Fill and Sign the Confidential Petition Addendum Form

PRINT in BLACK ink Enter the name of the county in which this case is filed. STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use This form is used for divorce, legal separation and paternity cases. Some information may not apply to your case. Confidential Petition Addendum Enter the case number and child support IV-D KIDS number, if known. Case No.       IV-D KIDS Case No.       1. Parties A . Wife/Mother Name:       Date of Birth:       Social Security Number:       B. Husband/Father/Alleged Father Name:       Date of Birth:       Social Security Number:       C. Other party (if any):       Date of Birth:       Social Security Number:       See attached. 2. Children A. All children (minor or adult) born to or adopted together by the parties in this action before or during the marriage/relationship are: None Name of child Date of birth Social security number                                                                                           See attached. B. If this is a divorce or legal separation, list other children born to the wife during this marriage, but not fathered by the husband: GF-179, 10/06 Confidential Petition Addendum §§767.215(5), and 767.54, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material.For divorce or legal separation ONLY : Enter the name, date of birth [month, day, year], and social security number for any other children born to the wife during the marriage but not fathered by the husband. If there are none, check None.Enter the name, date of birth [month, day, year], and social security number of each child. If there are no children, check none. Attach additional pages if necessary.Enter the name, date of birth [month, day, year], and social security number of each party. None Name of child Date of birth Social security number                                     See attached. The party(s) filing this addendum must sign and print your name and date the document. Signature       Print or Type Name       Date Signature       Print or Type Name       Date FA-???? DRAFT Pro Se 08/06 Petition Addendum §§765.03(2), 767.09(2), 767.20 and 767.37, Wisconsin Statutes Page 2 of 2