Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4130V, 05/17 Motion for and Notice of New (De Novo) Hearing 247757.69(8), Wisconsin Statutes/ This form shall not be modified. It may be supplemented with additional material. Enter the name of the county in which this case is filed. STATE OF WISCONSIN , CIRCUIT COURT, COUNTY Check marriage or paternity. If paternity, enter initials of child. IN R E : T HE MARRIAGE PATERNITY OF Petitioner/Jo int Petitioner A Name (First, Middle and Last) St reet City State Zip a nd Enter the name and current mailing address of Petitioner/Joint Petitioner A. Motion for and Notice of New (De Novo) Hearing Case No. Enter the name and current mailing address of Respondent/ Joint Petitioner B. Respondent/Joint Petitioner B Name (First, Middle and Last) Street City State Zip Enter the case number. Enter the name of the other party /parent. To: Name To review the decision of a harassment or domestic abuse injunction, use Motion for DeNovo Hearing, CV - 503. Enter the date [month, day, year] that the order was signed, the name of the circuit c ourt commissioner who granted the order, and mark the boxes that describe the issue(s) you want heard again. I request a new hearing on the following issue(s) decided on by the Circuit Court Commissioner: Child Support Maintenance/Family Support Legal Custody/Physical Placement Property and Debt Division Other: Check 1 or 2. If 1, att ach a copy of the signed order. 1. I have attached a copy of the signed Order from the above hearing date. 2. I have not yet received a copy of the s igned Order from the above hearing. The De Novo Hearing is scheduled: For Court Use Only : The Clerk will complete this section. NOTICE OF HEARING Date Time Location (Include Room No.) Circuit Court Official T he court may review any decision made by the Circuit Court Commissioner in the order being reviewed. If you require reasonable accommodations to participate in the court process due to a disability, please call prior to the scheduled court date. Please note that the court d oes not provide transportation. Sign and print your name. Enter the date in which you signed your name. Note: This signature does not need to be notarized. Signature Print or Type Name Date Note: A copy of this request must be served by mail on all other parties who appeared at the original hearing. American LegalNet, Inc. www.FormsWorkFlow.com