Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4127VA, 05/17 Stipulation for Temporary Order Without Minor Children 247247767.117, 767.127 and 767.225, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 5 Enter the name of the county in which you are filing this case. STATE OF WISCONSIN , CIRCUIT COURT, COUNTY Enter the name of Petitioner/Joint Petitioner A . IN RE : T HE MARRIAGE OF Petitioner/Joint Petitioner A Name (First, Middle and Last) a nd Enter the name of Respondent/Joint Petitioner B. Stipulation for Temporary Order Without Minor Children D ivorce - 40101 Legal Separation - 40201 Case No. Respondent/Joint Petitioner B Name (First, Middle and Last) Check divorce or legal separation. N OTE : Enter the case number, if known. If not leave blank. SUMMARY OF PERSONAL INFORMATION In 1, enter the requested information about Petitioner/Joint Petitioner A. 1. Petitioner/Joint Petitioner A : Address Address City State Zip Date of birth Include area codes with the requested phone numbers. Dates of birth should be written in the following format: [month, day, year]. Gross monthly income $ Employer name Address of payroll office City State Zip Phone Fax In 2, enter the requested information about Respondent/Joint Petitioner B. 2. Respondent/Joint Petitioner B : Address Address City State Zip Date of birth Include area codes with the requested phone numbers. Dates of birth should be written in the following format: [month, day, year]. Gross monthly income $ Employer name Address of payroll office City State Zip Phone Fax STIPULATION The parties agree that the following terms be in effect until the final hearing of this action except as modified by a future order of the court. 1. SUMMARY OF FINANCIAL AGREEMENTS For 1.A.1, check a or b. If b, enter the monthly amount of maintenance and the month and year on which the payments will begin. A. MAINTENANCE (Spousal Support). 1) Petitioner/ Joint Petitioner A a. g ives up right to receive maintenance at this time. b. Respondent/ Joint Petitioner B shall pay maintenance to Petitioner/ Joint Petitioner A in the amount of $ per month beginning on the first day of the month of , 20 . For 1.A.2, check a or b. 2) Respondent/ Joint Petitioner B a. g ives up right to receive maintenance at this time. American LegalNet, Inc. www.FormsWorkFlow.com Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4127VA, 05/17 Stipulation for Temporary Order Without Minor Children 247247767.117, 767.127 and 767.225, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 5 If b, enter the monthly amount of maintenance and month and year on which the payments will begin. b. Petitioner/ Joint Petitioner A shall pay maintenance to Respondent/ Joint Petitioner B in the amount of $ per month beginning on the first day of the month of , 20 . Check 1, 2, or 3. B. PAYMENTS FOR MAINTEN ANCE SHALL BE MADE 1) directly from the payer to WI SCTF (only if self - employed) . 2) 3) No maintenance is to be paid at this time. Parties may not make payments directly to each other. (See WI Stat. 24767.75) C. INFORMATION ABOUT HO W PAYMENTS ARE MADE TO WI SCTF . All payments for maintenance ordered shall note the case number and the names of the parties on the face of the check and should be made payable to WI SCTF, and sent to: Wisconsin Support Collections Trust Fund Box 74200 Milwaukee, WI 53274 - 0200 The WI SCTF will transmit the payments to the proper persons entitled to them. Failure of an employer to pay the proper amount shall not be a defense for failure to pay the proper amount. If an employer fails to take out the correct amount for maintenance, the party paying is responsible for the full and correct amount. The party paying maintenance is responsible for payment of the annual receiving and disbursing fee to WI SCTF. 2. SUMMARY OF OTHER AGREEMENTS In 2.a., check 1 or 2. A . RESIDENCE . 1) The parties do not own or rent a residence together. If 2, check a, b, c or d. 2) The parties do own or rent a residence together and agree that If a, b or d enter the date [month, day, year]. a. Petitioner/ Joint Petitioner A shall have temporary exclusive use of the residence and Respondent/ Joint Petitioner B shall leave the residence on or before . b. Respondent/ Joint Petitioner B shall have temporary exclusive use of the residence and Petitioner/ Joint Petitioner A shall leave the residence on or before . c. both parties agree to share the residence. d. b oth parties agree to vacate and/or sell the residence by . For 3, check a, b, or c. If c, enter the date. 3) Sale of Residence. a. The parties do not own a residence. b. The residence shall not be placed for sale at this time. c. The residence shall be placed for sale no later than . For 4, check a or b. If a, attach the agreed upon arrangements. 4 ) Other Real Estate . One or both of the parties own additional real estate, the agreement for temporary use of which is disclosed as an attachment. a. Yes, see attached agreement. b. No In B, check 1 or 2. If 2, complete the chart indicating who has and who will have possession while the case is pending . B. PERSONAL PROPERTY DI VISION . The parties agree that each shall be awarded the temporary and exclusive use of the personal property in their possession 1) with no exceptions. 2) except for the following property: Complete this section with as much detail as possible. NOTE: There are two things as homes and land. List the property and check who will have temporary use of the property until the divorce/legal separation is final. Who will have possession? A = Petitioner/ Joint Petitioner A B = Respondent/ Joint Petitioner B HOUSEHOLD ITEMS A B American LegalNet, Inc. www.FormsWorkFlow.com Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4127VA, 05/17 Stipulation for Temporary Order Without Minor Children 247247767.117, 767.127 and 767.225, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 3 of 5 includes all other things such as vehicles, clothing and other personal items, furniture, bank accounts, and retirement or investment accounts. NO TE: If you have already divided the property, you must still disclose how you divided it below. AUTOMOBILES Year, Make, Model A B LIFE INSURANCE Name of Company & Policy # A B BUSINESS INTERESTS Name of Business & Address A B SECURITIES: STOCKS, BONDS, MUTUA L FUNDS, COMMODITY A CCOUNTS Name of Company & # of shares A B PENSION, RETIREMENT ACCOUNTS, DEFER RED COMPENSATION, 40 1K PLANS, IRAS, PROF IT SHARING, ETC. Name of Company & Type of Plan A B CASH AND DEPOSIT (SA VINGS & CHECKING) AC COUNTS Name of Bank or Financial Institution A B OTHER PERSONAL PROPE RTY Description of Asset A B See attached Enter the date and describe exchange arrangements. Any exchange of property shall be made by [ D ate] , 20 according to the following arrangements: C. DEBTS AND LIABILITIE S . 1) Each of the parties shall be responsible for the following debts and liabilities to keep payments current: Payment for Payment to (Creditor) Monthly Payment Paid by Petitioner/ Joint Petitioner A Paid by Respondent/ Joint Petitioner B Shared E qually In C.1, for each debt owed individually and jointly, write the name, monthly payment, and check who Mortgage/Rent $ Mortgage/Rent $ Car 1 $ Car 2 $ American LegalNet, Inc. www.FormsWorkFlow.com Petitioner/Joint Petitioner A: Respondent/Joint Petitioner B: FA-4127VA, 05/17 Stipulation for Temporary Order Without Minor Children 247247767.117, 767.127 and 767.225, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 4 of 5 will be responsible for payment. NOTE: Any and all debts Financial Disclosure Statements that are still unpaid should be included here and divided between the parties. Any new debts incurred should also be listed and divided. If more space is necessary, attach add itional sheets. Car 3 $ Insurance (Auto) $ Insurance (Medical) $ Insurance (Life) $ Loans - Student $ Loans - Personal $ Loans - Other $ Credit Card