Response And Counterclaim Summary Form Page 2
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STATE OF WISCONSIN, CIRCUIT COURT,
For Official Use
Enter the name of the
county in which this case
COUNTY
was filed by your spouse.
In RE: The marriage of:
Enter your spouse’s name
Petitioner:
(he/she is the petitioner).
First name
Middle name
Last name
On the far right, check if
and
your spouse filed for
divorce or legal
Response and
separation.
Counterclaim
Respondent:
Enter your name (you are
Divorce-40101
the respondent).
Legal Separation-40201
First name
Middle name
Last name
Case No.
Enter the case number.
RESPONSE
I am the respondent in this action.
A. I accept all the statements made in section A of the Petition to be true and correct.
Yes
Read through section A,
No I am making the following changes:
section B, section C, and
section D of the Petition.
If all the statements are
true, check yes in the
B. I accept all the statements made in section B of the Petition to be true and correct.
appropriate section.
Yes
No I am making the following changes:
If any statement or fact
is untrue or incorrect,
check no in the
appropriate section and
C. I accept all the statements made in section C of the Petition to be true and correct.
enter the correct
Yes
information on the lines.
No I am making the following changes:
D. I accept all the statements made in section D of the Petition to be true and correct.
Yes
No I am making the following changes:
FA-4113V, 01/08 Response and Counterclaim
§§767.215 and 822.29, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
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