PRINT in BLACK ink For Official Use STATE OF WISCONSIN, CIRCUIT COURT, Enter the name of the county in which this case was filed by your spouse. Enter your spouse’s name (he/she is the petitioner). COUNTY In RE: The marriage of: Petitioner: On the far right, check if your spouse filed for divorce or legal separation. First name Enter your name (you are the respondent). Middle name Last name Respondent: and Response and Counterclaim Divorce-40101 Legal Separation-40201 First name Middle name Last name Case No. Enter the case number. RESPONSE I am the respondent in this action. Read through section A, section B, section C, and section D of the Petition. If all the statements are true, check yes in the appropriate section. If any statement or fact is untrue or incorrect, check no in the appropriate section and enter the correct information on the lines. A. I accept all the statements made in section A of the Petition to be true and correct. Yes No I am making the following changes: B. I accept all the statements made in section B of the Petition to be true and correct. Yes No I am making the following changes: C. I accept all the statements made in section C of the Petition to be true and correct. Yes No I am making the following changes: D. I accept all the statements made in section D of the Petition to be true and correct. Yes No I am making the following changes: FA-4113V, 01/08 Response and Counterclaim §§767.215 and 822.29, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com Response and Counterclaim Page 2 of 2 Case No. ____________ COUNTERCLAIM I REQUEST THE FOLLOWING RELIEF FROM THE COURT: Check 1, 2, or 3. If 2, explain why you are requesting a legal separation and not a divorce. A. A judgment of: 1. Divorce: This marriage is irretrievably broken. 2. Legal Separation: This marriage is broken and the reason I am requesting a legal separation and not a divorce is: 3. Dismissal of this action. B. Enter other orders as it deems just and equitable. STOP! If you have minor children, take this document to a Notary Public BEFORE you sign it. After you have been sworn by a Notary Public, sign and print your name and date the document in front of the Notary Public. Signature Print or Type Name If you do not have minor children, sign, print your name and date. A Notary is not required. Have the Notary Public sign, date, and seal the document. Date Subscribed and sworn to before me on (Seal) Notary Public, State of Wisconsin My commission expires: FA-4113V, 01/08 Response and Counterclaim §§767.215 and 822.29, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com