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Order To Show Cause And Affidavit For Temporary Order Without Minor Children Form. This is a Wisconsin form and can be use in Circuit Court Statewide.
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Tags: Order To Show Cause And Affidavit For Temporary Order Without Minor Children, FA-4129, Wisconsin Statewide, Circuit Court
FORM SUMMARY
Name of Form:
Order to Show Cause and Affidavit for Temporary Order
Without Minor Children
Form Number:
FA-4129V
Statutory Reference:
§§767.117, 767.127 and 767.225, Wisconsin Statutes
Benchbook Reference:
Purpose of Form:
This form allows a party in an action for divorce or legal
separation in which there are no minor children to request a
hearing before the court to have an order entered that would
resolve various issues such as asset allocation, debt payments,
maintenance payments, and similar matters while the case is
pending. It would be used when the parties are unable to reach
an agreement on such issues.
Who Completes It:
The party seeking the hearing would complete the caption and
sign the affidavit section on page 3. After signing the affidavit,
the signor would seek out a notary public, be sworn, and sign the
affidavit under oath. The notary public would complete the
notarial section. The party would then take the document to the
court to have the court complete the date, time, place of the
hearing and the name of the presiding court official.
Distribution of Form:
Original will be filed with the court. Authenticated copy would
be served on the other party.
Accompanying Forms:
Although none are necessarily required, there may be schedules
attached listing property, debts, or other information that doesn’t
fit on the form. Financial disclosure statements may also be
attached as needed.
New Form/Modification:
Modification; last update 10/06.
Modification:
Added more descriptive instructions and lines after "other
specific relief I believe appropriate as follows:" and further
ordered statement regarding completion of FDS.
Comments:
None
About this Form:
This form is the product of the Wisconsin Records
Management Committee, a committee of the Director of
State Court’s Office.
As a pro se form, its use is NOT mandatory but it is required
to be accepted and distributed by the circuit courts of the
State of Wisconsin.
Date: 01/17/2008
Page 1
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PRINT in BLACK ink
Enter the name of the
county in which you are
filing this case.
Enter the name and
address of the petitioner.
If joint petitioners, enter
the name of the wife.
For Official Use
STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
In RE: The marriage of:
Petitioner/Joint Petitioner-Wife:
First name
Middle name
Last name
Address
Order to Show Cause and
Affidavit for Temporary
Order
Address
City
Enter the name and
address of the respondent.
If joint petitioners, enter
the name of the husband.
State
Without Minor Children
Zip
and
Respondent/Joint Petitioner-Husband:
First name
Check divorce or legal
separation.
Last name
Case No.
Address
Enter the case number, if
known. If unknown, leave
blank.
Middle name
Divorce-40101
Legal Separation-40201
Address
City
State
Zip
ORDER TO SHOW CAUSE
Based on the attached Affidavit and Request for Hearing for Temporary Order,
IT IS ORDERED that the parties Show Cause, In Person:
Before:
Circuit Court Judge or Circuit Court Commissioner
For Court Use Only:
The clerk will complete
this section.
Location:
Date:
Time:
a.m./p.m.
or as soon as the matter may be heard, why a temporary order should not be entered
for the relief requested in the attached affidavit.
PENDING FURTHER COURT ORDER or written stipulation of the parties, neither party
shall engage in any activity that negatively affects the health, safety or welfare of either
party including but not limited to:
FA-4129V, 01/08 Order to Show Cause and Affidavit for Temporary Order-Without Minor Children
§§767.117, 767.127, and 767.225, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 1 of 3
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Order to Show Cause and Affidavit for Temporary Order-Without Minor Children
Page 2 of 3
Case No. ________________
•
Both parties are restrained from harassing, intimidating, physically abusing, or
imposing any restraint on the personal liberty of the other party, or the other
party’s employer.
•
Both parties are prohibited from going upon the premises occupied by the other
as a residence.
•
Both parties are restrained from making any further debts against the credit of
the other party. Further, unless otherwise ordered, any debt incurred after the
date of this order is the sole responsibility of the party incurring the debt.
•
Both parties are restrained from disconnecting any utility service or causing any
other essential services of the residence of either party to be disconnected.
•
Both parties shall maintain all current beneficiaries on all life, medical, hospital,
automobile, household or other insurances and in any current wills while this
action is pending.
IT IS FURTHER ORDERED that both parties bring to this hearing a completed
Financial Disclosure Statement.
Check your spouse and
check other if there is
another party(s) to the
action, and enter the
parties name.
IT IS FURTHER ORDERED that a copy of this order, together with the supporting
papers, be served in person at least 5 business days before the time of this hearing,
upon the:
Wife
Husband
Other:
Failure to appear as ordered may result in the issuance of a warrant directing the Sheriff to
arrest you and bring you to court.
Failure to appear will not stop the court from proceeding with the hearing and making the
orders requested by your spouse.
Parties are encouraged to arrive early and determine if any issues can be resolved before the
hearing.
BY THE COURT:
Circuit Court Judge/Circuit Court Commissioner
For Court Use Only
Print or Type Name
Date
FA-4129V, 01/08 Order to Show Cause and Affidavit for Temporary Order-Without Minor Children
§§767.117, 767.127, and 767.225, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 2 of 3
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Order to Show Cause and Affidavit for Temporary Order-Without Minor Children
Page 3 of 3
Case No. ________________
AFFIDAVIT
1. My spouse and I have not agreed on a temporary arrangement while this action is pending,
and there is a need for such an order.
2. I request that a hearing be held concerning one or more of the following issues:
List any additional
disputed matters
you need resolved at
the temporary
hearing.
•
•
•
•
•
•
Maintenance
Use of the residence and other property
Payment of debts and financial obligations
Payment of insurance and health care expenses
Other relief the court believes appropriate
Other specific relief I believe appropriate as follows:
See attached
3. I request a hearing be held and a temporary order be entered pursuant to §767.23(1), Wis.
Stats.
If you need help in this matter because of a disability, please call:
STOP!
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
Date
Have the Notary Public
sign, date, and seal the
document.
Subscribed and sworn to before me
(Seal)
on
Notary Public, State of Wisconsin
My commission expires:
FA-4129V, 01/08 Order to Show Cause and Affidavit for Temporary Order-Without Minor Children
§§767.117, 767.127, and 767.225, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 3 of 3
American LegalNet, Inc.
www.FormsWorkflow.com
