Fill and Sign the Physical Placement 497430935 Form

PRINT in BLACK ink Enter the name of the county in which the original case was filed. STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use Check marriage or paternity. If paternity, enter initials of child. In re the Marriage Paternity of       , Enter your name, address, and daytime phone number. You are the Petitioner for this proceeding. Moving Party (You) :       First name Middle name Last name       Current Mailing Address                         City State Zip Daytime phone number Vs.On the far right, enter the original case number. Order to Enforce Physical Placement Order Case No.       Enter the name, address, and daytime phone number of the other party. Responding Party (Other Party) :       First name Middle name Last name       Current Mailing Address                         City State Zip Daytime phone number Responding Party’s: Date of Birth       Sex       Race       Height       Weight       Hair color       Eye color       HEARING A hearing was conducted in this matter as follows: 1. Before:       Circuit Court Judge/ Circuit Court Commissioner 2 . Location:             3. Date:       APPEARANCES 1. Mother Appeared in person appeared by phone did not appear AND A . Was self-represented. B . Was represented by Attorney       . 2. Father Appeared in person appeared by phone did not appear AND A. Was self-represented. B. Was represented by Attorney       . 3. Others appearing at the hearing: A. None. B. Child Support Agency by       . FA-611 Pro Se, 10/06 Order to Enforce Physical Placement Order §767.471, 801.11, 801.15(4) Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 3STOP! Do not complete the remainder of this form unless required by the court official who is hearing this case.Enter the name of the court official who held the hearing and the address and date [month, day, year] of the hearing. Check one box from 1 and check a or b. If b, enter the name of the attorney. Check one box from 2 and check a or b. If b, enter the name of the attorney. Check a, b, c, or d. If b, c, or d, enter the name of the individual who appeared. C. Guardian ad Litem (GAL)       . D. Other       . FA-611 Pro Se, 10/06 Order to Enforce Physical Placement Order §767.471, 801.11, 801.15(4) Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 3 FINDINGS: THE COURT FINDS: 1. Moving party has filed a motion to enforce a physical placement order. 2. The motion and notice of hearing was was not properly served on the respondent. 3. Other Findings: A. Responding party has intentionally and unreasonably denied the moving party one or more periods of physical placement. B. Responding party has intentionally and unreasonably interfered with one or more of moving party’s periods of physical placement. C. Moving party has incurred a financial loss or expenses as a result of responding party’s intentional and unreasonable failure, without notice, to exercise periods of physical placement under an order or judgment setting specific placement times. D. Responding party is in contempt for failure to comply with the judgment or order. E. Moving party has requested that the sheriff assist in executing or serving an injunction. F. Moving party has not proven the allegations of the petition. ORDERS: IT IS ORDERED: 1. Additional periods of physical placement are granted as follows:       See attached. 2. Reasonable costs and attorney fees are awarded in the amount of $       and are to be paid to       by       . 3. Specific times for the exercise of periods of physical placement are set as follows:       See attached. 4. Responding party is sentenced to the county jail for       days for contempt. Responding party may purge the contempt by complying with the following:       See attached. 5. An injunction is granted ordering the responding party to strictly comply with the placement provisions of the judgment or order. This injunction shall be effective until       . Intentional violation of this injunction is punishable by imprisonment not to exceed two years or a fine not to exceed $10,000 or both. 6 . The sheriff shall assist moving party in executing or serving the injunction on the responding party. 7. Responding party shall pay moving party $       to compensate moving party for financial loss or expenses. 8. All amounts ordered shall be paid to moving party in full within       days of this order or as indicated as follows:       See attached. 9. The responding party to return the child to       by       . 10. This petition is dismissed. The responding party was personally served in court with a copy of this order. BY THE COURT: For Court Use Only _____________________________________________ Circuit Court Judge       _________________________________________ Print or Type Name       _________________________________________ Date When you submit this order to the court, you must send copies to the other parties. The other party has up to 5 business days to object to the accuracy of this order. FA-611 Pro Se, 10/06 Order to Enforce Physical Placement Order §767.471, 801.11, 801.15(4) Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 3 of 3The Findings is the section that includes information or facts that the court official took into consideration before making the Order. 2 and 3: check the correct boxes. 4: Check all that apply in A-F. The Order is the final decision that the court official made based on the facts that were presented in court. Check all that apply in 1-10 and attach and/or enter the corresponding information. Check the last box ONLY if the other party appeared in court and will be provided a copy of this Order before leaving.