STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Arrest-Bench Warrant Case No. Name of Person Person's Address Person's Date of Birth Driver's License Number Phone Number Sex Race Height Weight Eye Color Hair Color Other Identifying Characteristics TO ANY LAW ENFORCEMENT OFFICER, ARREST THE ABOVE-NAMED PERSON. THE PERSON: A. has not been served with a petition or motion to enforce an order of the Court. B. has not been served with a petition to determine paternity or a motion or petition to set or revise support, despite due diligence in attempting service. C. failed to appear in court as required on [Date] . D. failed to comply with an order of the Court as follows: . E. failed to comply with an order of the Court to pay child support. The person was found in contempt of court on [Date] and was given the opportunity to purge their contempt by paying $ per . The person has paid $ and $ remains due under purge as of [Date] . F. Other: THE PERSON: A. may be released upon payment of $ , plus statutory sheriff's fees. A new court date shall be provided to the person. being served with the petition or motion. A new court date shall be provided to the person. being served with the order. submission to genetic testing. Other: B. shall be held for an appearance in court. C. shall be confined for days, or until [specify condition to be met] , or until further order of the Court. BY THE COURT: Circuit Court Judge/Circuit Court Commissioner Geographic restriction: Statewide No restriction Within county of ORI Within adjacent counties of ORI Other: Title (Print or Type Name if not eSigned) Date FA-4181VB, 05/16 Arrest ­ Bench Warrant Chapter 785, §§818.01(2), 818.02(5) and (6), 818.03 and 818.04, Wisconsin Statutes American LegalNet, Inc. www.FormsWorkFlow.com This form shall not be modified. It may be supplemented with additional material.