SC-5500VB, 05/18 Order on Petition for Stay of Eviction Based on DefendantApplication for Emergency Assistance (Small Claims) 247799.40(4), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional materials. Enter the name of the county in which this case was filed. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Enter the Plaintiff( s ) name . Plaintiff(s): - vs - Defendant(s): Amended Order on Petition for Stay of Eviction Based on Emergency Assistance (Small Claims) Case No. Enter the Defendant( s ) name . Enter the eviction case number. A Petition for Stay of Eviction Based on Application for Emergency Assistance was filed on [Date] . No writ of restitution has been issued in this case. THE COURT ORDERS: The eviction proceedings are stayed until eligibility is determined. If the defendant is found to be eligible for emergency assistance, the stay will continue until the defendant receives emergency assistance. The defendant is ordered to inform the court and the plaintiff promptly of the outcome of the emergency assistance application. DISTRIBUTION : 1. Court 2. Parties American LegalNet, Inc. www.FormsWorkFlow.com