Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4143VA, 05/19 Stipulation Dismissing Divorce/Legal Separation 247247767.323 and 807.05, Wisconsin 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 Enter the name and address of the Petitioner/Joint P etitio ner A . IN RE : THE MARRIAGE OF P etitioner/Joint Petitioner A Name (First, Middle and Last) Address Address City State Zip a nd Stipulation Dismissing Divorce/ Legal Separation Case No. Enter the name and address of the Respondent/Joint Petitioner B. Respondent/Jo int Petitioner B Name (First, Middle and Last) Address Address City State Zip Enter the case number. IT IS STIPULATED : 1. The above parties wish to dismiss this case without further court proceedings . 2 . We understand that dismis sal of this case does not relieve a party from obligations to pay guardian ad litem fees, mediation fees, custody study fees, or any other court ordered costs. The state reserves the right to collect on any debts owed to it. Any income assignment shall end when the state has been paid in full. 3. If either party is receiving public assistance or there is a caseworker from the Child Support Agency we are providing a copy of this stipulation to the Child Support Agency. 4 . Warrants: Check A or B. If B, describe the warrant that has been issued in this case. A. There are no outstanding warrants to arrest issued in this action. B. There are outstanding warrants to arrest issued in this action . Explain: Note to the parties: This stipulation does not affect any domestic abuse, harassment, or child abuse injunctions under ch. 813, Wisconsin Statutes currently in effect . The Petitioner/Joint Petitioner A must sign and e nter the date on which it was signed. Note: This form does not need to be notarized. Petitioner/Joint Petitioner A Print or Type Name Date The Respondent/Joint Petitioner B must sign and enter the date on which it was signed. Note: This form does not need to be notarized. Respondent/Joint Petitioner B Print or Type Name Date Check box if a lawyer mediator helped to complete this form. This document was prepared with the assistance of a lawyer acting as mediator. PARTIES MUST INCLUDE A PROPOSED ORDER THAT WILL ONLY BECOME ENFORCEABLE IF SIGNED BY A CIRCUIT COURT JUDG E OR CIRCUIT COURT COMMISSIONER . American LegalNet, Inc. www.FormsWorkFlow.com