Fill and Sign the Respondentjoint Petitioner B Enter the Name of the State Form

Joint Petitioner A: Joint Petitioner B: FA-4111V , 05 /17 Joint Petition-W ithout Minor Children §767.215, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mat erial. Page 1 of 3 Enter the name of the county in which you are filing this case. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Enter the Joint Petitioner A’s name. IN RE : THE MARRIAGE OF Joint Petitioner A Name (First, Middle and Last) Address Address City State Zip and Enter the Joint Petitioner A’s address. On the far right, check divorce or legal separation. Joint Petition Without Minor Children Divorce-40101 Legal Separation-40201 Case No. Enter Joint Petitioner B ’s name. Joint Petitioner B Name (First, Middle and Last) Address Address City State Zip Enter the Joint Petitioner B’s address. Note: Leave case number blank; the clerk will add this. Enter Joint Petitioner A ’s date of birth [Month, Day, Year]. A. We are providing the following information about Joint Petitioner A: 1. Date of birth . 2. Immediately before filing this petition, Joint Petitioner A will have lived in this county for 30 days or more. Yes No For 2, 3, 4 and 5, check yes or no. 3. Immediately before filing this petition, Joint Petitioner A will have lived in the state of Wisconsin for 6 months or more. Military personnel: Please see Basic Guide to Divorce/Legal Separation. Yes No 4. Joint Petitioner A is currently on active duty as a member of the Armed Forces of the United States of America or its allies. Yes No 5. Joint Petitioner A is currently pregnant. Yes No Enter Joint Petitioner B ’s date of birth [Month, Day, Year]. B. We are providing the following information about the Joint Petitioner B: 1. Date of birth . For 2, 3, 4 and 5, check yes or no. 2. Immediately before filing this petition Joint Petitioner B will have lived in this county for 30 days or more. Yes No Military personnel: Please see Basic Guide to Divorce/Legal Separation. 3. Immediately before filing this petition, Joint Petitioner B will have lived in the state of Wisconsin for 6 months or more. Yes No 4. Joint Petitioner B is currently on active duty as a member of the Armed Forces of the United States of America or its allies. Yes No 5. Joint Petitioner B is currently pregnant. Yes No Joint Petitioner A: Joint Petitioner B: Joint Petition – Without Minor Children Page 2 of 3 Case No. FA-4111V, 05/17 Joint Petition-W ithout Minor Children §767.215, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mat erial. Page 2 of 3 Enter the date [Month, Day, Year], city, and state in which you were married. C. We are providing the following marriage information: 1. We were married on [Date] . 2. We were married in [City] [State] . 3. We are filing for: Check a or b. If b, explain why you are filing for a legal separation and not a divorce. a. Divorce: This marriage is irretrievably broken. b. Legal Separation: This marriage is broken and the reason we are requesting a legal separation and not a divorce is Check a or b. 4. Previous Actions This is the first time that either party have filed for divorce or legal separation from each other in W isconsin or in any other state: If b, enter the county and state in which it was filed, the case number assigned to it and check yes or no to indicate if the case has been dismissed. Check yes or no. a. Yes b. No: County State Case No. Has this case been dismissed? Yes No 5. This is Joint Petitioner A ’s first marriage. Yes No If no, respond to 5a-5d with information about Joint Petitioner A’s most recent previous marriage. a . Joint Petitioner A was previously married to . b. The marriage was terminated by divorce. death. c. Date of the divorce or death . d. The divorce was granted in: Name of court City State If Joint Petitioner A had an additional previous marriage, respond to 5e- 5h. e . Joint Petitioner A was also previously married to . f. The marriage was terminated by divorce. death. g. Date of the divorce or death . h. The divorce was granted in: Name of court City State If Joint Petitioner A had more than 2 previous marriages, repeat 5e- 5h on an additional sheet. Check yes or no. 6. This is Joint Petitioner B ’s first marriage. Yes No If no, respond to 6a-6d with information about Joint Petitioner B ’s most recent previous marriage. a. Joint Petitioner B was previously married to . b. The marriage was terminated by divorce. death. c. Date of the divorce or death . d. The divorce was granted in: Name of court City State If Joint Petitioner B had an additional previous marriage, respond to 6e-6h. e. Joint Petitioner B was also previously married to . f. The marriage was terminated by divorce. death. g. Date of the divorce or death . h. The divorce was granted in: Name of court City State If Joint Petitioner B had more than 2 previous marriages, repeat 6e-6 h on an additional sheet. D. We are providing the following information regarding our children: Check a or b. 1. a. No children were born to or adopted together by us before or during our marriage. If b, write the names and dates of birth of all adult children born to a party or adopted by you and the respondent during the marriage. b. All children, who are currently age 18 or older, born to a party, or adopted together by me and the other party during the marriage include: Name of Child Date of Birth Joint Petitioner A: Joint Petitioner B: Joint Petition – Without Minor Children Page 3 of 3 Case No. FA-4111V, 05/17 Joint Petition-W ithout Minor Children §767.215, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mat erial. Page 3 of 3 Check a or b. If a, attach a copy of the written agreement to this petition. 2. We have made written agreements or received orders from the court about some or all of the matters in this action such as maintenance (spousal support) or property division. a. Yes, and we have attached a copy of the written agreement to this Petition. b. No We consent to jurisdiction and waive service of summons. WE ASK THAT THE COURT: If you are requesting maintenance (spousal support) at this time, check yes. If not, check no. 1. Grant a judgment as requested. 2. Enter an order granting maintenance. Yes No 3. Enter other orders as it deems just and equitable. ACTS PROHIBITED BY STATUTE Neither party to this divorce or legal separation action can participate in any of the following activities while this action is pending: 1. Harassing, intimidating, physically abusing or imposing any restr aint on the personal liberty of the other party or a minor child of either of the parties. 2. Encumbering, concealing, damaging, destroying, transferring, or in any other way disposing of property owned by either or both of the parties, without the consent of the other party or an order of the court, except in the usual course of business, in order to secure necessities or in o rder to pay reasonable costs and expenses of the action, including attorney fees. A VIOLATION OF THE ABOVE PROHIBITIONS MAY RESULT IN PUNISHMENT FOR CONTEMPT, WHICH MAY INCLUDE MONETARY PENALTIES, IMPRISONMENT, AND OTHER SANCTIONS AS PROVIDED FOR IN SEC. 785.04 WIS. STATS. These PROHIBITIONS apply until the action is dismissed, a final judgment in th e action is entered, or the court orders otherwise. Joint Petitioner A must sign, print name and enter the date of which the document was signed. Note: This signature does not need to be notarized. ► Joint Petitioner A Print or Type Name Date Joint Petitioner B must sign, print name and enter the date of which the document was signed. Note: This signature does not need to be notarized. ► Joint Petitioner B Print or Type Name Date