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Order to Show Cause And Affidavit FA-4171 - Wisconsin
| Order to Show Cause And Affidavit Form. This is a Wisconsin form and can be used in Family Court Circuit Court Statewide . |
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FORM SUMMARY Name of Form: Order To Show Cause and Affidavit to: Change Legal Custody, Physical Placement, Child Support, Maintenance, and/or Other FA-4171V §§765.105, 767.451 and 767.59, Wisconsin Statutes Form Number: Statutory Reference: Benchbook Reference: Purpose of Form: This form may be used to order another party to come to court to justify why the requested change contained within the order should not be granted. Requests to change generally include issues concerning legal custody, physical placement, or child support of a minor child, as well as to change maintenance or any other aspect of a court order. Party seeking a modification to the custody, placement, child support, maintenance, or other orders; a judge or court commissioner signs the Order itself. Original to clerk of court. Depending on the particular county involved, either the original order itself, a duplicate original of the Order or an authenticated copy would be personally served on the other parties. Generally the form may be the only document needed. However if the form's instructions indicate a supporting document is needed (such as placement schedules or additional documentation), those document(s) should be attached. Modification; last update 01/09. New rule which took effect Jan. 1, 2010 to DCF 150, the Percentage of Income Standard which creates requirements for establishing medical support orders. Under the new rules, a parent who has insurance coverage available that means certain defined criteria must carry that coverage and the other parent may be ordered to contribute to the cost of that coverage. That contribution would be in the form of an upward or downward deviation in the child support amount dependent on which parent is the court ordered payee. 1. The party seeking the change could alternatively use a Notice and Motion to Modify (FA-4170V) to accomplish the same end. The basic difference between the two is one of service. An order to show cause must be personally served on the other party; a notice can be served by other means. The reason there are two forms is that the statutes provide that the request can be brought either by "motion" or "order to show cause." 2. If the parties can stipulate or agree to a change in the type of matters covered by this motion, the parties may use FA-604 to do so without the need for a hearing. Who Completes It: Distribution of Form: Accompanying Forms: New Form/Modification: Modification: Comments: About this Form: This form is the product of the Wisconsin Records Management Committee, a committee of the Director of State Court's Office. As a pro se form, its use is NOT mandatory but it is required to be accepted and distributed by the circuit courts of the State of Wisconsin. Approval Date: 02/11/2010 Release Date: 09/20/2010 Posted Date: 09/22/2010 Page 1 American LegalNet, Inc. www.FormsWorkFlow.com PRINT in INK Enter the name of the county in which the original case was filed. Check marriage or paternity. If paternity, enter initials of child. Enter the name, address, and daytime phone number of the petitioner or joint petitioner from the original case file. On the far right, mark the box for the change(s) you are requesting and enter the original case number. STATE OF WISCONSIN, CIRCUIT COURT, For Official Use COUNTY In RE: The marriage paternity of Petitioner/Joint Petitioner: First name Middle name Last name Current Mailing Address City State Zip Daytime phone number Order To Show Cause and Affidavit to Change: Legal Custody Physical Placement Child Support Maintenance Other: vs. Respondent/Joint Petitioner: Enter the name, address, and daytime phone number of the respondent or joint petitioner from the original case file. First name Middle name Last name Current Mailing Address City State Zip Daytime phone number Check if the State of Wisconsin is a party or not. If you are unsure, you may call your local Child Support Agency. The State of Wisconsin (Child Support Agency) is Case No. is not a party to this action. Enter the name of the party you want to appear in court. For Court Use Only: This section will be completed by the court. ORDER TO SHOW CAUSE Upon the attached Affidavit, IT IS ORDERED THAT Before Location Date a.m./p.m. , or as soon as the matter may be heard, Time to show cause (give reasons) why the requests in the attached affidavit should not be granted. If you do not appear as indicated, the court may proceed without you and grant the request. IT IS FURTHER ORDERED: · a copy of this order and affidavit be personally served upon all other parties at least 5 business days before the date of the hearing. · both parties must bring to court their fully completed, dated, and signed Financial Disclosure Statement and all required attachments. BY THE COURT: Circuit Court Judge Circuit Court Commissioner For Court Use Only. Name Printed or Typed Date FA-4171V, 02/10 Order To Show Cause and Affidavit to Change: Custody/Physical Placement/Support/Maintenance §§767.105, 767.451, and 767.59, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Order To Show Cause and Affidavit to Change: Custody/Physical Placement/Support/Maintenance Page 2 of 3 Case No. _______________ AFFIDAVIT Check A if you are requesting a change to physical placement, list the children affected, check 1-4 and/or 5 and/or 6 and complete the necessary information. Indicate if you have or have not attempted Mediation. If you have, indicate the date of the Mediation session. 1. Modify as follows: A. Physical Placement Order(s) (time with children) for the following children: 1. from primary physical placement with (Name of Parent) to primary placement with (Name of Parent) from shared placement to primary placement with (Name of Parent) 2. from primary placement to shared placement. 3. from the current shared placement schedule (if any) to a new shared placement 4. schedule. The requested placement schedule for the changes in 1-4 above is as follows: See attached 5. 6. to require placement with (Name of Parent) unsupervised. supervised. be Other: Check B if you are requesting a change to legal custody, list the children affected, check 1, 2, or 3 and complete the necessary information. Check C if you are requesting changes to support orders. Check 1 if you are requesting changes to child support, enter the amount and frequency of the current payment and check wheth
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