Instructions for Court Ordered mediation forms: 1) Fill out all three (3) forms. 2) Have notarized. 3) Take to the Family Court Commissioner for her signature. 4) Take to Clerk of Courts and have the “original” of each page filed in your court file. 5) You are responsible for distributing three copies of each page: - Family Court Program. - To the other parent. Certified mail is recommended, however, you may choose whatever method you want. - Your copy. American LegalNet, Inc. www.FormsWorkflow.com CIRCUIT COURT STATE OF WISCONSIN FAMILY COURT BRANCH OUTAGAMIE COUNTY ---------------------------------------------------------------------------------------------------------------------IN RE THE MARRIAGE/PATERNITY OF: ___________________________, Petitioner, POST-JUDGMENT ORDER FOR MEDIATION and Case No. _______________ ___________________________, Respondent/Jt. Petitioner. ---------------------------------------------------------------------------------------------------------------------WHEREAS, an affidavit has been filed with the Family Court Commissioner by the Petitioner/Respondent/Joint Petitioner in the above-entitled case, and; WHEREAS, the affidavit alleges problems with respect to the Custody/Physical Placement of the minor child(ren) of the parties, and; WHEREAS, the resolution of these issues is in the best interests of the minor child(ren) of the parties, and; WHEREAS, one of the parties has petitioned the Family Court Commissioner for an Order requiring the parties to mediate the issues of Custody/Physical Placement pursuant to Sec. 767.11(5). NOW THEREFORE, it is Ordered that both parties meet with the Family Court Counselors to participate in mediation. If the mediation is terminated prior to resolution of the issues, either party may move the Family Court Commissioner for an immediate hearing. The party requesting mediation shall be responsible for payment of the mediation fee of $200.00. Said fee shall be paid to the Clerk of Courts for Outagamie County or waived by the Family Court Commissioner within 60 days of the date of this Order. This Order shall become null and void 60 days after the date it is signed unless the mediation fee has been paid in full, or waived, and a copy of this Order has been served upon the other parent/party to the action. Dated and signed at Appleton, Wisconsin, this ________ day of __________________, 20___. BY THE COURT: ___________________________________ Family Court Commissioner American LegalNet, Inc. www.FormsWorkflow.com CIRCUIT COURT STATE OF WISCONSIN FAMILY COURT BRANCH OUTAGAMIE COUNTY ---------------------------------------------------------------------------------------------------------------------IN RE THE MARRIAGE/PATERNITY OF: ___________________________, Petitioner, AFFIDAVIT REQUESTING ORDER FOR POST-JUDGMENT MEDIATION and Case No. _______________ ___________________________, Respondent/Jt. Petitioner. ---------------------------------------------------------------------------------------------------------------------Under Oath, I swear or affirm that: 1. I am the Petitioner/Respondent/Joint Petitioner in the above-captioned case. 2. A Judgment of Divorce/Paternity was granted on _____________________. (date) 3. I have ____ minor children who were subject to the Court’s jurisdiction in the above-entitled case, namely: _________________________________, D.O.B. ___________________ _________________________________, D.O.B. ___________________ _________________________________, D.O.B. ___________________ _________________________________, D.O.B. ___________________ 4. The final Judgment/most recent Order of the Court dated ___________________ gives legal custody to ____________________________. Periods of Physical Placement are designated: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com 5. I am requesting mediation on the following issues: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________. 6. I am requesting mediation because: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________. 7. I believe the other parent will not voluntarily participate in mediation because: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________. 8. I agree to pay the $200.00 mediation fee (OR) I have had the mediation fee waived. 9. To the best of my knowledge all of the above information is true and correct. ____________________________ (Date) ___________________________________________ (Signature) Subscribed and sworn to before me this ______ day of ______________________, 20_____. ________________________________ Notary Public/Clerk of Circuit Court State of Wisconsin My Commission Expires ____________ American LegalNet, Inc. www.FormsWorkflow.com