Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Summons Without Minor Children Form. This is a Wisconsin form and can be use in Circuit Court Statewide.
Loading PDF...
Tags: Summons Without Minor Children, FA-4105, Wisconsin Statewide, Circuit Court
FORM SUMMARY
Name of Form:
Summons without Minor Children
Form Number:
FA-4105
Statutory Reference:
§§767.215(2m) and 801.095, Wisconsin Statutes
Benchbook Reference:
Purpose of Form:
To notify the respondent of the existence of an action for
divorce or legal separation in cases that the parties do not
have minor children.
Who Completes It:
Pro Se person seeking a divorce or legal separation
Distribution of Form:
Original filed with the court, copies authenticated by the
Clerk of Court for service on the respondent, Family Court
Commissioner and other parties.
Accompanying Forms:
The Petition is attached. Other documents may include
Order to Show Cause and Affidavit for Temporary Order,
Financial Disclosure statements, and locally-required
documents.
New Form/Modification:
Modification; last update; 08/06
Modification:
Updated to be compliant with 2005 Wisconsin Act 443.
Effective 01/07.
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: 10/05/2006
American LegalNet, Inc.
www.FormsWorkflow.com
PRINT in BLACK 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 your name (you are
the petitioner).
Petitioner:
First name
Middle name
Last name
Enter your address.
Address
On the far right, check
divorce or legal
separation.
Address
City
State
Zip
and
Enter your spouse’s name
(your spouse is the
respondent).
Enter your spouse’s
address.
Note: Leave case number
blank; the clerk will add
this.
Summons
Without Minor Children
Respondent:
First name
Middle name
Last name
Divorce-40101
Legal Separation-40201
Address
Address
City
State
Zip
Case No.
The State of Wisconsin, to the person named above as respondent:
You are notified that your spouse has filed a lawsuit or other legal action against you. The
Petition, which is attached, states the nature and basis of the legal action.
Within 20 days of receiving this Summons, you must provide a written response, as that
term is used in ch. 802, Wis. Stats., to the Petition. The court may reject or disregard a
response that does not follow the requirements of the statutes.
Enter the name and
address of the Clerk of
Court office.
DO NOT leave these
lines blank. You must
obtain this address and
fill it in, or your
Summons will be
incomplete and will harm
your case.
This information may be
available in the local
phone book under
listings for the county or
from your local Clerk of
Court’s office.
The response must be sent or delivered to the following government offices:
Clerk of Court
Name of county
Address
Address
City
State
Zip
The response must also be mailed or delivered within 20 days to the petitioner at the address
above.
It is recommended, but not required, that you have an attorney help or represent you.
FA-4105 Pro Se, 10/06 Summons-Without Minor Children
§§767.215(2m) and 801.095, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
American LegalNet, Inc.
Page 1 of 2
www.FormsWorkflow.com
If you do not provide a proper response within 20 days, the court may grant judgment against
you, and you may lose your right to object to anything that is or may be incorrect in the
Petition.
A judgment may be enforced as provided by law. A judgment may become a lien against any
real estate you own now or in the future, and may also be enforced by garnishment or seizure
of property.
If you need help in this matter because of a disability, please call:
Sign and print your name.
Signature
Name Printed or Typed
Enter the date on which
you signed your name.
Date
Note: This signature does
not need to be notarized.
FA-4105 Pro Se, 10/06 Summons-Without Minor Children
§§767.215(2m) and 801.095, 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
