CR-246B, 04/03 Order on Petition for Civil Judgment (Probation Revoked/Discharged, Parole/Extended Supervision Terminated) DOC-2213, 04/03 247247973.09(3)(b), 973.09(3)(bm)4, 973.20, and 973.20(1r), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY State of Wisconsin, Plaintiff - vs - Date of Birth DOC No. Order on Petition for Civil Judgment Probation Revoked Probation Discharged Parole Terminated Extended Supervision Terminated Case No. A Petition for Civil J udgment was filed with the court was filed on [Date] . THE COURT ORDERS: 1. Judgment is granted against the defendant in favor of the victim(s) listed in paragraph 2 above for the amount unpaid. 2. Judgment is granted against the defendant in favor of the Department of Corrections for unpaid supervision fees in the amount of $ . 3. The clerk enter this judgment on the judgment and lien docket without fee . DISTRIBUTION: 1. Court 2. Defendant 3. District Attorney 4. Dept. of Corrections 5. Victim(s) American LegalNet, Inc. www.FormsWorkFlow.com