principal, sign. The principal appeared to be 18
23years of age or older and acting voluntarily.
AB985,39,2424 10. The audiovisual technology used for the signing process was ....
AB985,40,9
111. The power of attorney was not signed in counterpart. The following
2methods were used to forward the power of attorney to each remote witness for
3signing and to the supervising attorney after signing. - OR - The power of attorney
4was signed in counterpart. The following methods were used to forward each
5counterpart to the supervising attorney. [If applicable] - The supervising attorney
6physically compiled the signed paper counterparts into a single document containing
7the power of attorney, the signature of the principal, and the signatures of the remote
8witnesses on [date] by [e.g., attaching page 7 from each counterpart signed by a
9remote witness to the back of the power of attorney signed by the principal].
AB985,40,1110 12. The name, state bar number, and business or residential address of the
11supervising attorney is ....
AB985,40,1312 13. [Optional] Other information that the supervising attorney considers to be
13material is as follows: ....
AB985,40,1414 .... (signature of supervising attorney)
AB985,40,1615 Subscribed and sworn to before me on .... (date) by .... (name of supervising
16attorney).
AB985,40,1717 .... (signature of notarial officer)
AB985,40,1818 Stamp
AB985,40,1919 .... (Title of office)
AB985,40,2020 [My commission expires: ....]
AB985,8 21Section 8 . 853.03 (2) (c) of the statutes is created to read:
AB985,40,2422 853.03 (2) (c) For purposes this subsection, “conscious presence” includes the
23simultaneous remote appearance by 2-way, real-time audiovisual communication
24technology if all of the following conditions are satisfied:
AB985,41,2
11. The signing is supervised by an attorney in good standing licensed by this
2state. The supervising attorney may serve as one of the remote witnesses.
AB985,41,43 2. The testator attests to being physically located in this state during the
42-way, real-time audiovisual communication.
AB985,41,65 3. Each remote witness attests to being physically located in this state during
6the 2-way, real-time audiovisual communication.
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