PRINT in INK Enter the name of the county in which you are filing this case. For Official Use STATE OF WISCONSIN, CIRCUIT COURT, COUNTY In RE: The marriage of Enter the wife’s name. Joint Petitioner-Wife: First name Middle name Last name Enter the wife’s address. Address On the far right, check divorce or legal separation. Address City State Zip and Enter the husband’s name. Enter the husband’s address. Joint Petition Without Minor Children Joint Petitioner-Husband: First name Middle name Last name Divorce-40101 Legal Separation-40201 Address Note: Leave case number blank; the clerk will add this. Address City Enter the wife’s date of birth [month, day, year]. For 2, 3 and 4, check yes or no. Military personnel: Please see Basic Guide to Divorce/Legal Separation. Enter the husband’s date of birth [month, day, year]. For 2, 3 and 4, check yes or no. Military personnel: Please see Basic Guide to Divorce/Legal Separation. State Zip Case No. A. We are providing the following information about the wife: 1. Date of birth 2. Immediately before filing this petition, the wife will have lived in this county for 30 days or more. No Yes 3. Immediately before filing this petition, the wife will have lived in the state of Wisconsin for 6 months or more. No Yes 4. The wife is currently on active duty as a member of the Armed Forces of the United States of America or its allies. No Yes B. We are providing the following information about the husband: 1. Date of birth 2. Immediately before filing this petition, the husband will have lived in this county for 30 days or more. No Yes 3. Immediately before filing this petition, the husband will have lived in the state of Wisconsin for 6 months or more. No Yes 4. The husband is currently on active duty as a member of the Armed Forces of the United States of America or its allies. No Yes FA-4111V, 01/09 Joint Petition-Without Minor Children §767.215, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Joint Petition – Without Minor Children Page 2 of 4 Case No. ________________ C. We are providing the following marriage information: Enter the date [month, day, year], city, and state in which you were married. Check a or b. If b, explain why you are filing for a legal separation and not a divorce. Check a or b. If b, enter the county and state in which it was filed, the case number assigned to it and check yes or no to indicate if the case has been dismissed. Check yes or no. If no, respond to 5a-5d with information about the wife’s most recent previous marriage. If the wife had an additional previous marriage, respond to 5e5h. Check yes or no. If no, respond to 6a-6d with information about the husband’s most recent previous marriage. If the husband had an additional previous marriage, respond to 6e-6h. 1. We were married on (date) 2. We were married in (city) (state) 3. We are filing for: Divorce: This marriage is irretrievably broken. a. Legal Separation: This marriage is broken and the reason we are requesting a b. legal separation and not a divorce is 4. Previous Actions This is the first time that either my spouse or I have filed for divorce or legal separation from each other in Wisconsin or in any other state: Yes a. No: County b. State Case No. No Yes Has this case been dismissed? 5. This is the wife’s first marriage. No Yes a. The wife was previously married to death. divorce. b. The marriage was terminated by: c. Date of the divorce or death d. The divorce was granted in: Name of court State City e. The wife was also previously married to death. divorce. f. The marriage was terminated by: g. Date of the divorce or death h. The divorce was granted in: Name of court State City If the wife had more than 2 previous marriages, repeat 5e-5h on an additional sheet. 6. This is the husband’s first marriage. No Yes a. The husband was previously married to death. divorce. b. The marriage was terminated by: c. Date of the divorce or death d. The divorce was granted in: Name of court State City e. The husband was also previously married to death. divorce. f. The marriage was terminated by: g. Date of the divorce or death h. The divorce was granted in: Name of court State City If the husband had more than 2 previous marriages, repeat 6e-6h on an additional sheet. FA-4111V, 01/09 Joint Petition-Without Minor Children §767.215, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Joint Petition – Without Minor Children Page 3 of 4 Case No. ________________ D. We are providing the following information regarding our children: 1. a. Check a or b. If b, write the names and dates of birth of all adult children born to the wife during the marriage. b. No children were born to or adopted together by us before or during our marriage. All children, who are currently age 18 or older, born to the wife during the marriage include: Name of Child Date of Birth 2. To the best of our knowledge, the wife in this marriage: is currently pregnant. (An attorney [guardian ad litem] for the unborn child will a. be required if the husband is not the father.) is not currently pregnant. b. Check a or b. If a, attach a copy of the written agreement to this petition. 3. We have made written agreements or received orders from the court about some or all of the matters in this action such as maintenance (spousal support) or property division. Yes, and we have attached a copy of the written agreement to this Petition. a. No b. We consent to jurisdiction and waive service of summons. WE ASK THAT THE COURT: If you are requesting maintenance (spousal support) at this time, check yes. If not, check no. 1. Grant a judgment as requested. 2. Enter an order granting maintenance. No Yes 3. Enter other orders as it deems just and equitable. ACTS PROHIBITED BY STATUTE In accordance with § 767.117 Wis. Stats., neither joint petitioners to this divorce or legal separation action can participate in any of the following activities while this action is pending: 1. Harassing, intimidating, physically abusing or imposing any restraint on the personal liberty of the other party or a minor child of either of the parties. 2. Encumbering, concealing, damaging, destroying, transferring, or in any other way disposing of property owned by either or both of the parties, without the consent of the other party or an order of the court or the Circuit Court Commissioner, except in the usual course of business, in order to secure necessities or in order to pay reasonable costs and expenses of the action, including attorney fees. A VIOLATION OF THE ABOVE PROHIBITIONS MAY RESULT IN PUNISHMENT FOR CONTEMPT, WHICH MAY INCLUDE MONETARY PENALTIES, IMPRISONMENT, AND OTHER SANCTIONS AS PROVIDED FOR IN SEC. 785.04 WIS. STATS. These PROHIBITIONS apply until the action is dismissed, a final judgment in the action is entered, or the court orders otherwise. FA-4111V, 01/09 Joint Petition-Without Minor Children §767.215, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Joint Petition – Without Minor Children Page 4 of 4 Case No. ________________ The wife must sign and print her name.   She must enter the date on which she signed her name. Signature of Wife Print or Type Name Note: This signature does not need to be notarized. Date The husband must sign and print his name.   Signature of Husband He must enter the date on which he signed his name. Print or Type Name Note: This signature does not need to be notarized. Date FA-4111V, 01/09 Joint Petition-Without Minor Children §767.215, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com