Fill and Sign the Fa 4162va Stipulation Converting Legal Separation to Divorce Form

Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4120V , 05 /17 Affidavit of Service §801.10, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mat erial. Page 1 of 2 Enter the name of the county in which this case is filed. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Enter the name of the petitioner. If joint petitioners, enter the name of Petitioner/Joint Petitioner A. IN RE: THE MARRIAGE PATERNITY OF Petitioner/Joint Petitioner A Name (First, Middle and Last) and Enter the name of the respondent. If joint petitioners, enter the name of Respondent/Joint Petitioner B. Affidavit of Service Case No. Respondent/Joint Petitioner B Name (First, Middle and Last) Enter the case number. UNDER OATH I STATE: Note: A party to this action cannot serve the documents on the other party. I am an adult resident of Wisconsin, Illinois, Iowa, Michigan, or Minnesota . I am not a party to this action. On [Date] , 20 at [Time] a.m. p.m. After the documents have been served, the person serving the documents must complete the information. Enter the date [month, day, year], time and the address at which the documents were served. At [Address] I served a copy of the following documents: Authenticated Summons and Petition Order to Show Cause and Affidavit for Temporary Order [Date] , 20 Check the boxes indicating the specific documents that were served. A blank Financial Disclosure Statement If one of the documents is an Order to Show Cause, enter the date [month, day, year] the Order To Show Cause was signed by a court official. Requirement to attend parent education Order to Appear Other: If other, enter the name of the document. Other: Other: Enter the name of the party to whom the papers were served. personally by delivering to and leaving these documents with the person served whom I know to be Take Notice: You must complete this task. At the time of service, I signed my name, time, date, place and manner of service and upon whom service was made on the copy that was served . Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: Affidavit of Service Page 2 of 2 Case No. FA-4120V , 05 /17 Affidavit of Service §801.10, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mat erial. Page 2 of 2 STOP! Take this document to a Notary Public BEFORE you sign it. After you, the server, have been sworn by a Notary Public, sign and print your name and date the document in front of the Notary Public.  Signature Name Printed or Typed Address Phone Number Date Have the Notary Public sign, date, and seal the document. State of County of Subscribed and sworn to before me on Notary Public/Court Official Name Printed or Typed My commission/term expires: (SEAL)