SC-5300VA, 11/17 Stipulation for Dismissal Eviction (Small Claims) 247799.24(3), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 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): Enter the Defendant(s) name. Enter the case number. Stipulation for Dismissal Eviction (Small Claims) Case No. The parties who have signed this stipulation agree that this case shall be dismissed as follows: For 1, check either A or B. If 1A, e nter the date and time that the defendant(s) agr ee to move out of the premises. 1. Agreement to Vacate Premises A. The defendant(s) will vacate the premises by [Date] at [Time] a.m. p.m . If the defendant(s) fail to vacate the premises by this date, the plaintiff(s) may, without notice to the defendant(s), ask the court to vacate ( set aside ) the dismissal and enter judgment against the defendant(s) for restitution (return) of the premises, plus statutory costs and disbursements, and order a writ of restitution (order to vacate) be issued . B. No agreement to vacate was entered. If 2 , check either A or B. If 2A , enter the amount and explain the payment agreement, if any, between the parties. Include payment amount(s) and due date(s) . Be specific. 2. Payment Agreement A. The defendant(s) shall pay the plaintiff(s) the amount of $ in full settlement of this case in the followi ng manner: See attached for additional information. NOTE: If there is additional information about the agreement, check the box and attach additional pages to this document. E nte r the grace period (number of days) for payment. Check either 2.A.1) or 2.A.2). If 2.A.2), fill in the amount. If the defendant(s) misses any scheduled payment by more than days, the plaintiff(s) may file an Affidavit Based on Noncompliance Eviction (SC - 5400VA/VB) without notifying the defendant(s), and ask the court to vacate (set aside) the dismissal, enter a judgment for restitution of the premises (eviction) , order a writ of restitution (order to vacate) be issued, and 1) schedule a hearing to determine the amount of a mone y judgment against the defendant(s), or 2) enter a money judgment against the defendant(s) in the amount of $ , plus statutory costs and disbursements, minus any payments made under this agreement. B. No payment agreements have been made. American LegalNet, Inc. www.FormsWorkFlow.com SC-5300VA, 11/17 Stipulation for Dismissal Eviction (Small Claims) 247799.24(3), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 For 3, check either A or B. If 3A, describe the other agreement made between the two parties. NOTE: If there is additional information about the agreement, check the box and attach additional pages to this document. 3. Other Agreement A. We have made the following other agreements: See attac hed for additional information. If either party does not or cannot comply with the terms of this agreement, either party may file a written request with the court for a hearing. B. No other agreements have been made. Have the Plaintiff (s) sign and print his/her name. Enter the date on which the plaintiff (s) signed his/her name. Note: This signature does not need to be notarized. Plaintiff(s) Print or Type Name Date Plaintiff(s) Print or Type Name Date Have the Defendant (s) sign and print his/her name. Enter the date on which the defendant (s) signed his/her name. Note: This signature does not need to be notarized. Defendant(s) Print or Type Name Date Defendant(s) Print or Type Name Date American LegalNet, Inc. www.FormsWorkFlow.com