Missouri Divorce Form

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Enter the name of the           STATE OF WISCONSIN, CIRCUIT COURT,                                         For Official Use
county in which this case                                                                       COUNTY
is filed.
Enter the name and              In RE: The marriage of
address of the petitioner.
If joint petitioners, enter     Petitioner/Joint Petitioner-Wife:
the name of the wife.

                                First name                   Middle name            Last name


                                Address (Street, City, State and Zip)                                             Stipulation and Order
                                                                                                                    Converting Legal
                                and                                                                               Separation to Divorce
Enter the name and              Respondent/Joint Petitioner-Husband:
address of the respondent.
If joint petitioners, enter
the name of the husband.        First name                  Middle name             Last name
                                                                                                           Case No.
Enter the case number.
                                Address (Street, City, State and Zip)



                                STIPULATION TO CONVERT LEGAL SEPARATION TO DIVORCE JUDGMENT
In 1,enter the date
[month, day, year] on           1. A legal separation was granted on (Date)                                                                             .
which the legal
                                2. The parties agree that the legal separation should be converted to a divorce.
separation was granted.
                                3. We ask the court to issue an order converting the legal separation to a divorce.

                                4. We have attached a completed vital statistics form.

                                5. Former Surnames:
Check A, B, or C.                  A.   Neither party requests the right to use a former legal surname.
                                   B.   The wife requests the right to use a former legal surname of                                                .
If A or B, enter the               C.   The husband requests the right to use a former legal surname of                                             .
former surname.
                                     Note: If this is an action for legal separation, the court cannot allow a spouse to resume a former legal
                                           surname unless and until the judgment is converted to a divorce.

 The wife must sign her
 name. Enter the date on
 which it was signed.                                                               ►
                                                                                                            Wife
 Note: This form does not
 need to be notarized.                                                                               Print or Type Name

                                                                                                            Date


 The husband must sign his
 name. Enter the date on                                                            ►
 which it was signed.                                                                                     Husband

 Note: This form does not                                                                            Print or Type Name
 need to be notarized.
                                                                                                           Date




     FA-4162V, 01/09 Stipulation and Order Converting Legal Separation to Divorce                   §§765.03(2), 767.35 and 767.395, Wisconsin Statutes
                                     This form shall not be modified. It may be supplemented with additional material.
                                                                               Page 1 of 2
    Stipulation and Order Converting Legal Separation to Divorce              Page 2 of 2                    Case No.       ____________


                               ORDER

                                  1. The judgment of legal separation is converted to a judgment of divorce.
                                  2. Any party may resume the use of a former legal surname approved in the Findings of
                                     Fact, Conclusions of Law and Judgment or as requested in this stipulation.
                                  3. The Findings of Fact Conclusions of Law and Judgment and Marital Settlement
                                     Agreement, Proposed Marital Settlement, or Divorce Judgment Addendum previously
                                     entered in the legal separation remains in effect without modification.


                                  The parties are notified that:
                                  It is unlawful for any person who is or has been a party to an action for divorce in any court in
                                  this state, or elsewhere, to marry again until 6 months after judgment of divorce is granted,
                                  and the marriage of any such person solemnized before the expiration of 6 months from the
                                  date of the granting of judgment of divorce shall be void.

                                                                                    BY THE COURT:


For Court Use Only.                                                                          Circuit Court Judge/Circuit Court Commissioner

                                                                                                        Name Printed or Typed

                                                                                                                 Date




    FA-4162V, 01/09 Stipulation and Order Converting Legal Separation to Divorce                    §§765.03(2), 767.35 and 767.395, Wisconsin Statutes
                                    This form shall not be modified. It may be supplemented with additional material.
                                                                              Page 2 of 2

				
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