S T A T E O F W I S C O N S I N C I R C U I T C O U R T FAMILY COURT BRANCH In re the Paternity of: __________ _____________________________, Joint Petitioner-Mother and _______________________, S T . C R O I X C O U N T Y CASE TYPE: PATERNITY CASE CODE: 40501 JOINT PETITION Case # _____ PA ________________________ Joint Petitioner-Father The joint petitioner – (mother/father) _____________________________________________________, joins the joint petitioner – (mother/father) _________________________________________________________, and state as follows: Mother Name ________________________________________ Date of Birth __________________________________ Address ______________________________________ _____________________________________________ Home phone no. _______________________________ Work phone no. ________________________________ Employer _____________________________________ Address ______________________________________ _____________________________________________ Social Security no. _____________________________ Father Name ________________________________________ Date of Birth __________________________________ Address ______________________________________ _____________________________________________ Home phone no. _______________________________ Work phone no. ________________________________ Employer _____________________________________ Address ______________________________________ _____________________________________________ Social Security no. _____________________________ 1. That the child, ___________________________________, born on ______________________________, in _________________________________; currently resides with joint petitioner (mother/father). 2. No other action to determine paternity of the child or rebut the presumption of paternity to the child has been commenced, or is pending before any judge or court commissioner, in this state or elsewhere. 3. The joint petitioners have (not) entered into any written agreements as to support, custody, or visitation of the child(ren) (a copy of which agreement is attached). 4. Joint petitioners __________________________________ and ________________________________, consent to the personal jurisdiction of the Family Court Branch of St. Croix County and waive any service of summons in this action in accordance with sec. 767.05(3), Stats. JOINT PETITIONERS REQUEST THE FOLLOWING RELIEF: A. Granting to the (both parties/mother/father) the (care, custody, physical placement or periods of physical placement) of the minor child(ren). B. Child support and income assignment pursuant to § 767.265, Stats. C. Provision for health care insurance and contribution to uninsured health care expenses for the child D. Contribution to the reasonable expenses of pregnancy and confinement. Paternity Forms Joint Petition Page 1 of 2 Rev. 5/02 American LegalNet, Inc. www.FormsWorkFlow.com E. Such other relief as is appropriate. ___________________________________________ __________________________________________ (Mother’s Name) (Father’s Name) Subscribed and sworn to before me this ______ day of _______________, 200_______. Subscribed and sworn to before me this ______ day of _______________, 200_______. ______________________________________________ __________________________________________ Notary public, State of Wisconsin Notary public, State of Wisconsin My commission expires: _______________________ My commission expires: ______________________ Divorce Forms Joint Petition Page 2 of 2 Rev. 3/02 American LegalNet, Inc. www.FormsWorkFlow.com