Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B:
FA-4150V, 05/17 Marital Settlement Agreement - W ith Minor Children §767.34, W isconsin Statutes
This form shall not be modified. It may be supplemented with additional material. Page 1 of 11 - -
Enter the name of the county in which this case
is filed.
STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
Enter the name of the Petitioner/Joint P etitio ner
A.
IN RE : THE MARRIAGE OF
Petitioner/Joint Petitioner A
Name (First, Middle and Last)
and
Marital Settlement Agreement
With Minor Children
Divorce -40101
Legal Separation -40201
Case No.
Enter the name of the Respondent/ Joint Petitioner B . Res pondent/Joint Petitioner B
Name (First, Middle and Last)
Check divorce or legal separation.
Enter the case number.
Warning: Subject to court approval, t he terms of this agreement will be included in your judgment of divorce or legal
separation. Be sure you understand it completely. Some portions of this agreement cannot be changed after the
court approves it, even if you did not understand or expect how it would affect you. You may wish to speak with a
lawyer before you sign this agreement to be sure you are fully aware of the laws that may apply to you.
WE AGREE AS FOLLOWS:
In A, check 1 or 2. A. 1. MARITAL RELATIONSHIP
If 2, enter reason you are asking for a legal
separation and not a divorce.
2. 1. Divorce. This marriage is irretrievably broken.
3. 2. Legal Separation . This marriage is broken and the reason we are requesting a legal
separation and not a divorce is
B. MAINTENANCE (Spousal Support)
4. 1. Petitioner/Joint Petitioner A :
In B.1, check a, b, or c.
5. a. gives up the rig ht to receive maintenance and understands that by giving u p
maintenance at this time, may never ask for maintenance.
If b, enter a date and choose 1 or 2.
6. b. is not requesting maintenance at this time, but leaves open the right to request it
until . The right to request
maintenance is limited to
If 1, enter the reasons. 7. 1) the following circumstance(s) only:
8. 2) any appropriate substantial change in circumstance.
If c, enter the maintenance
amount and the date the payments should begin and end.
9. c. Respondent/Joint Petitioner B shall pay maintenance to Petitioner/Joint Petitioner
A in the amount of $ per month beginning , 20 .
Maintenance shall end , 20 , or until Petitioner/Joint
Petitioner A remarries, dies, or by court order, whichever comes first.
In 2, check a, b, or c. 10. 2. Respondent/Joint Petitioner B :
11. a. gives up the right to receive maintenance and understands that by giving up
maintenance at this time, may never ask for maintenance.
If b, enter a date and
choose 1 or 2.
12. b. is not requesting maintenance at this time, but leaves open the right to request it
until . The right to request maintenance is limited to
If 1, enter the reasons. 13. 1) the following circumstance(s) only:
14. 2) any appropriate substantial change in circumstance.
If c, enter the maintenance
amount and the date the payments should begin and end.
15. c. Petitioner/Joint Petitioner A shall pay maintenance to Respondent/Joint Petitioner
B in the amount of $ per month beginning , 20 .
Maintenance shall end , 20 , or until the Respondent/Joint
Petitioner B remarries, dies, or by court order, whichever comes first.
In 3, check a or b. 16. 3. Payments shall be made
17. a. no payments are ordered.
If b, check 1 or 2. If 2, enter
employer information.
18. b. to the W isconsin Support Collections Trust Fund (WI SCTF) at Box 74200,
Milwaukee, Wisconsin 53274 -0200
19. 1) directly from the payer to WI SCTF (only allowable if self -employed) .
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20. 2) by income assignment from the payer’s employer as indicated below:
21. Employer name
22. Address of payroll office
23. City State Zip
24. Phone Fax
NOTE: An arrearage is an amount ordered that has not been paid and is overdue.
25. 4. Arrearages for Previously Ordered Maintenance.
26. The parties agree to handle the maintenance arrears as follows:
27. a. No maintenance was previously ordered. There is no amount due.
28. b. The party has paid all maintenance as ordered. There is no amount due.
In 4, c heck a, b, c, d, e or f.
If d, e nter the monthly
payment amount, date
payments begin and the
interest rate percentage for
arrearages.
29. c. If the re are any arrearages for maintenance now or at the time of the final hearing,
those arrearages are waived and the court financial records shall be set at zero.
30. d. As currently reflected in the WI SCTF KIDS computer system and shall be paid
through monthly income withholding b y the WI SCTF in the amount of $
beginning , 20 . The arrears balance shall
earn interest at the rate of % per year until the arrearages are paid in full.
If e, enter the amount of the
arrears balance and check 1
or 2. If 1, enter the date of
the one -time payment. If 2,
enter the monthly payment
amount, the date payments
begin and the interest rate
percentage for arrearages.
31. e. The arrears shall be set at $ and paid through
32. 1) a one -time payment to the WI SCTF made by [Date] , 20 .
33. 2) monthly income withholding by the W I SCTF in the amount of $
beginning , 20 . The arrears balance shall earn
interest at the rate of % per year until the arrearages are paid in full.
34. f. Shall be determined by the court at the time of the final hearing.
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.
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.
D. PERSONAL PROPERTY DIVISION
1. Division. The parties agree to the final personal property division as indicated below:
List the property and check who
will have permanent use of the property once the
divorce/legal separation is final.
Who will have possession?
A = Petitioner/Joint Petitioner A
B = Respondent/Joint Petitioner B
HOUSEHOLD ITEMS A B
If more space is necessary,
mark the box and attach additional sheets.
AUTOMOBILE
Year, Make, Model A B
NOTE: Any and all assets disclosed on the parties’
Financial Disclosure Statements should be included here and divided between the
parties.
LIFE INSURANCE
Name of Company & Policy # A B
NOTE: If you have already
divided the property, you
must still disclose how you
divided it.
BUSINESS INTERESTS
Name of Business & Address A B
If the parties have
SECURITIES: STOCKS, BONDS, MUTUAL FUNDS, COMMODITY ACCOUNTS
Name of Company & # of shares A B
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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.
PENSION, RETIREMENT ACCOUNTS,
DEFERRED COMPENSATIO N, 401K PLANS, IRAS, PROFIT SHARING, ETC.
Name of Company & Type of Plan
A B
CASH AND DEPOSIT (SA VINGS & CHECKING) AC COUNTS
Name of Bank or Financial Institution A B
OTHER PERSONAL PROPE RTY
Description of Asset A B
See attached
Indicate when and how
any exchange of property
will take place.
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] , 20
according to the following arrangements:
Any item of personal property not listed above shall be awarded to the p arty who
has possession at the time of the final hearing. In F, c heck 1 or 2. E. DIVISION OF REAL ESTATE
1. Neither party owns any real estate at this time.
If 2, and the parties own a
primary residence, check a.
If a, enter the address and
Parcel I dentification
Number ( found on your
real estate tax bill ).
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)
Attach a copy of the
legal description.
Attached is a legal description of this property.
1) This primary residence shall be awarded to the
Check 1 or 2. A. Petitioner/Joint Petitioner A
If 1, check A or B and
enter other provisions, if
any.
B. Respondent/Joint Petitioner B
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
If 2, check 1, 2, 3, or 4 in
A, B , and C for the
responsibility for other
expenditures that occur
while the property is being
sold.
2) This residence shall be placed on the market for sale.
A. Pending sale, the residence shall be occupied, used, or managed by
1. Petitioner/Joint Petitioner A .
2. Respondent/Joint Petitioner B .
3. shared equally.
4. Other:
B. Pending sale, the mortgage, taxes, and insurance shall be paid by
1. Petitioner/Joint Petitioner A .
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2. Respondent/Joint Petitioner B .
3. shared equally.
4. Other:
C. Pending sale, any necessary repairs, special assessments and other sale -
related expenses shall be paid by
1. Petitioner/Joint Petitioner A .
2. Respondent/Joint Petitioner B .
3. shared equally.
4. Other:
Enter the percentage each
party shall receive in a and
b. The total amount must
equal 100 %.
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. Petitioner/Joint Petitioner A to receive %.
b. Respondent/Joint Petitioner B to receive %.
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.
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. Both parties understand that this 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 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. F. DEBTS AND LIABILITIES
The following is a listing of ALL the debts and liabilities that we presently owe (both individually and
as a couple) and who we agree shall be responsible for the payment of each debt:
Payment for Payment to
(Creditor)
Balance
Due
Paid by
Petitioner/
Joint Petitioner A
Paid by Respondent/ Joint Petitioner B
Shared
Equally
In F, for each debt owed
individually and 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 div ided between
the parties. Any new
debts incurred should also
be listed and divided.
Mortgage /Rent $
Mortgage /Rent $
Car 1 $
Car 2 $
Car 3 $
Loans -Student $
Loans -Personal $
Loans -Other $
Credit Card 1 $
Credit Card 2 $
Credit Card 3 $
Credit Card 4 $
Other $
Other $
If more space is necessary,
attach additional sheets.
Other $
See attached
The parties agree and understand:
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 the debt.
Creditors are NOT boun d by this agreement and both parties remain 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 or an order to show cause for contem pt of
court.
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In G, c heck 1 or 2. G. EQUALIZATION OF MARITAL PROPERTY DIVISION
If 1, check a or b. 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.
If 2, enter the amount . In
a, check 1 or 2. 2. A payment of $ is required to equalize the marital property division.
a. This payment shall be made by the
1) Petitioner/Joint Petitioner A to Respondent/Joint Petitioner B .
2) Respondent/Joint Petitioner B to Petitioner/Joint Petitioner A .
In b, check 1, 2 or 3. If 2, enter the date [month ,
day, year]. If 3, enter the amount and date.
b. This payment
1) was made.
2) shall be made in a lump sum payment no later than [Date] , 20 .
3) shall be paid in the amount of $ per month beginning , 20 ,
until paid in full.
In c, enter the percentage and check 1 or 2.
c. The amount shall earn interest until paid in full at the rate of % per year from
the date
1) of the final hearing.
2) 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, W isconsin 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 are responsible for seeking tax advice from a
tax professional with regard to issues of this divorce/legal separation.
Child support is NOT deductible by the payer or taxable to the payee.
Maintenance is deductible by the payer and taxable to the payee.
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).
2. Years Before Divorce/Legal Separation.
a. Tax returns for all previous years were 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
In I, check 1, 2, or 3. 1. Neither party requests the right to use a former legal surname.
If 2 or 3, enter the former
legal surname.
2. Petitioner/Joint Petitioner A requests the right to use a former legal surname of .
3. Respondent/Joint Petitioner B requests the right to use a former legal surname of . Note: If this is an action for legal separation, the court cannot allow either party to resume a
former legal surname unless and until the judgment is converted to a divorce. NOTE: Legal custody is the right and responsibility
to make major decisions about a child.
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:
In J, enter the name, date of birth [month, day, year], of each child and check
custody option.
Name of Minor Child Birth Date Joint Legal
Custody
Sole Legal Custody
to Petitioner/
Joint Petitioner A
Sole Legal Custody
to Respondent/
Joint Petitioner B
NOTE: To include more detail, check the box and
attach a parenting plan or other separate description.
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Also see attached parenting plan or other separate description. 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.
NOTE: Physical Placement
means where the child lives
or spends their time.
Shared placement: child
spends at least 25% or 92
days per year with each
parent. Otherwise, one
parent is considered to have
primary placement.
In K, enter the names of the
children. Check shared,
primary mother, or primary
father for each child. If 1,
attach parenting plan and/or
a schedule. If 2, describe
how placement will be
arranged.
K. PHYSICAL PLACEMENT OF MINOR CHILDREN
The physical placement of the minor children shall be as follows:
Name of Minor Child Shared
Primary with
Petitioner/
Joint Petitioner A
Primary with
Respondent/
Joint Petitioner B
and the placement schedule shall be
1. as listed in the attached parenting plan and/or schedule.
2. as follows :
See attached
Check 1 or 2. L. MEDICAL AND HEALTH CARE EXPENSES
1. Medical Insurance and Payments . Parents are required to provide private health
insurance for their minor child(ren) if service providers are located within 30 miles or 30
minutes from the child’s residence and if the cost is reasonable. Reasonable cost is
defined as the difference between single and family coverage where the added cost does
not exceed 5% of the insuri ng parent’s monthly income available for child support. The
insuring parent may receive a contribution toward the cost of the insurance from the other
parent, either as a credit against the child support obligation or an increase in the non -
insuring paren t’s child support obligation as long as the increase does not exceed 5% of
the non -insuring parent’s gross monthly income. The parties agree that such medical
insurance coverage for the minor child(ren) including medical, dental, orthodontic,
hospital, psy chiatric, counseling, drug and other health expenses which is currently
offered shall be provided and paid by
If b, enter who will provide insurance, the out of pocket cost for such
insurance, and the amount the other party will contribute.
a. both parties shall provide private health insurance and neither parent is required
to make a cash contribution to the other.
b. shall provide private health insurance. The
out of pocket cost (difference between single and family coverage) to cover the child(ren)
under such insurance is $ . The other parent shall contribute $
toward that cost (as a reasonable cash contribution) and that amount, if any, is included
as a deviation in the child support calculation in M. Child Support and Financial
Expenses below.
If c, indicate who will be
responsible for providing
public health insurance and
whether the children are
enrolled to need to be
enrolled.
Also, check 1 or 2.
If 2, indicate the cost for
such insurance and the
amount the other party will
contribute.
c. A comprehensive private health insurance policy is not available to either parent at
a reasonable cost. Petitioner/Joint Petitioner A Respondent/Joint Petitioner B
has enrolled in shall promptly apply for Public Health Insurance.
1) There is no out of pocket expense for the above Public Health Insurance.
2) Out of pocket cost for such insurance is $ . The other parent
shall contribute $ toward that cost (as a reasonable cash
contribution) and that amount, if an y, is included as a deviation in the child
support calculation in M.Child Support and Financial Expenses below. If
an accessible private health insurance policy becomes available at a
reasonable cost to either parent, that parent shall enroll the child(r en) as
covered dependents under their health insurance.
If d, check which party has
income below 150% of the
federal poverty level.
d. Petitioner/Joint Petitioner A Res pondent/Joint Petitioner B does n ot have
free health insurance available and has income below 150% of the federal
poverty level and is therefore unable to make a cash contribution toward the
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cost of the child(ren)’s healthcare. The appropriate cash medica l support
obligation is $0. If accessible private health insurance becomes available at a
reasonable cost to either parent, that parent shall enroll the child(ren) as
covered dependents under their health insurance. The insuring parent shall provide the other parent and the child support agency with
copies of policy information and insurance cards. The insuring parent shall inform the
child sup port agency about any change in employment and the availability of
insuran ce.
In 2, enter the percentage
that each parent will pay
in a. and b. The total must
equal 100%.
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. Petitioner/Joint Petitioner A to pay 50% of the total amount. Other: %
b. Respondent/Joint Petitioner B to pay 50% of the total amount. Other: %
In 3, enter the number of days for the deadline. 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. Other: days.
In M. 1, check the guideline
that applies to the specifics of
this case after considering the
gross income of the parties,
other payment obligations of
the parties, and physical
placement of the children. In
2.a, enter the payer’s name,
recipient’s name, payment
frequency (weekly, bi -weekly,
monthly, bi -monthly) and
guideline amount.
M. CHILD SUPPORT AND FINANCIAL EXPENS ES
1. The child support percentage of income standards, the standard calculation, based on
gross income that applies to this case is
17% for one child. split -placement formula.
25% for two children. shared -placement formula.
29% for three children. serial -family parent formula.
31% for four children. low -income payer formula.
34% for five or more children . high -income payer formula.
2. Child Support Order and Basis for any Deviation .
a. Based on the above standard calculation, the amount payable by
to per is
$
In b .1, enter the medical
deviation from L .1.b or c or “0” if none and check if the amount should increase
or decrease the guideline amount .
b. The parties agree to deviate from that amount of child support.
1) A medical cash contribution from above in
L.1.b. or L.1.c.2. MEDICAL AND HEALTH CARE EXPENSES
increases decreases this child support amount by
(If no deviation, enter “0” or “None”)
$
In b .2, enter the other
deviations or 0 if none. I n
c, enter the date the
payment begin s and
determine the net child
support amount after
adding or subtracting the
deviations in 2 .a.
2) A deviation is based on: (Explain the reasons for any other deviation here)
and this increases decreases this child support amount by (If no deviation, enter “0” or “None”)
$
c. Beginning [Date] the amount payable by
to per is (If no child support is to be paid, enter “0” or “Held Open”)
$
3. Payments for Child Support and/or Maintenance shall be made
In 3, check a or b. a. no payments are ordered.
b. to the W isconsin Support Collections Trust Fund (WI SCTF) at Box 74200 ,
Milwaukee, Wisconsin 53274 -0200
If b, check 1 or 2. If 2, enter the payer’s employer information.
NOTE: For more
information on DCF 150,
contact your local Child
Support Agency.
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
NOTE: An arrearage is
an amount ordered that
has not been paid and is
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:
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overdue.
In 4, check a, b, c, d, e or
f. If d, enter the monthly
payment amount and the
date payments begin. If e,
enter the amount of the
arrears balance and check
1 or 2. If 1, enter the date
of the one -time payment.
If 2, enter the amount of
the monthly paymen t and
the date payments begin.
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 at zero.
d. The total amount currently reflected in the WI SCTF KIDS computer system and
shall be paid through monthly income withholding by the WI SCTF in the amount of
$ beginning , 20 until the arrearag es are paid in full.
e. The arrears shall be set at $ and paid through
1) a one -time payment to the WI SCTF made by [Date] .
2) monthly income withholding by the W I SCTF in the amount of $
beginning , 20 until the arrearages are paid in full.
f. Shall be determined by the court at the time of the final hearing.
In 5, if applicable, enter the
percentage each parent
shall pay (if different than
50%). The total amount
must equal 100 %.
In 5.c, enter the number of
days for each deadline.
NOTE: Variable cost
orders are mandatory only for shared placement situations in which a child
spends at least 25% or 92 days per year with each parent.
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. We agree to 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 can’t be made through WI SCTF)
1) Petitioner/Joint Petitioner A to pay 50% of the variable costs.
Other: %
2) Respondent/Joint Petitioner B to pay 50% of the variable costs.
Other: %
c. The request for reimbursement for variable costs shall be made in writing and sent
to the other party within days from the day the cost was incurred. Each party
shall pay the r equired percentage within days from the date of the request.
Other: days.
6. Deductions for Children as dependents and exemptions for income tax purposes.
In 6, enter the name of
each child and then check
the box to indicate how
the deduction will be
distributed.
Name of Child
Petitioner/
Joint Petitioner A to claim in
all tax years
Respondent/
Joint Petitioner B to claim in
all tax years
Petitioner/ Joint Petitioner A to claim in even tax years;
Respondent/ Joint Petitioner B to claim in odd tax years
Respondent/ Joint Petitioner B to claim in even tax years;
Petitioner/ Joint Petitioner A 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 they are substantially current in payment of
child support as of December 31 of the year in which they intend to claim the exemption.
8. Each party agrees to 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. N. LIFE INSURANCE
In N, c heck 1 or 2.
Each party shall keep in full force and pay the premiums on all life insurance presently held
upon their 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 1 8 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 agrees to furnish the other
with proof of the named so le primary beneficiary upon request. This provision may be satisfied
in a will or trust.
If 2, enter the name of the 1. The parties do not currently have any life insurance policies in force.
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company who holds the policy, the policy number, and the name of the party
who the policy currently insures.
2. 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 agreement, nor
use it as collateral, without the written consent of the other party.
In O, check 1 or 2.
If 2, attach any additional
agreements.
O. OTHER AGREEMENTS
We understand that any oral agreements are not enforceable by the court.
1. We have no other agreements, written or oral, concerning this marriage.
2. We have additional written agreements concerning this marriage, copies of which are
attached.
In P, e nter the date by
which you will exchange
financial information each
year.
P. AGREEMENTS and UNDERSTANDINGS
We understand and agree:
We could each get an attorney to review this agreement.
This form was provided as a convenience and may NOT cover all issues.
This agreement may have tax consequences and that seeking tax advice is suggested.
We have each fully disclosed each of our 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.
The parents agree that these legal custody and physical placement arrangements are in
the best interests of the minor child(ren) at this time .
Any court order regarding child support, legal custody, or physical placement is not final
and may be modified under an appro priate change of circumstances.
We must exchange annual financial information no later than [Date] ,
each year. 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, W is. Stats.
Whenever private, accessible and reasonably -priced health insurance becomes available
to either parent at a reasonable cost, that parent shall enroll the child(ren) under the plan,
unless the child(ren) are already enrolled under another private health insurance plan or
unless the parent's income is below 150% of the federal poverty level.
An y 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 W isconsin law, such as:
Marital property should be divided 50/50.
Legal custody of minor chil dren should be granted jointly to both parents.
A child born or conceived during the marriage is presumed to be
Petitioner/Joint Petitioner A Respondent/Joint Petitioner B. Q. VOLUNTARY EXECUTION / NATURE OF AGREEMENT
We assume equal responsibility for the entire content of this agreement. We have entered into
this marital settlement agreement freely and voluntarily and not because of any undue
influence. In some instances, the agreement represents a compromise of disp uted issues. W e
believe the terms to be fair and reasonable under the circumstances.
We acknowledge that there may be substantial legal and tax implications with regard to this
agreement. We understand that lack of knowledge of the law may not be sufficient to convince
the court that relief from these provisions is required. We acknowled ge that each of us has the
right to seek the advice of our own personal attorney. R. MUTUAL / GENERAL RELEASE
We release each other from any claim of any nature that may exist. Neither of us may, at any
time hereafter, sue the other, or our heirs, personal representatives, and assigns, for the
purpose of enforcing any or all of the rights relinquished and/or waive d under this agreement.
We agree that in the event any suit shall be commenced, this release, when pleaded, shall
Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: Marital Settlement Agreement with Minor Children Page 10 of 11 Case No.
FA-4150V , 05/17 Marital Settlement Agreement – with Minor Children §767.34, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 10 of 11
constitute a complete defense to any such claim or suit so instituted by the other party. We
understand that this mutual and general release shall not become effective until this Marital
Settlement Agreement is approved by the court. S. FULL DISCLOSURE AND RELIANCE
We warrant to each other that there has been an accurate, complete, and current disclosure of
all income, assets, debts, and liabilities. We understand and agree 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 agreement represents all the property in which e ither
party has any interest. This agreement is based on our financial disclosure statements. We
relied on these financial representations when entering into this agreement. T. RESTRAINING ORDER
We agree to never 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, we agree to execute and deliver any and all documents that
may be necessary to carry out the terms and conditions of this agreement. V. DIVESTING OF PROPERTY RIGHTS
We give up all rights to the property awarded to the other, except as otherwise provided for in
this agreement.
All property awarded to a party shall be the separate property of that party.
We shall have the right to manage our separate property as if we had never been married. W. SURVIVAL OF AGREEMENT AFTER JUDGMENT
We agree that the provisions of this agreement shall survive any subsequent judgment of
divorce and shall have independent legal significance. This agreement is a legally binding
contract, entered into for good and valuable consideration. It is contemplated that in the future
either of us m ay enforce this 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
We have read this agreement and agree with its terms. We submit this Marital Settlement
Agreement to the court for approval and request the court to incorporate its terms in the final
judgment. Once approved by the court, we understan d that either of us may enforce this
agreement in this or any other court of competent jurisdiction. Z. WAIVER OF APPEARANCE
We agree that 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 Marital Settlement
Agreement even if the respondent or one of the joint petitioners does not appear.
Petitioner/Joint Petitioner A
must sign and print their
name. Enter the date on
which it was signed.
Note: This signature does not need to be notarized.
►
Petitioner/Joint Petitioner A
Print or Type Name
Date
Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: Marital Settlement Agreement with Minor Children Page 11 of 11 Case No.
FA-4150V , 05/17 Marital Settlement Agreement – with Minor Children §767.34, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 11 of 11
Respondent/Joint Petitioner
B must sign and print their
name. Enter the date on
which it was signed.
Note: This signature does
not need to be notarized.
►
Respondent/Joint Petitioner B
Print or Type Name
Date
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.
State of Wisconsin, Child Support Agency
Approved
Not Approved
Not Required
Authorized Signature
Print or Type Name
Title
Date
If a Guardian ad Litem has been appointed to your
case, you must take this agreement to the GAL for their approval.
If not, mark not required .
Guardian ad Litem
Approved
Not Approved
Not Required (no GAL has been appointed)
Authorized Signature
Print or Type Name
Title
Date
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
GA L for his/her
approval.
If not, mark not
required.
Petitioner/Joint Petitioner A: Case No. Respondent/Joint Petitioner B:
FA-4150V, 05/17 Marital Settlement Agreement - W ith Minor Children §767.34, W isconsin Statutes
This form shall not be modified. It may be supplemented with additional material. - - -
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. This property shall be awarded to the A. Petitioner/Joint Petitioner A
B. Respondent/Joint Petitioner B 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. This property shall be placed on the market for sale. A. Pending sale, the property shall be occupied , used , or managed by
1. Petitioner/Joint Petitioner A . 2. Respondent/Joint Petitioner B . 3. shared equally.
4. Other: B. Pending sale, the mortgage, taxes, and insurance shall be paid by 1. Petitioner/Joint Petitioner A .
2. Respondent/Joint Petitioner B . 3. shared equally. 4. Other:
C. Pending sale, any necessary repairs, special assessments and other sale -related expenses shall be pa id by 1. Petitioner/Joint Petitioner A .
2. Respondent/Joint Petitioner B . 3. shared equally. 4. Other:
The money from the sale of this real estate shall be used to pay the usual costs of a sale and proratio ns, 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. Petitioner/Joint Petitioner A to receive %. b. Respondent/Joint Petitioner B 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 descriptio n of this property. 1. This property shall be awarded to the
A. Petitioner/Joint Petitioner A B. Respondent/Joint Petitioner B and that party shall be responsible for outstanding f inancial obligations, and the other party shall be held
harmless from any liability. Other provisions including refinancing requirements, if any: See attached 2. T his property shall be placed on the market for sale.
A. Pending sale, the property shall be occupied, used, or managed by 1. Petitioner/Joint Petitioner A . 2. Respondent/Joint Petitioner B .
3. shared equally. 4. Other: B. Pending sale, the mortgage, taxes, and insurance shall be paid by
1. Petitioner/Joint Petitioner A . 2. Respondent/Joint Petitioner B . 3. shared equally.
4. Other: C. Pending sale, any necessary repairs, special assessments and other sale -related expenses shall be pa id by
1. Petitioner/Joint Petitioner A . 2. Respondent/Joint Petitioner B . 3. shared equally.
4. Other:
