Use and download this form to file for Divorce in the State of Wisconsin if you have Minor Children.
Wisconsin Petition With Minor Children
Text version of this Form
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PRINT in INK
Enter the name of the STATE OF WISCONSIN, CIRCUIT COURT, For Official Use
county in which you are COUNTY
filing this case.In RE: The marriage of
Enter your name (you arethe petitioner). Petitioner:
First name Middle name Last name
Enter your address.Address
On the far right, check
Address
divorce or legalseparation.
City State Zip
Petition
andWith Minor Children
Enter your spouse’s name Respondent:(your spouse is the
respondent). First name Middle name Last name
Enter your spouse’s
Divorce-40101
address. Address
Legal Separation-40201Note: Leave case number Address
blank; the clerk will add
Case No.
this. City State ZipI am the petitioner in this action.
In A.1, enter your A. I am providing the following information about myself:
date of birth [month, 1. Date of birth .
day, year].
2. Immediately before filing this petition, I will have lived in this county for 30 days or more.
Yes No
3. Immediately before filing this petition, I will have lived in the state of Wisconsin for 6 months
For 2, 3 and 4, check or more.
yes or no. Yes No
4. I am currently on active duty as a member of the Armed Forces of the United States of
America or its allies.
Yes NoIn B.1, enter your B. I am providing the following information about the respondent, my spouse:
spouse’s date of birth 1. Date of birth .
[month, day, year].
2. Immediately before filing this petition, the respondent will have lived in this county
for 30 days or more.
For 2, 3 and 4, check Yes No
yes or no. 3. Immediately before filing this petition, the respondent will have lived in the state of
Wisconsin for 6 months or more.
Yes No
4. The respondent is currently on active duty as a member of the Armed Forces of the
United States of America or its allies.
Yes NoFA-4108V, 05/12 Petition-With Minor Children §§767.215 and 822.29, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
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Petition – With Minor Children Page 2 of 7 Case No. _______________
In C.1 and 2, enter thedate [month, day, C. I am providing the following marriage information:
year], city, and state in 1. My spouse and I were married on (Date) .
which you were
married. 2. We were married in (City) (State) .3. I am filing for
a. Divorce. This marriage is irretrievably broken.
b. Legal Separation. This marriage is broken and the reason I am requesting a legal
separation and not a divorce is .
In 4, check a or b. If b, 4. Previous Actions
enter the county and
This is the first time that either my spouse or I have filed for divorce or legal
state in which it was
filed, the case number separation from each other in Wisconsin or in any other state:
assigned to it, and a. Yes
check yes or no to b. No: County
indicate if the case has State
been dismissed . Case No.
Has this case been dismissed? Yes No
5. This is my first marriage. Yes Noa. I was previously married to
In 5, check yes or
b. The marriage was terminated by divorce. death.
no. If no, respond to
5a-5d with c. Date of the divorce or death
information about d. The divorce was granted in:
your most recent Name of court
previous marriage. City State
e. I was also previously married to
f. The marriage was terminated by divorce. death.
g. Date of the divorce or death
If you had an h. The divorce was granted in:
additional previous Name of court
marriage, respond to City State
5e-5h.If you had more than 2 previous marriages, repeat 5e-5h on an additional sheet.
6. This is my spouse’s first marriage. Yes No
In 6, check yes or no.
a. My spouse was previously married to
If no, respond to 6a-
b. The marriage was terminated by divorce. death.
6d with information
about your spouse’s c. Date of the divorce or death
most recent previous d. The divorce was granted in:
marriage, if known. Name of court
City Statee. My spouse was also previously married to
If your spouse had an
f. The marriage was terminated by: divorce. death.
additional previous
marriage, respond to g. Date of the divorce or death
6e-6h. h. The divorce was granted in
Name of courtCity State
If your spouse had more than 2 previous marriages, repeat 6e-6h on an additional sheet.
FA-4108V, 05/12 Petition-With Minor Children §§767.215 and 822.29, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.Page 2 of 7
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Petition – With Minor Children Page 3 of 7 Case No. _______________
In D.1, enter the name D. I am providing the following information regarding children:
and date of birth 1. The minor children (age 17 or younger) born to or adopted together by me and my
[month, day, year] for spouse before or during our marriage are
each minor child. If None.
there are no other Name of Minor Child Date of Birth
kids, check None.In 2, enter the name 2. The adult children (age 18 or older) born to or adopted together by me and my spouse
and date of birth before or during our marriage are
[month, day, year] for None.
each adult child. If Name of Adult Child Date of Birth
you and your spouse
do not have adultchildren together,
check None.
In 3, enter the name 3. Other children born to the wife during this marriage, but not fathered by the husband are
and date of birth None.
[month, day, year] for Name of Child Date of Birth
each other child. If
you and your spouse do
not have other children
together, check None.4. To the best of my knowledge, the wife in this marriage
a. is currently pregnant. (An attorney [guardian ad litem] for the unborn child will be
In 4, check a or b. required if the husband is not the father.)
b. is not currently pregnant.5. The current address of the minor children is
In 5, check a, b, c or d. a. with mother at above address.
If d, enter the current
b. with father at the above address.
address of the minor
children. If the children c. with both mother and father at the above addresses.
currently reside at d. at the address below:
separate addresses, Address
provide those addresses
Address
on an additional sheet.
City State ZipIn 6, enter any previous 6. Previous addresses for the minor children are
addresses for the minor None (the children have lived at the current address for the last five years).
children living with the Address
parents during the past Address
5 years. If none check
City State Zip
“none.” If the children
have lived in more than
Address
2 places over the past 5
years, provide those Address
addresses on an City State Zip
additional sheet.
In 7, check yes or no. 7. Currently, or during the last 5 years, one or more of the minor children lived with a personFA-4108V, 05/12 Petition-With Minor Children §§767.215 and 822.29, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.Page 3 of 7
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Petition – With Minor Children Page 4 of 7 Case No. _______________
other than a parent.
Yes No
If yes, enter the name Child
of that minor child Person
and the name and Address
address of the person Address
with whom that child
lived. City, State, ZipChild
Attach an additional Person
sheet, if necessary. Address
AddressCity, State, Zip
Child
Person
Address
Address
City, State, Zip8. I personally have been (or I am aware of others who have been) a party, witness or participated in
In 8, check a or b. another way in other past court proceedings concerning the custody of or physical
placement or visitation with the minor children listed in D1 or D3, in Wisconsin or in any
other state.
If a, enter the name of a. Yes and the custody, physical placement, or visitation order was granted in:
the court in which it Name of court
was ordered, the case Case Number Date
number assigned to it,
b. No.
and date it was ordered.
9. I am aware of a proceeding that could affect the current proceeding, including
In 9, check a or b. proceedings for enforcement and proceedings related to domestic violence, protective
orders, termination of parental rights, or adoption concerning the children listed in D1 or
D3, in Wisconsin or any other state.
If a, enter the name a. Yes, and the proceeding that could affect the current proceeding is in:
of the court, the case Name of court
number assigned to Case Number
it, and the nature of Nature of Proceeding
the proceeding. b. No.10. My spouse and I have made written agreements or received orders from the court about
In 10, check a or b. some or all of the matters in this action such as maintenance (spousal support), child support,
If a, attach a copy of legal custody or physical placement of the minor children, or property division.
written agreement. a. Yes, and I have attached a copy of the written agreement to this Petition.b. No
If you are requesting I ASK THAT THE COURT:
maintenance, child 1. Grant a judgment as requested.
support and/orfamily support at
2. Enter an order granting maintenance, child support and/or family support. Yes No
this time, check yes.
If not, check no.
3. Enter other orders as it deems just and equitable.FA-4108V, 05/12 Petition-With Minor Children §§767.215 and 822.29, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.Page 4 of 7
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Petition – With Minor Children Page 5 of 7 Case No. _______________
ACTS PROHIBITED BY STATUTE
In accordance with §767.1 17, Wis. Stats., neither the petitioner nor the respondent to this divorce or
legal separation action can participate in any of the following activities while this action is pending:1. Harassing, intimidating, physically abusing or imposing any restraint on the personal liberty of the
other party or a minor child of either of the parties.2. Encumbering, concealing, damaging, destroying, transferring, or in any other way disposing of
property owned by either or both of the parties, without the consent of the other party or an order of the
court or the Circuit Court Commissioner, except in the usual course of business, in order to secure
necessities or in order to pay reasonable costs and expenses of the action, including attorney fees.3. Establishing a residence with a minor child of the parties outside the state of Wisconsin or more than
150 miles from the residence of the other party within the state without the consent of the other party or
an order of the court or Circuit Court Commissioner.4. Removing a minor child of the parties from the state of Wisconsin for more than 90 consecutive days
without the consent of the other party or an order of the court or Circuit Court Commissioner.5. Concealing a minor child of the parties from the other party without the consent of the other party or
an order of the court or Circuit Court Commissioner.A VIOLATION OF THE ABOVE PROHIBITIONS MAY RESULT IN PUNISHMENT FOR
CONTEMPT, WHICH MAY INCLUDE MONETARY PENALTIES, IMPRISONMENT, AND
OTHER SANCTIONS AS PROVIDED FOR IN SEC. 785.04 WIS. STATS.A violation of paragraphs 3, 4, or 5 above is not a contempt of court if the court finds that the action
was taken to protect a party or a minor child of the parties from physical abuse by the other party and
that there was no reasonable opportunity under the circumstances for the party to obtain an order
authorizing the action.These PROHIBITIONS apply until the action is dismissed, a final judgment in the action is entered, or
the court orders otherwise.STOP!
Take this document to a Notary Public BEFORE you sign it.After you have been
sworn by a Notary
Public, sign and print
your name and date the Signature
document in front of theNotary Public. Print or Type Name
Date
State of
Have the Notary Public County of
sign, date, and seal the Subscribed and sworn to before me on (Seal)
document.
Notary Public/Court OfficialName Printed or Typed
My commission/term expires:
FA-4108V, 05/12 Petition-With Minor Children §§767.215 and 822.29, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.Page 5 of 7
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Petition – With Minor Children Page 6 of 7 Case No. _______________
Wisconsin Department of Children and Families
Child Support Percentage of Income StandardsAuthority and Purpose
§49.22(9), Wis. Stats. requires the Department to adopt and publish a standard, based upon a
percentage of the gross income and assets of either or both parents, to be used by courts in
determining child support obligations. Chapter DCF 150 of the Wisconsin Administrative Code
establishes Wisconsin’s percentage of income standard for child support. It is based upon the
principle that the child’s standard of living should, to the degree possible, be the same as if the child’s
parents were living together.Chapter DCF 150 defines the income upon which the support obligation is based, and sets the
percentages of income for computing the support obligation based upon a number of children. It also
explains optional procedures for adjusting the obligation when the parents share placement, when the
parent has an obligation to support another family, or when the payer has particularly high or low
income.Applicability
The percentage standard applies to any temporary and final order for child support, including child
support stipulations agreed to by both parents and modifications of existing child support orders.
When used to calculate family support, the amount determined under the standard should be
increased by the amount necessary to provide a net family support payment, after state and federal
income taxes are paid, of at least the amount of a child support payment under the standard.Definition of Income and Assets
Chapter DCF 150 defines gross income as income from any source, whether or not it is reported or
taxed under federal law. The income can be in the form of money, property, or services. Public
assistance or child support received from previous marriages or business expenses, which the court
determines are reasonably necessary for the production of income or operation of a business are
subtracted, and wages paid to dependent household member are added to determine “gross income
available for child support.”The court may also determine that income may be “imputed” (assumed at a given level) based on
earning capacity and/or assets, and that imputed income is added to the gross income for the
calculation of the support obligation.THE PERCENTAGE STANDARD
The percentages are: 17% for one child
25% for two children
29% for three children
31% for four children
34% for five or more childrenWisconsin Statutes require temporary and final support orders to be expressed as fixed sum in most situations.
For further details, refer to Chapter DCF 150 of the Wisconsin Administrative Code and Wisconsin Statute
767 Actions Affecting the Family. (Choose “Wisconsin Law” on http://www.legis.state.wi.us)FA-4108V, 05/12 Petition-With Minor Children §§767.215 and 822.29, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.Page 6 of 7
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Petition – With Minor Children Page 7 of 7 Case No. _______________
Statutory Factors Courts May Consider In Determining Child Support Awards for
Paternity, Divorce, or Legal Separation§767.511, Child Support.
(1 m) Upon request by a party, the court may modify the amount of child support payments
determined under §767.511 (1j) if, after considering the following factors, the court finds by the
greater weight of the credible evidence that use of the percentage standard is unfair to the child or to
any of the parties:(a) The financial resources of the child.
(b) The financial resources of both parents.
(bj) Maintenance received by either party.
(bp) The needs of each party in order to support himself or herself at a level equal to or greater than
that established under 42 USC 9902 (2).(bz) The needs of any person, other than the child, whom either party is legally obligated to support
(c) If the parties were married, the standard of living the child would have enjoyed had the marriage
not ended in annulment, divorce or legal separation.(d) The desirability that the custodian remain in the home as a full-time parent.
(e) The cost of day care if the custodian works outside the home, or the value of custodial services
performed by the custodian if the custodian remains in the home.(ej) The award of substantial periods of physical placement to both parents.
(em) Extraordinary travel expenses incurred in exercising the right to periods of physical placement
under §767.41.(f) The physical, mental and emotional health needs of the child, including any costs for health
Insurance as provided for under sub. (4m).(g) The child’s educational needs.
(h) The tax consequences to each party.
(hm) The best interests of the child.
(hs) The earning capacity of each parent, based on each parent’s education, training and work
experience and the availability of work in or near the parent’s community.(i) Any other factors which the court in each case determines are relevant.
FA-4108V, 05/12 Petition-With Minor Children §§767.215 and 822.29, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.Page 7 of 7