Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4150V, 05/19 Marital Settlement Agreement With Minor Children 247767.34, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 11 - - Enter the name of the county in which this case is filed. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Enter the name of the Petitioner/Joint P etitio ner A . IN RE : THE MARRIAGE OF Petitioner/Joint Petitioner A Name (First, Middle and Last) and Marital Settlement Agreement With Minor Children D ivorce - 40101 Legal Separation - 40201 Case No. Enter the name of the Respondent/ Joint Petitioner B . Res pondent/Joint Petitioner B Name (First, Middle and Last) Check divorce or legal separation. Enter the case number. Warning: Subject to court approval, t he terms of this agreement will be included in your judgment of divorce or legal separation. Be sure you understand it completely. Some portions of this agreement cannot be changed after the court approves it, even if you did not understand or expect how it would affect you. You may wish to speak with a lawyer before you sign this agreement to be sure you are fully aware of the laws that may apply to you. WE AGREE AS FOLLOWS: In A, check 1 or 2. A. 1. MARITAL RELATIONSHIP If 2, enter reason you are asking for a legal separation and not a divorce. 2. 1. Divorce. This marriage is irretrievably broken. 3. 2. Legal Separation . This marriage is broken and the reason we are requesting a legal separation and not a divorce is B. MAINTENANCE (Spousal Support) 4. 1. Petitioner/Joint Petitioner A : In B.1, check a, b, or c. 5. a. g ives up the rig ht to receive maintenance and understands that by giving u p maintenance at this time, may never ask for maintenance. If b, enter a date and choose 1 or 2. 6. b. is not requesting maintenance at this time, but leaves open the right to request it until . The right to request maintenance is limited to If 1, enter the reasons. 7. 1) the following circumstance(s) only: 8. 2) any appropriate substantial change in circumstance. If c, enter the maintenance amount and the date the payments should begin and end. 9. c. Respondent/Joint Petitioner B shall pay maintenance to Petitioner/Joint Petitioner A in the amount of $ per month beginning , 20 . Maintenance shall end , 20 , or until Petitioner/Joint Petitioner A remarries, dies, or by court order, whichever comes first. In 2, check a, b, or c. 10. 2. Respondent/Joint Petitioner B : 11. a. gives up the r ight to receive maintenance and understands that by giving up maintenance at this time, may never ask for maintenance. If b, enter a date and choose 1 or 2. 12. b. is not requesting maintenance at this time, but leaves open the right to request it until . The right to request maintenance is limited to If 1, enter the reasons. 13. 1) the following circumstance(s) only: 14. 2) any appropriate substantial change in circumstance. If c, enter the maintenance amount and the date the payments should begin and end. 15. c. Petitioner/Joint Petitioner A shall pay maintenance to Respondent/Joint Petitioner B in the amount of $ per month beginning , 20 . Maintenance shall end , 20 , or until the Respondent/Joint Petitioner B remarries, dies, or by court order, whichever comes first. In 3, check a or b. 16. 3. Payments shall be made 17. a. no payments are ordered. American LegalNet, Inc. www.FormsWorkFlow.com Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4150V, 05/19 Marital Settlement Agreement With Minor Children 247767.34, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 11 If b, check 1 or 2. If 2, enter employer information. 18. b. t o the Wisconsin Support Collections Trust Fund (WI SCTF) at Box 74200, Milwaukee, Wisconsin 53274 - 0200 19. 1) directly from the payer to WI SCTF (only allowable if self - employed) . 20. 2) 21. Employer name 22. Address of payroll office 23. City State Zip 24. Phone Fax NOTE: An arrearage is an amount ordered that has not been paid and is overdue. 25. 4. Arrearages for Previously Ordered Maintenance. 26. The parties agree to handle the maintenance arrears as follows: 27. a. No maintenance was previously ordered. There is no amount due. 28. b. The party has paid all maintenance as ordered. There is no amount due. In 4, c heck a, b, c, d, e or f. If d, e nter the monthly payment amount, date payments begin and the interest rate percentage for arrearages. 29. c. If the re are any arrearages for maintenance now or at the time of the final hearing, those arrearages are waived and the court financial records shall be set at zero. 30. d. As currently reflected in the WI SCTF KIDS computer system and shall be paid through monthly income withholding b y the WI SCTF in the amount of $ beginning , 20 . The arrears bala nce shall earn interest at the rate of % per year until the arrearages are paid in full. If e, enter the amount of the arrears balance and check 1 or 2. If 1, enter the date of the one - time payment. If 2, enter the monthly payment amount, the date payments begin and the interest rate percentage for arrearages. 31. e. The arrears shall be set at $ and paid through 32. 1) a one - time payment to the WI SCTF made by [ D ate] , 20 . 33. 2) monthly income withholding by the WI SCTF in the amount of $ beginning , 20 . The arrears balance shall earn interest at the rate of % per year until the arrearages are paid in full. 34. f . Shall be determined by the court at the time of the final hearing. C. MEDICAL INSURANCE No later than the date of the final hearing, each party shall notify the other party in writing of the availability of COBRA or other continuation benefits under their current health care policy. NOTE: There are two things as homes and land. includes all other things such as vehic les, clothing and other personal items, furniture, bank accounts, and retirement or investment accounts. D. PERSONAL PROPERTY DIVISION 1. Division. The parties agree to the final personal property division as indicated below: List the property and check who will have permanent use of the property once the divorce/legal separation is final. Who will have possession? A = Petitioner/Joint Petitioner A B = Respondent/Joint Petitioner B HOUSEHOLD ITEMS A B If more space is necessary, mark the box and attach additional sheets. AUTOMOBILE Year, Make, Model A B NOTE: Any and all assets disclosed on Financial Disclosure Statements should be included here and divided between the parties. LIFE INSURANCE Name of Company & Policy # A B NOTE: If you have already divided the property, you must still disclose how you divided it. BUSINESS INTERESTS Name of Business & Address A B American LegalNet, Inc. www.FormsWorkFlow.com Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4150V, 05/19 Marital Settlement Agreement With Minor Children 247767.34, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 3 of 11 If the parties have disposed of an asset from the time the Financial Disclosure was done, to the final hearing, please indicate what was disposed and what happened to it. SECURITIES: STOCKS, BONDS, MUTUA L FUNDS, COMMODITY A CCOUNTS Name of Company & # of shares A B PENSION, RETIREMENT ACCOUNTS, DEFERRED COMPENSATIO N, 401K PLANS, IRAS, PROFIT SHARING, ETC. Name of Company & Type of Plan A B CASH AND DEPOSIT (SA VINGS & CHECKING) ACCOUNTS Name of Bank or Financial Institution A B OTHER PERSONAL PROPE RTY Description of Asset A B See attached Indicate when and how any exchange of property will take place. 2. Exchange. The following items still need to be exchanged between the parties : a. None. All personal property has already been exchanged to the satisfaction of both parties. b. List of items: The exchange of personal property shall be made by [ D ate] , 20 according to the following arrangements: Any item of personal property not listed above shall be awarded to the p arty who has possession at the time of the final hearing. In F, c heck 1 or 2. E . DIVISION OF REAL ESTATE 1. Neither party owns any real estate at this time