Form FA-4128VA "Affidavit to Show Cause and Request for Hearing for Temporary Order With Minor Children" - Wisconsin

What Is Form FA-4128VA?

This is a legal form that was released by the Wisconsin Circuit Court - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2020;
  • The latest edition provided by the Wisconsin Circuit Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form FA-4128VA by clicking the link below or browse more documents and templates provided by the Wisconsin Circuit Court.

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Download Form FA-4128VA "Affidavit to Show Cause and Request for Hearing for Temporary Order With Minor Children" - Wisconsin

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Petitioner/Joint Petitioner A:
Respondent/Joint Petitioner B:
Enter the name of the
STATE OF WISCONSIN, CIRCUIT COURT,
county in which you are
COUNTY
filing this case.
Enter the name and
IN RE: THE MARRIAGE OF
address of Petitioner/Joint
Petitioner A.
Petitioner/Joint Petitioner A
Name (First, Middle and Last)
Address
Address
Affidavit to Show Cause
and Request for Hearing
City
State
Zip
for Temporary Order
and
With Minor Children
Respondent/Joint Petitioner B
Enter the name and
address of Respondent/
Divorce
- 40101
Joint Petitioner B.
Name (First, Middle and Last)
Legal Separation
- 40201
Check divorce or legal
separation.
Case No.
Address
Enter the case number, if
Address
known. If unknown, leave
blank.
City
State
Zip
1.
The other party and I have not agreed on a temporary arrangement while this action is
pending, and there is a need for such an order.
2.
I request that a hearing be held and a temporary order be entered concerning one or
more of the following issues:
A. Legal custody and physical placement
B. Child support
C. Maintenance
D. Use of the residence and other property
E. Payment of debts and financial obligations
F. Payment of insurance and health care expenses
G. Other relief the court believes appropriate
H. Other relief as follows:
List any additional disputed
matters you need resolved
See attached
at the temporary hearing.
If you require reasonable accommodations due to a disability to participate in the court process, please call
prior to the scheduled court date. Please note that the court does not provide transportation.
STOP!
Take this document to a Notary Public BEFORE you sign it.
After you have been
State of
sworn by a Notary
Signature
County of
Public, sign and print
Subscribed and sworn to before
your name and date the
Name Printed or Typed
me on
document in front of
the Notary Public.
Notary Public/Court Official
Address
Have the Notary Public
sign and date.
Name Printed or Typed
Email Address
Telephone Number
My commission/term expires:
Date
State Bar No. (if any)
This notarial act involved the use of
communication technology.
FA-4128VA, 05/20 Affidavit to Show Cause and Request for Hearing for Temporary Order with Minor Children
§§767.117, 767.127 and 767.225, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Petitioner/Joint Petitioner A:
Respondent/Joint Petitioner B:
Enter the name of the
STATE OF WISCONSIN, CIRCUIT COURT,
county in which you are
COUNTY
filing this case.
Enter the name and
IN RE: THE MARRIAGE OF
address of Petitioner/Joint
Petitioner A.
Petitioner/Joint Petitioner A
Name (First, Middle and Last)
Address
Address
Affidavit to Show Cause
and Request for Hearing
City
State
Zip
for Temporary Order
and
With Minor Children
Respondent/Joint Petitioner B
Enter the name and
address of Respondent/
Divorce
- 40101
Joint Petitioner B.
Name (First, Middle and Last)
Legal Separation
- 40201
Check divorce or legal
separation.
Case No.
Address
Enter the case number, if
Address
known. If unknown, leave
blank.
City
State
Zip
1.
The other party and I have not agreed on a temporary arrangement while this action is
pending, and there is a need for such an order.
2.
I request that a hearing be held and a temporary order be entered concerning one or
more of the following issues:
A. Legal custody and physical placement
B. Child support
C. Maintenance
D. Use of the residence and other property
E. Payment of debts and financial obligations
F. Payment of insurance and health care expenses
G. Other relief the court believes appropriate
H. Other relief as follows:
List any additional disputed
matters you need resolved
See attached
at the temporary hearing.
If you require reasonable accommodations due to a disability to participate in the court process, please call
prior to the scheduled court date. Please note that the court does not provide transportation.
STOP!
Take this document to a Notary Public BEFORE you sign it.
After you have been
State of
sworn by a Notary
Signature
County of
Public, sign and print
Subscribed and sworn to before
your name and date the
Name Printed or Typed
me on
document in front of
the Notary Public.
Notary Public/Court Official
Address
Have the Notary Public
sign and date.
Name Printed or Typed
Email Address
Telephone Number
My commission/term expires:
Date
State Bar No. (if any)
This notarial act involved the use of
communication technology.
FA-4128VA, 05/20 Affidavit to Show Cause and Request for Hearing for Temporary Order with Minor Children
§§767.117, 767.127 and 767.225, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.