Fill and Sign the Wisconsin Order Form

PRINT in BLACK ink Enter the name of the county in which the original case was filed. STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use Check marriage or paternity. If paternity, enter initials of child. In RE: The marriage paternity of:       Enter the name, address, and daytime phone number of the petitioner or joint petitioner from the original case file. Petitioner/Joint Petitioner :       First name Middle name Last name       Current Mailing Address       City State Zip Daytime phone number vs.On the far right, enter the original case number. Decision & Order For Contempt Arrest and Commitment Order Case No.       Enter the name, address, and daytime phone number of the respondent or joint petitioner from the original case file. Respondent/Joint Petitioner :       First name Middle name Last name       Current Mailing Address       City State Zip Daytime phone number Check if the State of Wisconsin is a party or not. If you are unsure, you may call your local Child Support Agency. The State of Wisconsin: (Child Support Agency) is is not a party to this action. HEARING A hearing was conducted in this matter as follows: 1. Before:       Circuit Court Judge/ Circuit Court Commissioner 2 . Location:             3. Date:       APPEARANCES 1. Former Wife/Mother: appeared in person appeared by phone did not appear AND A. was self-represented. B. was represented by Attorney       . 2. Former Husband/Father: appeared in person appeared by phone did not appear AND A. was self-represented. B . was represented by Attorney       . 3. Others appearing at the hearing: A. None. FA-4176V, 01/08 Decision & Order for Contempt §767.78 Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 3 - -Enter the name of the court official who held the hearing and the address and date [month, day, year] of the hearing. Check one box from 1 and check a or b. If b, enter the name of the attorney. Check one box from 2 and check a or b. If b, enter the name of the attorney. Check a, b, c, or d. If b, c, or d, enter the name of the individual who appeared. STOP! Do not complete the remainder of this form unless required by the court official who is hearing this case. Decision & Order for Contempt Page 2 of 3 Case No. ____________ B. Child Support Agency by       . C. Guardian ad Litem (GAL)       . D. Other:       . FINDINGS and ORDER Based on the findings and reasons stated. IT IS ORDERED: 1. The Order to Show Cause requested that       be found in Contempt. A. The above named party IS NOT found to be in Contempt. B. The above named party has intentionally and without legal justification failed to comply with a court order and IS found in Contempt for failure to : 1. Pay child support in the amount of $       per       . 2. Pay maintenance (spousal support) in the amount of $       per       . 3. Pay family support in the amount of $       per       . 4. Pay uninsured medical bills in the total amount of $       . 5. Return property that was awarded to the other party. 6. Sign/complete final documentation (Quit Claim Deed, QDRO, WI Real Estate Transfer Return, vehicle titles, etc.). 7. Pay debts that he/she was ordered to pay. 8. Pay the amount of $       to equalize the property settlement. 9. Allow the other party to claim the children as tax exemptions as ordered. 10. Provide medical insurance cards and/or other medical records. 11. Pay transportation expenses related to placement in the total amount of $       12. Other:       13. Other:       2. Remedial Sanctions (requirements to force compliance with a court order) A. No Remedial Sanctions are ordered. B. The party named in #1 above is ordered arrested and committed to the County jail for       days. 1. With Huber (Work Release) Privileges. 2. Without Huber (Work Release) Privileges. C. Other Sanctions as follows:       D . Effective Date: The Remedial Sanction in B & C above is: 1. Made effective immediately       . 2. Stayed (delayed) until       At which time the party shall report to the County Jail if not in full compliance. 3. Purge Terms: The party is given the ability to purge (get rid of) the contempt by: A. No purge terms are ordered. B. Paying $       1. In a one time payment by the following date       2. Per month beginning       until a. (date)       b. All arrears balances are paid in full. c. Other:       C. Other as follows:       See attached 4. Payments shall be made: A. No payments are ordered to be made. B. to the Wisconsin Support Collections Trust Fund (WI SCTF) at Box 74200, Milwaukee, Wisconsin 53274-0200. 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:       FA-4176V, 01/08 Decision & Order for Contempt §767.78 Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 3Enter the name of the party who was requested to be found in contempt. Check A or B. If B, check all that apply in 1-13 for which the party was found in contempt and enter the corresponding information. Check A, B, and/or C. If B, enter the number of days sentenced and check 1 or 2 to indicate if work release privileges were granted. If C, enter the other punishments. If B or C, complete D by checking 1 or 2 and entering the date. Check A, B, and/or C. If B, enter the amount and the method of payment the court ordered. If C, enter the other terms under which the party may get out of contempt. Mark how the court ordered the payments to be made. Decision & Order for Contempt Page 3 of 3 Case No. ____________ City:       State:       Zip:       Phone:       Fax:       5. Other order(s):       See attached 6. A future hearing A. is NOT required. B. is set for (date)       time       am/pm before       in Room #       . 7. Both parties shall notify the Clerk of Courts and the local Child Support Agency in writing, within 10 business days of any change of address, employment, and of any substantial change in income affecting the ability to pay support. This notification does not change the support order. Any party may file moving papers to change this order. 8. If this matter was heard by a Court Commissioner, and either party requests a new hearing, a Request for New (DeNovo) Hearing must be filed with the Clerk of Court’s within the time period established by local court rule. 9. If this matter was heard by a Circuit Court Judge, this is a final judgment/order for purposes of appeal. FAILURE TO OBEY THIS ORDER IS PUNISHABLE AS CONTEMPT OF COURT AND MAY RESULT IN A JAIL SENTENCE. BY THE COURT: For Court Use Only Signature of Circuit Court Judge/Court Commissioner       Name Printed or Typed       Date RATIFICATION AND CONFIRMATION This Order of the Court Commissioner is ratified and confirmed as an Order of the Circuit Court. BY THE COURT: For Court Use Only Signature of Circuit Court Judge       Name Printed or Typed       Date When you submit this order to the court, you must send copies to the other parties. The other party has up to 5 business days to object to the accuracy of this order. FA-4176V, 01/08 Decision & Order for Contempt §767.78 Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 3 of 3Enter other orders made by the court. Check A or B. If B, enter the date and time of the review hearing, the judge who will preside, and the room number where the hearing will take