PRINT in INK
Enter the name of the
county in which this case
is filed. STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY For Official Use
Enter the name of the
petitioner. If joint
petitioners, enter the name
of the wife. In RE: The marriage of
Petitioner/Joint Petitioner-Wife :
First name Middle name Last name
and Proposed Marital
Settlement
With Minor Children
D ivorce-40101
Legal Separation-40201
Case No. Enter the name of the
respondent. If joint
petitioners, enter the name
of the husband. Respondent/Joint Petitioner-Husband :
First name Middle name Last name
Check divorce or legal
separation.
Enter the case number.
I REQUEST THAT THE COURT GRANT THE FOLLOWING:
A. MARITAL RELATIONSHIP
1. Divorce: This marriage is irretrievably broken.
2. Legal Separation : This marriage is broken and the reason I am requesting a legal
separation and not a divorce is
B. MAINTENANCE (Spousal Support)
1. For the Wife:
a. The wife gives up her right to receive maintenance. She understands that by giving
up maintenance at this time, she may never ask for maintenance.
b. The wife is not requesting maintenance at this time, but leaves open her right to request
it until . Her right to request maintenance is limited to:
1. the following circumstance(s) only:
2. any appropriate substantial change in circumstance.
c. The husband shall pay maintenance to the wife in the amount of $ per
month beginning on the first day of the month of , 20 .
Maintenance shall end on the last day of the month of 20 ,
or until the wife remarries, dies, or by court order, whichever comes first.
2. For the Husband:
a. The husband gives up his right to receive maintenance. He understands that by
giving up maintenance at this time, he may never ask for maintenance.
b. The husband is not requesting maintenance at this time, but leaves open his right to
request it until . His right to request maintenance is limited to:
1. the following circumstance(s) only:
2. any appropriate substantial change in circumstance.
c. The wife shall pay maintenance to the husband in the amount of $
per month beginning on the first day of the month of 20 .
Maintenance shall end on the last day of the month of , 20 ,
or until the husband remarries, dies, or by court order, whichever comes first.
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 1 of 10Check 1 or 2.
If 2, enter the reason you
are asking for a legal
separation and not a
divorce.
Check a, b, or c.
If b, enter a date and
choose 1 or 2.
If 1, enter the reasons.
If c, enter the
maintenance amount and
the month and year the
payments should begin
and end.Check a, b, or c.
If b, enter a date and
choose 1 or 2.
If 1, enter the reasons.
If c, enter the
maintenance amount and
the month and year the
payments should begin
and end.
Proposed Marital Settlement With Minor Children Page 2 of 10 Case No. Error: Reference source not found __________
3. Payments shall be made:
a. No payments are ordered to be made.
b. to the Wisconsin Support Collections Trust Fund (WI SCTF) at Box 74200,
Milwaukee, Wisconsin 53274-0200:
1. directly from the payer to WI SCTF ( only allowable if self-employed ).
2 . by income assignment from the payer’s employer as indicated below:
Employer name
Address of payroll office
City State Zip
Phone Fax
4. Arrearages for Previously Ordered Maintenance: The amount of the maintenance
arrears owed to a party shall be paid as follows:
a. No maintenance was previously ordered. There is no amount due.
b. The party has paid all maintenance as ordered. There is no amount due.
c. If there are any arrearages for maintenance now or at the time of the final hearing,
those arrearages are waived and the court financial record shall be set to zero.
d. The parties propose that the amount of the arrears:
1. shall be set as follows: $
2. shall be determined by the court at the time of the final hearing.
and shall be paid and earn interest at the rate of % per year and
payment shall be made as:
A. a one-time payment to the WI SCTF made by (date) .
B. through monthly income withholding by the WI SCTF in the amount of
$ beginning on the first day of the
month of , 20 until the arrearages are paid in full.
C. MEDICAL INSURANCE
No later than the date of the final hearing, each party shall notify the other party in writing of
the availability of COBRA or other continuation benefits under their current health care policy.
D. DEBTS AND LIABILITIES
The following is a listing of ALL the debts and liabilities that we presently owe (either individually
or as a couple) and who I propose shall be responsible for the payment of each debt:
Creditor’s Name Balance To be Paid
by Wife To be Paid
by Husband
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 2 of 10For each debt owed
individually or jointly,
write the name, current
balance, and check who
will be responsible for
payment.
Note: Any and all debts
disclosed on the parties’
Financial Disclosure
Statements that are still
unpaid should be
included here and divided
between the parties. Any
new debts incurred
should also be listed and
divided.
If more space is
necessary, attach
additional sheets.Note: An arrearage is an
amount ordered that has
not been paid and is
overdue.
Check a, b, c or d.
If d, check 1 or 2 and
enter the arrearage
amount.
If 2, enter the interest rate
and check A or B. If A,
enter the date. If B, enter
the amount of the
monthly payment and the
month and year the
payments shall begin. Enter a or b.
If b, check 1 or 2. If 2,
enter the employer
information.
Proposed Marital Settlement With Minor Children Page 3 of 10 Case No. Error: Reference source not found __________
The parties understand that:
Each party assigned a debt shall be fully responsible for that obligation and
shall not make any demands upon the other party concerning that debt.
Any debt not listed shall be the responsibility of the party who incurred it and that party
shall not make any demands upon the other party concerning that debt.
Creditors are NOT bound by this proposal and each party remains liable to creditors for
all marital debts.
Any party who suffers a loss because of a failure of the other party to pay an assigned
debt may enforce that obligation by a motion for contempt of court.
E. PERSONAL PROPERTY DIVISION
1. Division: The parties agree to the final personal property division as indicated below:
List the property and check if the wife or husband
will have permanent use of the property once the
divorce/legal separation is final. Who will have possession?
Wife = W Husband = H
Household Items W H
Automobiles
Year, Make, Model W H
Life Insurance
Name of Company & Policy # W H
Business Interests
Name of Business & Address W H
Securities: Stocks, Bonds, Mutual Funds, Commodity Accounts
Name of Company & # of shares W H
Pension, Retirement Accounts,
Deferred Compensation, 401K Plans, IRAs, Profit Sharing, etc.
Name of Company & Type of Plan W H
Cash and Deposit (Savings & Checking) Accounts
Name of Bank or Financial Institution W H
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 3 of 10Complete this section
with as much detail as
possible.
Note: There are two
types of property. “Real
estate” includes such
things as homes and land.
“Personal property”
includes all other things
such as vehicles, clothing
and other personal items,
furniture, bank accounts,
and retirement or
investment accounts.
Note: If you have
already divided the
property, you must still
disclose how you divided
it below.
Note: Any and all
assets disclosed on the
parties’ Financial
Disclosure Statements
should be included
here and divided
between the parties.
If the parties have
disposed of an asset
from the time the
Financial Disclosure
was done, to the final
hearing, please
indicate what was
disposed and what
happened to it.
Proposed Marital Settlement With Minor Children Page 4 of 10 Case No. Error: Reference source not found __________
Other Personal Property
Description of Asset W H
See attached
2. Exchange: The following items still need to be exchanged between the parties :
a. None: all personal property has already been exchanged to the satisfaction of
both parties.
b. List of items:
The exchange of personal property shall be made by (date)
according to the following arrangements:
Any item of personal property not listed in #2(b) above shall be awarded to the
party who has possession at the time of the final hearing.
F. DIVISION OF REAL ESTATE
1. Neither party owns any real estate at this time.
2. One or both parties own real estate at this time.
a. Primary Residence : The parties own a primary residence located at:
Address
City State Zip
Parcel Identification Number (Tax Key Number)
Attached is a legal description of this property.
1. The primary residence shall be awarded to the:
A. wife
B. husband
and that party shall be responsible for outstanding financial obligations, and
the other party shall be held harmless from any liability. Other provisions
including refinancing requirements, if any:
See attached
2. The residence shall be placed on the market for sale.
A. Pending sale, the mortgage, taxes, and insurance shall be paid by:
1. wife.
2. husband.
3. shared equally.
4. shared as follows:
B. Pending sale, any necessary repairs, special assessments and other
sale-related expenses shall be paid by:
1. wife.
2. husband.
3. shared equally.
4. shared as follows:
The money from the sale of this residence shall be used to pay the usual
costs of a sale and prorations, and any balance on the existing mortgage.
Upon payment of all costs, the proceeds left from the sale shall be
divided between the parties as follows:
a. The wife to receive %.
b. The husband to receive %.
b. Other Real Estate : One or both of the parties own additional real estate,
including any timeshare interests, which is disclosed and divided as set forth in
the attached Schedule A.
Transfer of Title: This proposed marital settlement agreement alone will not transfer title
to one party or the other, but such a transfer requires a fully executed Quit Claim Deed
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 4 of 10Check 1 or 2.
If 2, and the parties own
a primary residence,
check a.
If a, enter the address and
Parcel Identification
Number, which can be
found on your real estate
tax bill.
Attach a copy of the
legal description.
Check 1 or 2.
If 1, check A or B and
enter other provisions, if
any.
If 2, check 1, 2, 3, or 4 in
A or 1, 2, 3, or 4. in B
for the responsibility for
other expenditures that
occur while the property
is being sold.
Enter the percentage each
party shall receive in a
and b. The total amount
must equal 100%.Indicate when and how
any exchange of
property will take
place.Check a or b. If b, list
the items and indicate
when and how any
exchange of personal
property will take place. If more space is
necessary, mark the box
and attach additional
sheets.
If the parties own other
real estate (including any
timeshare interests),
check b, complete the
attached Schedule A
found at the end of this
document.
Proposed Marital Settlement With Minor Children Page 5 of 10 Case No. Error: Reference source not found __________
and a Wisconsin Real Estate Transfer Return signed by the parties. The party
awarded a parcel of real estate shall be responsible for having the necessary documents
prepared.
G. EQUALIZATION OF MARITAL PROPERTY DIVISION
1. No payment is required to be made to equalize the marital property division because:
a. the property and debt division are equalized to the satisfaction of the parties.
b. equalization has been accomplished through a division of real estate sale proceeds.
2. A payment of $ is required to equalize the marital property division.
a. This payment shall be made by the:
1. wife to the husband.
2. husband to the wife.
b. This payment:
1. has already been made.
2. shall be made in a lump sum payment no later than (date) .
3. shall be paid in the amount of $ per month beginning
on the first day of the month of , 20 .
c. The amount shall earn interest until paid in full at the rate of % per year:
1. from the date of the final hearing.
2. from the date the payment was due.
H. TAXES
1. Year of Divorce/Legal Separation:
The parties agree to file their income tax returns for the year of the divorce/legal
separation consistent with the rules of the IRS, Wisconsin Department of Revenue,
and Wisconsin’s Marital Property law.
The parties understand that their marital status on the last day of the year determines
their filing status for that year, whether married or single.
The parties acknowledge that each is responsible for seeking tax advice from a tax
professional with regard to issues of this divorce/legal separation.
2. Years Before Divorce/Legal Separation:
a. Tax returns for all previous years have been filed.
b. The parties agree to file returns for the previous tax years as follows:
1. share preparation expenses, tax liability and/or refund equally.
2. Other:
I. LEGAL NAME RESTORATION
1. Neither party requests the right to use a former legal surname.
2. The wife requests the right to use a former legal surname of
3. The husband requests the right to use a former legal surname of
Note: If this is an action for legal separation, the court cannot allow a spouse to resume a former legal
surname unless and until the judgment is converted to a divorce.
J. LEGAL CUSTODY OF MINOR CHILDREN
The minor children (age 17 or younger) born to or adopted together by the parties, before or
during the marriage, are listed below and the legal custody of each shall be as follows:
Name of Child Birth Date Joint
Legal
Custody Sole Legal
Custody to
Mother Sole Legal
Custody to
Father
Also see attached parenting plan or other separate description.
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 5 of 10Check 1, 2, or 3.
If 2 or 3, enter the
former legal surname.
Enter the name, date of
birth [month, day,
year], of each child
and check custody
option.
Note: To include more
detail, check the box
and attach a parenting
plan or other separate
description. If 1, check a or b.
If 2, enter the amount.
In a, check 1 or 2.
In b, check 1, 2 or 3.
If 2, enter the date
[month, day, year].
If 3, enter the amount
and date.
In c, enter the
percentage and check 1
or 2.
In 2, check a or b.
If b, check 1 or 2.
If 2, indicate how the
parties agree to handle
the filing (expense and
refund, if any).
Proposed Marital Settlement With Minor Children Page 6 of 10 Case No. Error: Reference source not found __________
In a sole legal custody arrangement, the parent not granted sole legal custody, shall file a
medical history form with the court in compliance with §767.41(7m) Wis. Stats.
K. PHYSICAL PLACEMENT OF MINOR CHILDREN
The physical placement of the minor children shall be as follows:
Shared Primary Primary
Name of Minor Child w/Mother w/Father
and the placement schedule shall be as follows:
a. as listed in the attached parenting plan and/or schedule.
b. as follows:
See attached
L. CHILD SUPPORT
1. The child support is based on: (All calculations are based on gross income)
17% for one child.
25% for two children.
29% for three children.
31% for four children.
34% for five or more children.
split-placement formula.
shared-placement formula.
serial-family payer formula.
low-income payer formula.
high-income payer formula.
If not based on options above, explain:
2. Child support shall be paid as follows:
a . The husband shall pay child support to the wife in the amount of $ per month,
beginning on the first day of the month of , 20 .
b. The wife shall pay child support to the husband in the amount of $ per month,
beginning on the first day of the month of , 20 .
c. No child support shall be ordered from either party at this time because
.
3. Payments shall be made:
a. No payments are ordered to be made.
b. to the Wisconsin Support Collections Trust Fund (WI SCTF) at Box 74200,
Milwaukee, Wisconsin 53274-0200:
1. directly from the payer to WI SCTF ( only allowable if self-employed ).
2 . by income assignment from the payer’s employer as indicated below:
Employer name
Address of payroll office
City State Zip
Phone Fax
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 6 of 10 Note: Physical Placement
means where the child
lives or spends their time.
Shared placement occurs
when a child spends at
least 25% or 92 days per
year with each parent.
Otherwise one parent is
considered to have
primary placement.
Enter the names of the
children. Check shared,
primary mother or
primary father for each
child.
Check a or b. If a, attach
parenting plan and/or a
schedule. If b, describe
how placement will be
shared.
Note: Child Support
generally includes costs
for food, shelter,
clothing, transportation,
personal care and
incidental recreational
costs.
For 1, check the
appropriate method of
calculation.
Check a, b, or c. If a or
b, enter the amount and
the month and year the
payment shall begin.
If c, enter the reason
[reference §767.511(1m)]
for a listing of the factors
by which a court can
deviate from child
support standards).
Note: For more
information on DCF 150,
contact your local Child
Support Agency.
In 3, enter a or b.
If b, check 1 or 2. If 2,
enter the employer
information.
Proposed Marital Settlement With Minor Children Page 7 of 10 Case No. Error: Reference source not found __________
4. Arrearages for Child Support: The amount of the child support arrears owed to a party
shall be paid and earn interest at the statutory interest rate. Payments shall be made as
follows:
a. No child support was previously ordered. There is no amount due.
b. The party has paid all child support as ordered. There is no amount due.
c. If there are any arrearages for child support now or at the time of the final hearing,
those arrearages are waived and the court financial record shall be set to zero.
d. I propose that the amount of the arrears:
1. shall be set as follows: $ .
2. shall be determined by the court at the time of the final hearing
and shall be paid as:
A. a one-time payment to the WI SCTF made by (date) .
B. through monthly income withholding by the WI SCTF in the amount of
$ beginning on the first day of the
month of , 20 until the arrearages are paid in full.
5 . Variable costs (required only in cases of shared physical placement), which are
those reasonable costs above basic support costs for a minor child, including but not
limited to child care costs, tuition, a child’s special needs, and other activities that involve
substantial cost:
a. The parties shall consult with each other before incurring any variable costs requiring
reimbursement.
b. Shall be paid as follows (payments must be paid directly to the parent and cannot be
made through WI SCTF):
1. The wife to pay % of the variable costs.
2. The husband to pay % of the variable costs.
c. The request for reimbursement for variable costs shall be made in writing within
days from the day the cost was incurred. Each party shall pay the required
percentage within days from the date of the request.
6. Deductions for Children as dependents and exemptions for income tax purposes:
Name of Child Mother
to claim
in all tax
years Father to
claim in
all tax
years Mother to claim in
even tax years;
Father to claim in
odd tax years Father to claim in
even tax years;
Mother to claim
in odd tax years
7. Any party ordered to pay child support may only claim the minor children as exemptions for
federal and state income tax purposes if he or she is current in payment of child support as
of December 31 of the year in which he or she intends to claim the exemption, pursuant to
DCF 150.02(12).
8. Each party shall cooperate in signing IRS Form 8332, or other appropriate state or federal
tax forms, as necessary, in order to carry out the options selected above.
M. MEDICAL AND HEALTH CARE EXPENSES
1. Medical Insurance and Payments : The medical insurance coverage for the minor
children including medical, dental, orthodontic, hospital, psychiatric, counseling, drug and
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 7 of 10In 5, enter the percentage
each parent shall pay.
The total amount must
equal 100 %.
Enter the number of days
for each deadline.
Note: Variable Costs are
defined in DCF 150.02
(29). Variable cost
orders are mandatory
only for shared
placement situations.
Enter the name of each
child and then check the
box to indicate how the
deduction will be
distributed.Check a, b, c or d.
If d, check 1or 2. If 1,
enter arrearage amount.
If 2, check A or B. If A,
enter the date. If B, enter
the amount of the
monthly payment and the
month and year the
payments shall begin.
Proposed Marital Settlement With Minor Children Page 8 of 10 Case No. Error: Reference source not found __________
other health expenses which is offered now or may be offered by a present or future
employer shall be obtained and paid by:
a. both parties shall provide coverage.
b. The wife shall provide coverage and the husband shall pay $ per month
directly to the wife to cover the difference between single and family coverage.
c. The husband shall provide coverage and the wife shall pay $ per month
directly to the husband to cover the difference between single and family coverage.
This person shall also provide the other parent with copies of policy information and
insurance cards.
2. Uninsured Health Care Expenses : Payments for health care expenses for the minor
children not covered by insurance, including medical, dental, orthodontic, hospital,
psychiatric, counseling, drug and other health expenses shall be paid as follows:
a. The wife to pay % of the total amount.
b. The husband to pay % of the total amount.
3. Reimbursements: Any request for reimbursement from the other party for medical
insurance and uninsured health care expenses shall be made in writing. The other party
shall pay their required percentage within days after receiving a written
request.
N. LIFE INSURANCE
Each party shall keep in full force and pay the premiums on all life insurance presently held
upon his or her life, naming the minor children of the parties as sole primary beneficiaries in
equal shares, until the youngest of the minor children reaches age of 18 or age 19 if they are
pursuing a high school diploma or its equivalent. If current coverage is lost, the party with the
current life insurance policies shall provide equivalent coverage. Each party proposes to
furnish the other with proof of the named sole primary beneficiary upon request. This
provision may be satisfied in a will or trust.
a. The parties do not currently have any life insurance policies in force.
b. The following life insurance policies are currently in full force:
Company Name Policy Number Name of Insured
Neither party may borrow against any life insurance policy after the date of this proposal, nor
use it as collateral, without the written consent of the other party.
O. OTHER PROPOSED AGREEMENTS
1. I have no other proposals, written or oral, concerning this marriage.
2. I have additional written proposals concerning this marriage, copies of which are
attached.
P. UNDERSTANDINGS
I understand that:
I could each get an attorney to review this proposed agreement.
This form was provided as a convenience and may NOT cover all issues.
These proposed agreements may have tax consequences and that seeking tax
advice is suggested.
I have fully disclosed my income, debts, assets and liabilities to each other.
Maintenance is deductible by the payer and taxable to the payee.
Child support is NOT deductible by the payer or taxable to the payee.
I believe that these legal custody and physical placement arrangements are in the
best interests of the minor children at this time .
Any court order regarding child support, legal custody, or physical placement is not
final and may be modified under an appropriate change of circumstances.
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 8 of 10Check a or b.
If b, enter the name of the
company who holds the
policy, the policy
number, and the name of
the party who the policy
currently insures.
Check 1 or 2.
If 2, attach any additional
agreements.Enter the percentage
that each parent will
pay in a and b. The
total must equal 100%.
Enter the number of
days for the deadline. Check a, b or c.
If b or c, enter the
amount, if any, that the
other parent will pay.
Proposed Marital Settlement With Minor Children Page 9 of 10 Case No. Error: Reference source not found __________
If the court orders child support, financial information shall be exchanged
annually. A party who fails to furnish the information as required by the court under
this subsection may be proceeded against for contempt of court under ch. 785 Wis.
Stats.
Any court order regarding the division of property is final as of the date of the final
hearing and can never be changed.
There are certain legal presumptions under Wisconsin law, such as:
Marital property should be divided 50/50.
Legal custody of minor children should be granted jointly to both parents.
A child born or conceived during the marriage is presumed to be the husband’s
child.
Q. VOLUNTARY EXECUTION / NATURE OF PROPOSED AGREEMENT
I assume responsibility for the entire content of this proposed agreement. I have proposed
these agreements freely and voluntarily and not because of any undue influence. I believe
the terms to be fair and reasonable under the circumstances.
I acknowledge that there may be substantial legal and tax implications with regard to this
proposal. I understand that lack of knowledge of the law may not be sufficient to convince
the court that relief from these provisions is required. I acknowledge that I have the right to
seek the advice of my own personal attorney.
R. GENERAL RELEASE
The parties are released from any claim of any nature that may exist. Neither party may, at
any time hereafter, sue the other, personal representatives, and assigns, for the purpose of
enforcing any or all of the rights relinquished and/or waived under this proposal. In the
event any suit shall be commenced, this release, when pleaded, shall constitute a complete
defense to any such claim or suit so instituted by the other party. I understand that this
general release shall not become effective until this Proposed Marital Settlement is
approved by the court.
S. FULL DISCLOSURE AND RELIANCE
I warrant that I have provided an accurate, complete, and current disclosure of all income,
assets, debts, and liabilities. I understand that deliberate failure to provide complete
disclosure constitutes perjury under § 767.127 Wis. Stats. and a fraud upon the court. The
property referred to in this proposed agreement represents all the property in which either
party has any interest. This proposed agreement is based on my financial disclosure
statement.
T. RESTRAINING ORDER
Neither party may interfere with the personal liberty of the other, or to go on the premises
occupied by the other as a residence except with permission of that party.
U. EXECUTION OF DOCUMENTS
Now, or in the future, on demand, the parties shall execute and deliver any and all
documents that may be necessary to carry out the terms and conditions of this proposed
agreement.
V. DIVESTING OF PROPERTY RIGHTS
Except as otherwise provided for in this proposed order, the parties give up all rights to the
property awarded to the other.
All property awarded to a party shall be the separate property of that party.
The parties shall have the right to manage our separate property as if we had never been
married.
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 9 of 10
Proposed Marital Settlement With Minor Children Page 10 of 10 Case No. Error: Reference source not found __________
W. SURVIVAL OF PROPOSED AGREEMENT AFTER JUDGMENT
The provisions of this proposed agreement shall survive any subsequent judgment of
divorce and shall have independent legal significance. This proposed agreement is a
legally binding contract, entered into for good and valuable consideration. It is
contemplated that in the future either party may enforce this proposed agreement in this or
any other court of competent jurisdiction.
X. JURISDICTION
This county shall have jurisdiction for all disputes unless otherwise agreed to in writing or as
provided under Wisconsin Statutes.
Y. APPROVAL OF COURT REQUIRED
I submit this proposed agreement to the court for approval and request the court to
incorporate its terms in the final judgment. Once approved by the court, I understand that
either of us may enforce this proposed agreement in this or any other court of competent
jurisdiction.
Z. WAIVER OF APPEARANCE
The court may proceed with the final hearing without further notice, and consent to judgment
being entered on the petition, pursuant to the terms of this Proposed Marital Settlement
even if the respondent or one of the joint petitioners does not appear .
The party who is proposing
the above agreements must
sign.
Enter the date on which
he/she signed.
Note: This signature does
not need to be notarized.
Signature
Print or Type Name
Date
If the other party does later
agree with your proposal
you may have him/her sign
and print his/her name.
Note: This signature does
not need to be notarized.
Signature
Print or Type Name
Date
State of Wisconsin, Child Support Agency
Approved
Not Approved
Not Required
Authorized Signature
Print or Type Name
Title
Date
Guardian ad Litem
Approved
Not Approved
Not Required (no GAL has been appointed)
Authorized Signature
Print or Type Name
Title
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 10 of 10If a Guardian ad Litem
has been appointed to
your case, you must
take this agreement to
the GAL for his/her
approval.
If not, mark not
required. If either party is receiving
public assistance or there
is a case worker from the
Child Support Agency
assigned to your case, you
must take this agreement
to the Child Support
Agency in your county for
their approval.
If not, mark not required.
If a Guardian ad Litem
has been appointed to
your case, you must
take this agreement to
the GAL for his/her
approval.
If not, mark not
required. If a Guardian ad Litem has
been appointed to your
case, you must take this
agreement to the GAL for
his/her approval.
If not, mark not required.
Proposed Marital Settlement With Minor Children Page 11 of 10 Case No. Error: Reference source not found __________
Date
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 11 of 10
SCHEDULE A – DIVISION OF OTHER REAL ESTATE
A. Parcel 2: The parties own other real estate located at:
Address
City State Zip
Parcel Identification Number (Tax Key Number)
Attached is a legal description of this property.
1. The real estate shall be awarded to the:
a. wife
b. husband
and that party shall be responsible for outstanding financial obligations, and the other party shall be
held harmless from any liability. Other provisions including refinancing requirements, if any:
See attached
2. The residence shall be placed on the market for sale.
a. Pending sale, the mortgage, taxes, and insurance shall be paid by:
1. wife.
2. husband.
3. shared equally.
4. shared as follows:
b. Pending sale, any necessary repairs, special assessments and other sale-related expenses shall be
paid by:
1. wife.
2. husband.
3. shared equally.
4. shared as follows:
The money from the sale of this real estate shall be used to pay the usual costs of a sale and
prorations, and any balance on the existing mortgage. Upon payment of all costs, the proceeds left
from the sale shall be divided between the parties as follow:
a. The wife to receive %.
b. The husband to receive %.
B. Parcel 3: The parties own other real estate located at:
Address
City State Zip
Parcel Identification Number (Tax Key Number)
Attached is a legal description of this property.
1. The real estate shall be awarded to the:
a. wife
b. husband
and that party shall be responsible for outstanding financial obligations, and the other party shall be held
harmless from any liability. Other provisions including refinancing requirements, if any:
See attached
2. The residence shall be placed on the market for sale.
a. Pending sale, the mortgage, taxes, and insurance shall be paid by:
1. wife.
2. husband.
3. shared equally.
4. shared as follows:
b. Pending sale, any necessary repairs, special assessments and other sale-related expenses shall
be paid by:
1. wife.
2. husband.
3. shared equally.
4. shared as follows:
The money from the sale of this real estate shall be used to pay the usual costs of a sale and
prorations, and any balance on the existing mortgage. Upon payment of all costs, the proceeds
left from the sale shall be divided between the parties as follow:
a. The wife to receive %.
b. The husband to receive
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 1 of 1
FA-4152V, 01/09 Proposed Marital Settlement With Minor Children §767.34, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 2 of 10
