Response And Counterclaim Summary Form Page 3

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Response and Counterclaim
Page 2 of 2
Case No. ____________
COUNTERCLAIM
I REQUEST THE FOLLOWING RELIEF FROM THE COURT:
A. A judgment of:
Check 1, 2, or 3. If 2,
explain why you are
1.
Divorce: This marriage is irretrievably broken.
requesting a legal
separation and not a
2.
Legal Separation: This marriage is broken and the reason I am requesting a legal
divorce.
separation and not a divorce is:
3.
Dismissal of this action.
B. Enter other orders as it deems just and equitable.
STOP!
If you have minor children, take this document to a Notary Public BEFORE you sign it.
After you have been
Signature
sworn by a Notary Public,
sign and print your name
and date the document in
Print or Type Name
front of the Notary Public.
If you do not have minor
Date
children, sign, print your
name and date. A Notary
is not required.
Have the Notary Public
Subscribed and sworn to before me
sign, date, and seal the
on
document.
(Seal)
Notary Public, State of Wisconsin
My commission expires:
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.
Page 2 of 2

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