Fill and Sign the Bench Warrant Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use Case Caption: Bench Warrant Civil      Case No.       Name of Person       Person’s Address       Person’s Phone Number (       )       Person’s Date of Birth       Sex       Race       Driver’s License Number       Height       Weight       Eye Color       Hair Color       Other Identifying Characteristics       TO ANY LAW ENFORCEMENT OFFICER: Arrest and deliver to the sheriff the above named person because this person: failed to appear in court as required: Date of court appearance:       Type of court appearance:       failed to:       . This person may be released upon completion of any all of the following conditions: Completing the attached Order for Financial Disclosure and Financial Disclosure Statement, SC-506. Agreeing to appear at a future supplementary examination at a time and place to be determined by the judgment creditor. Paying the amount owed on the judgment $       . Paying the statutory sheriff’s fees. Paying other costs $       . Performing the following conditions as authorized by the court: (All conditions under this section must be specifically authorized by the court.)       Other:       If the person posts the total amount due and is released, the law enforcement agency shall inform the court and district attorney of any new court date. GF-165 , 10/05 Bench Warrant Civil §§785.04, 857.09, 880.252, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Bench Warrant Civil Page 2 of 2 Case No. Geographic restriction: Statewide Within county of ORI Within adjacent counties of ORI Other: ____________________ BY THE COURT: Circuit Court Judge/Court Commissioner       Name Printed or Typed       Date GF-165 , 12/01 Bench Warrant Civil §§785.04, 857.09, 880.252, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2