Fill and Sign the State of Wisconsin Circuit Court La Crosse County Form

PR IN T i n I N K FA -4 14 3V , 0 1/0 9 S tip ula tio n a nd O rd e r D is m is sin g D iv o rc e /L e gal S ep ara tio n §§7 67.3 2 3 a nd 8 0 7.0 5 W is co nsin S ta tu te s T h is f o rm s h all n ot b e m odif ie d . It m ay b e s u pple m en te d w it h a d dit io nal m ate ria l. P age 1 o f 2 E nte r t h e n am e o f t h e c o unty i n w hic h t h is c ase i s f ile d . S TA TE O F W IS C O NSIN , C IR CUIT C O URT, C O UNTY E nte r t h e n am e o f t h e p etitio n er. I f j o in t p etitio n ers , e n te r t h e n am e o f t h e w if e . F or O ffic ia l U se In R E: T he m arria ge o f P etit io ner/J o in t P etit io ner-W if e F ir s t n am e M id dle n am e L ast n am e a nd E nte r t h e n am e o f t h e r e sp ond en t. I f j o in t p etitio n ers , e n te r t h e n am e o f t h e h usb an d. E nte r t h e c ase n u m ber. R esp onden t/J o in t P etit io ner-H usb an d: F ir s t n am e M id dle n am e L ast n am e S tip ula tio n a n d O rd er D is m is sin g D iv o rc e /L eg al S ep ara tio n C ase N o. S TIP U LA TIO N IT IS S TIP U LA TE D T H AT: 1 . The a bove p artie s h a ve r e co ncil e d. 2 . This a ctio n m ay b e d is m is se d w it h o ut f u rth er c o sts to e it h er o f th e p artie s. 3 . An o rd er m ay b e e nte re d w it h o ut n otic e to e it h er o f th e p artie s. 4 . Any in co m e a ssig nm ent s h all e n d w hen t h e s ta te h as b een p a id in f u ll. T he s ta te r e se rv e s th e r ig ht t o c o lle ct o n a ny d eb ts o w ed to it . 5 . Warra nts : A . T here a re n o o uts ta nd in g w arra nts t o a rre st is su ed in t h is a ctio n. B . T here a re o uts ta nd in g w arra nts to a rre st is su ed in th is a ctio n . E xp la in : N ote t o t h e p artie s: T his s tip u la tio n d o es n ot a ffe ct a ny d om estic a buse , h ara ssm ent, o r c h ild a b use in ju nctio ns u n der § 81 3, W is c o nsin S ta tu te s c u rre ntly in e ffe ct. The w if e m ust s ig n a n d p rin t h er n am e. E nte r t h e d ate o n w hic h t h e w if e s ig n ed . N ote : T his s ig n atu re d oes n ot n eed t o b e n ota riz ed . S ig natu re o f W if e P rin t o r T yp e N am e D ate C heck A o r B . I f B , d esc rib e t h e w arra n t t h at h as b een i s su ed i n t h is c ase . Stip ula tio n a nd O rd er D is m is s in g D iv o rc e /L egal S epara tio n Page 2 o f 2 Case N o. _ _ ___ ___ ___ ___ _ F A -4 14 3V , 0 1/0 9 S tip ula tio n a nd O rd e r D is m is sin g D iv o rc e /L e gal S ep ara tio n §§7 67.3 2 3 a nd 8 0 7.0 5 W is co nsin S ta tu te s T h is f o rm s h all n ot b e m odif ie d . It m ay b e s u pple m en te d w it h a d dit io nal m ate ria l. P age 2 o f 2 T he h usb an d m ust s ig n a n d p rin t h is n am e. E nte r t h e d ate o n w hic h t h e h u sb an d s ig n ed . N ote : T his s ig n atu re d oes n ot n eed t o b e n ota riz ed . S ig natu re o f H usb and P rin t o r T yp e N am e D ate Sta te o f W is co nsin , C hild S upport A gen cy I f e ith er p arty i s r e c eiv in g p ublic a ssis ta n ce o r t h ere i s a c ase w ork er f r o m t h e C hild S up po rt A gen cy a ssig n ed t o y o ur c ase , y o u m ust t a k e t h is a g re e m en t t o t h e C hild S upp ort A gen cy i n y o ur c o un ty f o r t h eir a p p ro val. I f n ot, m ark n ot r e q uir e d . A ppro ve d N ot A ppro ve d N ot R equ ir e d A uth oriz e d S ig natu re P rin t o r T yp e N am e Tit le D ate O RDER IT IS O RDER ED , t h at t h is a ctio n is d is m is se d w it h ou t fu rth er c o sts to e it h er o f th e p artie s. TH IS IS A F IN AL O RD ER F O R P U R PO SES O F A PP EA L. BY T H E C O URT: F or C ou rt U se O nly . C ir c u it C ourt J u dge/C ir c u it C ourt C om m is sio ner P rin t o r T yp e N am e D ate