Fill and Sign the Wi Legal Separation Form

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 and address 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       Address (Street, City, State and Zip) and Stipulation and Order Converting Legal Separation to Divorce Case No.       Enter the name and address of the respondent. If joint petitioners, enter the name of the husband. Respondent/Joint Petitioner-Husband:       First name Middle name Last name       Address (Street, City, State and Zip)Enter the case number. STIPULATION TO CONVERT LEGAL SEPARATION TO DIVORCE JUDGMENT 1. A legal separation was granted on (date)       . 2. The parties agree that the legal separation should be converted to a divorce. 3. We ask the court to issue an order converting the legal separation to a divorce. 4. We have attached a completed vital statistics form. 5. Former Surnames: A . Neither party requests the right to use a former legal surname. B . The wife requests the right to use a former legal surname of       C . 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. The wife should sign and print her name. Enter the date on which you signed your name. Note: This signature does not need to be notarized. u Signature of Wife       Name Printed or Typed       Date The husband should sign and print his name. Enter the date on which you signed your name. Note: This signature does not need to be notarized. u Signature of Husband       Name Printed or Typed       Date FA-4162V, 01/09 Stipulation and Order Converting Legal Separation to Divorce §§765.03(2), 767.35 and 767.395, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2Write the date [month, day, year] on which the legal separation was granted. Check A, B, or C . If A or B , enter the former surname. Stipulation and Order Converting Legal Separation to Divorce Page 2 of 2 Case No. Error: Reference source not found ____________ ORDER 1. The judgment of legal separation is converted to a judgment of divorce. 2. Any party may resume the use of a former legal surname approved in the Findings of Fact, Conclusions of Law and Judgment or as requested in this stipulation. 3. The Findings of Fact Conclusions of Law and Judgment and Marital Settlement Agreement , Proposed Marital Settlement, or Divorce Judgment Addendum previously entered in the legal separation remains in effect without modification. The parties are notified that: It is unlawful for any person who is or has been a party to an action for divorce in any court in this state, or elsewhere, to marry again until 6 months after judgment of divorce is granted, and the marriage of any such person solemnized before the expiration of 6 months from the date of the granting of judgment of divorce shall be void. BY THE COURT: For Court Use Only. Circuit Court Judge/Circuit Court Commissioner       Name Printed or Typed       Date FA-4162V, 01/09 Stipulation and Order Converting Legal Separation to Divorce §§765.03(2), 767.35 and 767.395, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2