Fill and Sign the State of Wisconsin Circuit Court County Form

Petitioner/Joint Petitioner A : Respondent/Joint Petitioner B : FA-4130V, 05/17 Motion for and Notice of New (De Novo) Hearing §757.69(8), W isconsin Statutes / This form shall not be modified. It may be supplemented with additional material. Enter the name of the county in which this case is filed. STATE OF WISCONSIN , CIRCUIT COURT, COUNTY Check marriage or paternity. If paternity, enter initials of child. IN R E: THE MARRIAGE PATERNITY OF Petitioner/Joint Petitioner A Name (First, Middle and Last) Street City State Zip and Enter the name and current mailing address of Petitioner/Joint Petitioner A. Motion for and Notice of New (De Novo) Hearing Case No. Enter the name and current mailing address of Respondent/ Joint Petitioner B. Respondent/Joint Petitioner B Name (First, Middle and Last) Street City State Zip Enter the case number. Enter the name of the other party /parent. To: Name To review the decision of a harassment or domestic abuse injunction, use Motion for DeNovo Hearing, CV -503. Enter the date [month, day, year] that the order was signed, the name of the circuit court commissioner who granted the order, and mark the boxes that describe the issue(s) you want heard again. I request a new hearing on the following issue(s) decided on by the Circuit Court Commissioner: Child Support Maintenance/Family Support Legal Custody/Physical Placement Property and Debt Division Other: Check 1 or 2. If 1, att ach a copy of the signed order. 1. I have attached a copy of the signed Order from the above hearing date. 2. I have not yet received a copy of the s igned Order from the above hearing. The De Novo Hearing is scheduled: Before Circuit Court Judge Location Date Time a.m. p.m. The court may review any decision made by the Circuit Court Commissioner in the order being reviewed . For Court Use Only : The Clerk will complete this section. If you require reasonable accommodations to participate in the court process due to a disability, please call at least 10 days prior to the scheduled court date. Please note that the court does not provide transportation. Sign and print your name. Enter the date in which you signed your name. Note: This signature does not need to be notarized. ► Signature Print or Type Name Date Note: A copy of this request must be served by mail on all other parties who appeared at the original hearing.