In Re Family Law Rules of Procedure

663 So.2d 1049 (1995) In re FAMILY LAW RULES OF PROCEDURE. No. 84337. Supreme Court of Florida. November 22, 1995. *1050 John F. Harkness, Jr., Executive Director, The Florida Bar, Tallahassee, Florida; and Michael L. Hastings, Chairperson, Family Law Rules Committee, Hastings & Estreicher, P.A., St. Petersburg, Florida, for Petitioner. Steven H. Preston of Gurney & Handley, P.A., Orlando, Florida; Henry P. Trawick, Jr. of the Law Offices of Trawick, Valentine & Hagan, P.A., Sarasota, Florida; Honorable E. Earle Zehmer, Chief Judge, First District Court of Appeal, Tallahassee, Florida; Cynthia B. Glazier, Program Attorney, State of Florida Guardian Ad Litem Program, Fourth Judicial Circuit, Jacksonville, Florida; Beth E. Spiegel, North Miami Beach, Florida; S. William Goldstein of the Law Offices of Goldstein & Goldstein, Jacksonville, Florida; B. Niklas Brihammar, Key West, Florida; Paul R. Marcus of the Law Offices of Paul R. Marcus, Miami, Florida; Honorable Dale Ross, Chief Judge, Seventeenth Judicial Circuit, Fort Lauderdale, Florida; Maurice Jay Kutner of Kutner & West, P.A., Miami, Florida; Richard P. Aranson of Beiner & Nussbaum, P.A., Boca Raton, Florida; Honorable Richard Yale Feder, Administrative Judge, Family Division, Eleventh Judicial Circuit, Miami, Florida; Honorable Gerald T. Wetherington, Circuit Judge, Eleventh Judicial Circuit, Miami, Florida; Honorable Joseph P. Farina, Chief Judge, Eleventh Judicial Circuit, Miami, Florida; Honorable Donald Moran, Jr., Chief Judge and Honorable Hugh A. Carithers, Jr., Administrative Judge, Family Law Division, Fourth Judicial Circuit, Jacksonville, Florida; Andrew M. Leinoff of Leinoff & Silvers, P.A., Coral Gables, Florida; Honorable Hugh E. Starnes, Chief Judge, Twentieth Judicial Circuit, Fort Myers, Florida; Honorable Leonard Rivkind, Circuit Judge, Eleventh Judicial Circuit, Miami, Florida; Honorable F. Dennis Alvarez, Chief Judge, and judges presiding in the Family Law Division, Thirteenth Judicial Circuit, Tampa, Florida; Peter M. Hockman, Homestead, Florida; Honorable Thomas S. Wilson, Jr., Circuit Judge, Eleventh Judicial Circuit, Miami, Florida; Lawrence M. Watson, Jr., Chair, Supreme Court Committee on Mediation and Arbitration Rules, Orlando, Florida; Raquel A. Rodriquez, Coral Gables, Florida; Nancy M. Blount, Assistant State Attorney, Eleventh Judicial Circuit, Miami, Florida; Darlene Schweitzer-Ramras of Schweitzer & Schweitzer-Ramras, P.A., Miami, Florida; Robert J. Jones, Miami, Florida; Marsha B. Elser, Cynthia L. Greene, Judith Hodor and Laura M. Fabar of Elser, Greene, Hodor & Fabar, Miami, Florida; Peter A. Collins, Miami, Florida; William A. Daniel, Jr., Miami, Florida; Norman D. Levin of Levin & Rabinowitz, Longwood, Florida; Honorable Anthony Rondolino, Circuit Judge, Sixth Judicial Circuit, St. Petersburg, Florida; Sharon L. Langer, Director, Dade County Bar Association Legal Aid Society, Miami, Florida; Honorable Alan S. Gold, *1051 Circuit Judge, Eleventh Judicial Circuit, Miami, Florida; Fred M. Dellapa, Coral Gables, Florida; Joy B. Shearer, General Master, Administrative Office of the Court, Fifteenth Judicial Circuit, West Palm Beach, Florida; Rosemarie S. Roth, Miami, Florida; Martin J. Nolan, E.R. Whitehouse, Rusela V. Orr and Charlene Sharp Bogolub, certified and court appointed family mediators, Eleventh Judicial Circuit, Miami, Florida; Bette Ellen Quiat, Miami, Florida; Perry S. Itkin, Chairperson, Education & Training Committee, Florida Association of Professional Family Mediators, Dispute Resolution, Inc., Fort Lauderdale, Florida; Honorable Roger A. Silver, County Judge, County Court of Dade County, Miami, Florida; Marilyn Blumberg of the Law Offices of Bette Ellen Quiat, Miami, Florida; Honorable Herbert M. Klein, Circuit Judge, Eleventh Judicial Circuit, Miami, Florida; Melvyn B. Frumkes of the Law Offices of Melvyn B. Frumkes & Associates, P.A., Miami, Florida; William T. Bornhauser, Director, Family Mediation Program, Twelfth Judicial Circuit, Sarasota, Florida; Honorable Ronald M. Friedman, Circuit Judge, Eleventh Judicial Circuit, Miami, Florida; Honorable John L. Phillips, Administrative Judge, Family Division, Fifteenth Judicial Circuit, West Palm Beach, Florida; Honorable George S. Reynolds, III, Vice-Chair, Family Law Rules Committee, Second Judicial Circuit, Tallahassee, Florida; Honorable Stuart M. Simons, Circuit Judge, Eleventh Judicial Circuit, Miami, Florida; Catherine Marie Ivey of the Law Office of Henshaw & Ivey, Cape Coral, Florida; and Honorable Seymour Benson, Circuit Judge, Eighteenth Judicial Circuit, Sanford, Florida, submitting comments regarding Family Law Rules. OVERTON, Justice. On July 7, 1995, this Court adopted new family law rules in accordance with our prior determination to have separate rules for family law cases. See In re Family Law R.P., 663 So.2d 1047 (Fla. 1995). After we issued the new rules, we published them in The Florida Bar News for further comment. Additionally, we asked the Family Law Rules Committee to review the rules for comment in view of the substantial modifications this Court made to the rules as proposed. The comments of the committee and others are now before this Court for review. We have jurisdiction. Art. V, § 2(a), Fla. Const. After having reviewed the comments, we hereby modify the rules as set forth in the attached appendices. The changes include a number of technical modifications and some substantive modifications. General and Special Masters A majority of the comments received concern the rules governing general and special masters. These comments request that we address the restrictions the rules place on the authority of masters. Specifically, this Court has been asked to modify the rules to: (1) eliminate the provision that prohibits general and special masters from hearing civil contempt proceedings; and (2) eliminate the requirement of Florida Family Law Rule of Procedure 12.490 that a general master must take the evidence in writing and must file that writing with the master's report and instead allow general masters to take testimony and establish a record electronically. After consideration, we grant the first request and have modified Florida Family Law Rules 12.490 and 12.492 as set forth in attached Appendix B to eliminate the provision prohibiting general and special masters from hearing contempt proceedings. In granting this request, we note that, under the rules governing masters, no matter shall be heard by a general master without the consent of all parties. See Fla.Fam.L.R. 12.490(b)(1). We also grant the second request as limited herein because we find that its implementation, with certain modifications, will expedite the family law litigation process and reduce costs. In the second request we are urged to find that allowing the use of an electronic record in lieu of requiring a master to take the evidence in writing is permissible under our constitution. The reason Florida Rule of Civil Procedure 1.490 and now rule 12.490 require the written recording of documentary evidence by a master is to ensure that the party taking exceptions to the master's report has an adequate and fair opportunity *1052 for review and to ensure that a master's report is not contrary to the evidence or to the law. Knupp v. Knupp, 625 So.2d 865 (Fla. 3d DCA 1993); Petrakis v. Petrakis, 597 So.2d 856 (Fla. 3d DCA 1992). In other words, some type of record must be created to protect a litigant's right to ultimate review by a judge. We find that electronically recording the master's proceeding and preserving that recording for future access sufficiently protects a litigant's rights by providing the ability to have the electronic record transcribed to establish an appropriate record for review if exceptions are filed. In reaching this decision, we emphasize that we are in no way implying that judges may merely "rubber-stamp" the recommendations of masters. An adequate method of judicial review of the recommendations is still required given the limited judicial authority that may be vested in masters. According to comments received by this Court, however, confusion apparently exists as to the appropriate requirements for review given our holding in Lyon v. Lyon, 54 So.2d 679, 680 (Fla. 1951), in which we stated: We do not construe the ... rule to mean that, in the absence of exceptions, the entry of final decree by the court in accordance with the findings and recommendations of the Master becomes a mere formality. Whether exceptions are filed to the report of the Master or not, it is the duty of the court to examine and carefully consider the evidence and determine whether under the law and the facts the court is justified in entering the decree recommended by the Master. We find that, provided a judge carefully considers (1) whether the evidence and facts, as fully set forth in a master's report, support the recommendations of the master and (2) whether the recommendations are justified under the law, then the review, absent exceptions, is adequate and satisfies the spirit of Lyon. Notwithstanding this finding, we emphasize that a judge must review the entire record if exceptions are filed. We have modified rule 12.490 accordingly. Other Changes In response to other remarks, we have made a number of technical and stylistic changes throughout the rules, forms, and appendices. We have also made the following substantive changes to the rules pursuant to the recommendations of the committee or others who submitted comments: (1) In rule 12.010, moved definition of family law matters from commentary into body of rule. (2) Deleted the requirement in rule 12.105 that simplified dissolutions must comply with requirements of rule 12.285. (3) Added the following to the comment to rule 12.110: "Rule 1.110(h) is to be interpreted to require service of process on a supplemental petition as set forth in Florida Family Law Rule of Procedure 12.070." (4) Added rule 12.190 (amended and supplemental pleadings shall be governed by Florida Rule of Civil Procedure 1.190). (5) Deleted "allegations of domestic violence" from rule 12.200(9), (10), and (11) in master and mediation referrals and inserted instead "significant history that would compromise the process"; and added to rule 12.200(11) the words "consistent with Florida law" to reflect that arbitration would be coordinated consistent with Florida law. (6) Altered rule 12.285(b)(1)(A) to add "unless the documents have been served under subdivision (b)(2) of this rule." A similar change was made to rule 12.285(b)(1)(B). (7) Changed the term "deliver" as set forth throughout rule 12.285 to "serve" and changed the 20-day time period in rule 12.285(b)(1)(B) as follows to make the rule consistent with Florida Rule of Judicial Administration 2.085(d)(1)(C) and other rules regarding service: The responding party shall serve the required documents on the party seeking relief on or before 5:00 p.m., 2 business days before the day of the temporary financial hearing if served by delivery or 7 days before the day of the temporary financial hearing if served by *1053 mail, unless the documents have been received previously by the party seeking relief under subdivision (b)(2) of this rule. A responding party shall be given no less than 12 days to serve the documents required under this rule, unless otherwise ordered by the court. If the 45-day period for exchange of documents provided for in subdivision (b)(2) of this rule will occur before the expiration of the 12 days, the provisions of subdivision (b)(2) control. (8) Added adoptions to proceedings exempted from disclosure under rule 12.285(a)(1), and clarified that rule 12.285(c) applies to parties whose annual income and expenses are less than $50,000 and that rule 12.285(d) applies to parties whose annual income or expenses are equal to or more than $50,000. (9) Added rule 12.407 (Testimony and Attendance of Minor Child. No minor child shall be deposed or brought to a deposition, brought to court to appear as a witness or to attend a hearing, or subpoenaed to appear at a hearing without prior order of the court based on good cause shown unless in an emergency situation.). (10) Amended rule 12.470 to include exceptions to general masters' reports. (11) Renumbered rules 12.491 and 12.492 as requested by the committee. (12) Added the following comment to rule 12.491: "It is intended that any administrative order issued by the chief justice of the Florida Supreme Court under rule 1.491(a) shall remain in full force and effect as though such order was rendered under this rule until changed by order of that same court." (13) Amended rule 12.491(e) to clarify that hearing officers are not to conduct contested paternity proceedings. (14) Amended rule 12.610 to: (a) require that service of papers on the respondent include a copy of the temporary injunction if one has been entered; (b) state that assistance shall be given as required by law and to provide for the confidential filing of a petitioner's address when required for safety reasons; (c) reflect in the commentary that the limitation on the taking of testimony raises due process concerns and, as such, that the limits on the taking of testimony have been made permissive rather than mandatory under the rule even though the statute requires that the testimony be limited. (15) Amended rules 12.740 and 12.741 to reflect changes to those mediation rules as recommended by the mediation committee. (16) Renumbered, reorganized, and updated the forms that accompany the rules. Future Changes to the Rules Regarding future modifications to the family law rules, we issue the following directives. The Family Law Rules Committee shall have continuing responsibility for review of the family law rules, including all forms and appendices. We also ask the Family Courts Steering Committee to review these rules, forms, and appendices and to make recommendations to this Court, with particular emphasis on revisions to further simplify the family law process for the many pro se litigants in family law cases. Finally, consistent with this Court's directives regarding mediation and arbitration rules in other areas, we direct that the Supreme Court Mediation and Arbitration Rules Committee shall have continuing responsibility for review of rules 12.740 and 12.741 governing family law mediation. This Court acknowledges that, because these rules are new, additional changes to the rules may need to be implemented outside of the four-year rule revision cycle set forth in Florida Rule of Judicial Administration 2.130. Consequently, we hereby grant to these committees a one-year extension beyond the time requirements of rule 2.130 for filing proposed revisions to the rules, forms, and appendices. Accordingly, we reaffirm our adoption, effective January 1, 1996, of the amendments to the Florida Rules of Civil Procedure (attached to this opinion as appendix A) and the new Florida Family Law Rules of Procedure (attached to this opinion as appendix B), as provided in In re Family Law Rules of Procedure, 663 So.2d 1047 (Fla. 1995), and as modified herein. The comments to the rules *1054 are included for explanation and guidance only and are not adopted as an official part of the rules. It is so ordered. GRIMES, C.J., and SHAW, KOGAN, HARDING, WELLS and ANSTEAD, JJ., concur. *1055 APPENDIX A AMENDMENTS TO FLORIDA RULES OF CIVIL PROCEDURE The Florida Rules of Civil Procedure are hereby amended as follows (additions are underlined; deletions are struck-through): RULE 1.010. SCOPE AND TITLE OF RULES These rules apply to all actions of a civil nature and all special statutory proceedings in the circuit courts and county courts except those to which the Florida Probate Rules, the Florida Family Law Rules of Procedure, or the Small Claims Rules apply. The form, content, procedure, and time for pleading in all special statutory proceedings shall be as prescribed by the statutes governing the proceeding unless these rules specifically provide to the contrary. These rules shall be construed to secure the just, speedy, and inexpensive determination of every action. These rules shall be known as the Florida Rules of Civil Procedure and abbreviated as Fla. R. Civ. P. . . . . RULE 1.360. EXAMINATION OF PERSONS (a) Request; Scope. (1) A party may request any other party to submit to, or to produce a person in that other party's custody or legal control for, examination by a qualified expert when the condition that is the subject of the requested examination is in controversy. (A) When the physical condition of a party or other person under subdivision (a)(1) is in controversy, the request may be served on the plaintiff without leave of court after commencement of the action, and on any other person with or after service of the process and initial pleading on that party. The request shall specify a reasonable time, place, manner, conditions, and scope of the examination and the person or persons by whom the examination is to be made. The party to whom the request is directed shall serve a response within 30 days after service of the request, except that a defendant need not serve a response until 45 days after service of the process and initial pleading on that defendant. The court may allow a shorter or longer time. The response shall state that the examination will be permitted as requested unless the request is objected to, in which event the reasons for the objection shall be stated. (B) In cases where the condition in controversy is not physical, including domestic relations and bastardy cases when the blood group is in issue, a party may move for an examination by a qualified expert as in subdivision (a)(1). The order for examination shall be made only after notice to the person to be examined and to all parties, and shall specify the time, place, manner, conditions, and scope of the examination and the person or persons by whom it is to be made. (2) An examination under this rule is authorized only when the party submitting the request has good cause for the examination. At any hearing the party submitting the request shall have the burden of showing good cause. (3) Upon request of either the party requesting the examination or the party or person to be examined, the court may establish protective rules governing such examination. (b) Report of Examiner. (1) If requested by the party to whom a request for examination or against whom an order is made under subdivision (a)(1)(A) or (a)(1)(B) or by the person examined, the party requesting the examination to be made shall deliver to the other party a copy of a detailed written report of the examiner setting out the examiner's findings, including results of all tests made, diagnosis, and conclusions, with similar reports of all earlier examinations of the *1056 same condition. After delivery of the detailed written report, the party requesting the examination to be made shall be entitled upon request to receive from the party to whom the request for examination or against whom the order is made a similar report of any examination of the same condition previously or thereafter made, unless in the case of a report of examination of a person not a party the party shows the inability to obtain it. On motion, the court may order delivery of a report on such terms as are just; and if an examiner fails or refuses to make a report, the court may exclude the examiner's testimony if offered at the trial. (2) By requesting and obtaining a report of the examination so ordered or requested or by taking the deposition of the examiner, the party examined waives any privilege that party may have in that action or any other involving the same controversy regarding the testimony of every other person who has examined or may thereafter examine that party concerning the same condition. (3) This subdivision applies to examinations made by agreement of the parties unless the agreement provides otherwise. This subdivision does not preclude discovery of a report of an examiner or taking the deposition of the examiner in accordance with any other rule. (c) Examiner as Witness. The examiner may be called as a witness by any party to the action, but shall not be identified as appointed by the court. . . . . RULE 1.491. CHILD SUPPORT ENFORCEMENT is deleted in its entirety (See new Florida Family Law Rule of Procedure 1.492). . . . . RULE 1.540. RELIEF FROM JUDGMENT, DECREES, OR ORDERS (a) Clerical Mistakes. Clerical mistakes in judgments, decrees, or other parts of the record and errors therein arising from oversight or omission may be corrected by the court at any time on its own initiative or on the motion of any party and after such notice, if any, as the court orders. During the pendency of an appeal such mistakes may be so corrected before the record on appeal is docketed in the appellate court, and thereafter while the appeal is pending may be so corrected with leave of the appellate court. (b) Mistakes; Inadvertence; Excusable Neglect; Newly Discovered Evidence; Fraud; etc. On motion and upon such terms as are just, the court may relieve a party or a party's legal representative from a final judgment, decree, order, or proceeding for the following reasons: (1) mistake, inadvertence, surprise, or excusable neglect; (2) newly discovered evidence which by due diligence could not have been discovered in time to move for a new trial or rehearing; (3) fraud (whether heretofore denominated intrinsic or extrinsic), misrepresentation, or other misconduct of an adverse party; (4) that the judgment or decree is void; or (5) that the judgment or decree has been satisfied, released, or discharged, or a prior judgment or decree upon which it is based has been reversed or otherwise vacated, or it is no longer equitable that the judgment or decree should have prospective application. The motion shall be made within a reasonable time, and for reasons (1), (2), and (3) not more than 1 year after the judgment, decree, order, or proceeding was entered or taken, except that there shall be no time limit for motions based on fraudulent financial affidavits in marital cases. A motion under this subdivision does not affect the finality of a judgment or decree or suspend its operation. This rule does not limit the power of a court to entertain an independent action to relieve a party from a judgment, decree, order, or proceeding or to set aside a judgment or decree for fraud upon the court. Writs of coram nobis, coram vobis, audita querela, and bills of review and bills in the nature of a bill of review are abolished, and the procedure for obtaining any relief from a judgment or decree shall be by motion as prescribed in these rules or by an independent action. . . . . *1057 RULE 1.611. MARITAL AND POST-MARITAL PROCEEDINGS is deleted in its entirety (See new Florida Family Law Rules of Procedure 12.105, 12.285, and 12.611). . . . . RULE 1.740. FAMILY MEDIATION is deleted in its entirety (See new Florida Family Law Rule of Procedure 1.740). . . . . FORM 1.918. LIS PENDENS NOTICE OF LIS PENDENS TO DEFENDANT ___________________________________, AND ALL OTHERS WHOM IT MAY CONCERN: YOU ARE NOTIFIED of the institution of this action by the plaintiff against you seeking ("to foreclose a mortgage on" or "to partition" or "to quiet title to" or "a divorce and relief concerning" or other type of action) the following property in ________________ County, Florida: (legal description of property) DATED on ____________, 19__. Attorney for __________________________ _______________________________________ _______________________________________ Address Florida Bar No. _______________________ FORM 1.919. NOTICE OF ACTION; CONSTRUCTIVE SERVICE — NO PROPERTY NOTICE OF ACTION TO ___________________: YOU ARE NOTIFIED that an action for ("dissolution of marriage" or "construction of a will" or "re-establishment of a lost deed" or other type of action) has been filed against you and you are required to serve a copy of your written defenses, if any, to it on ________________, the plaintiff's attorney, whose address is _______________, on or before ____________, 19__, and file the original with the clerk of this court either before service on the plaintiff's attorney or immediately thereafter; otherwise a default will be entered against you for the relief demanded in the complaint or petition. DATED on ___________, 19__. (Name of Clerk) As Clerk of the Court By As Deputy Clerk NOTE: This form must be modified to name the other defendants when there are multiple defendants and all are not served under the same notice. See section 49.08(1), Florida Statutes (1979). . . . . *1058 FORM 1.943. DISSOLUTION OF MARRIAGE is deleted in its entirety (See Family Law Forms). . . . . FORM 1.975. FINANCIAL STATEMENT FOR DISSOLUTION OF MARRIAGE (DIVORCE) is deleted in its entirety (see Family Law Forms). . . . . FORM 1.982. CONTEMPT NOTICE MOTION AND NOTICE OF HEARING TO: (name of attorney for party, or party if not represented) YOU ARE NOTIFIED that plaintiff will apply to the Honorable ____________, Circuit Judge, on ___________, 19__, at ____ m., in the _____________ County Courthouse at _______________, Florida, for an order adjudging (defendant's name) in contempt of court for violation of the terms of the order or judgment entered by this court on ________, 19__, by failing to ___________, and I certify that a copy hereof has been furnished to ________________ by mail on ____________, 19__. NOTE: If the violation is of another nature, tThe particular violation must be inserted instead of failure to pay alimony in the motion and notice. A separate motion is unnecessary. . . . . FORM 1.995. FINAL JUDGMENT DISSOLVING MARRIAGE is deleted in its entirety (See Family Law Forms). . . . . FORM 7. MARRIAGE DISSOLUTION — INTERROGATORIES TO PARTY is deleted in its entirety (See Family Law Forms). APPENDIX B NEW FLORIDA FAMILY LAW RULES OF PROCEDURE RULE 12.000. PREFACE These rules consist of two separate sections. Section I contains the procedural rules governing family law matters and their commentary. Section II contains forms, commentary, and appendices. The commentary and appendices to the forms are included to assist litigants unrepresented by counsel and do not, in and of themselves, constitute official rules or commentary of the Florida Supreme Court. Commentary 1995 Adoption. These rules were adopted after the Florida Supreme Court determined that separate rules for family court procedure were necessary. See In re Florida R. Fam. Ct. P., 607 So.2d 396 (Fla. 1992). The court recognized that family law cases are different from other civil matters, emphasizing that the 1993 creation of family divisions in the circuit courts underscored the differences between family law matters and other civil matters. In adopting the family law rules, the court stressed the need for simplicity due to the large number of pro se litigants (parties without counsel) in family law matters. In an effort to assist the many pro se litigants in this field, the court has included simplified forms and instructional commentary in these rules. See Section II. The instructional commentary to the forms refers to these rules or the Florida Rules of Civil Procedure, where applicable. *1059 The forms originally were adopted by the court pursuant to Family Law Rules of Procedure, ___ So.2d ___ (Fla. 1995); In re Petition for Approval of Forms Pursuant to Rule 10-1.1(b) of the Rules Regulating The Florida Bar — Stepparent Adoption Forms, 613 So.2d 900 (Fla. 1992); Rules Regulating The Florida Bar — Approval of Forms, 581 So.2d 902 (Fla. 1991). SECTION I FAMILY LAW RULES OF PROCEDURE RULE 12.005. TRANSITION RULE These rules shall apply to all family law cases effective January 1, 1996. Any action taken in a family law case before January 1, 1996, that conformed to the then-effective rules or statutes governing family law cases, will be regarded as valid during the pendency of the litigation. Commentary 1995 Adoption. This rule provides for an effective date of January 1, 1996, for these Florida Family Law Rules of Procedure. Under this rule, any action taken in a family law matter before January 1, 1996, will be regarded as valid during the pendency of the litigation so long as that action was taken in accordance with the then-effective rules or statutes governing family law cases. Any action taken after January 1, 1996, in new or pending family law cases will be governed by these rules. ------------------------------------------------------------------------ RULE 12.010. SCOPE, PURPOSE, AND TITLE (a) Scope. (1) These rules apply to all actions concerning family matters, including actions concerning domestic and repeat violence, except as otherwise provided by the Florida Rules of Juvenile Procedure or the Florida Probate Rules. "Family matters," "family law matters," or "family law cases" as used within these rules include, but are not limited to, matters arising from dissolution of marriage, annulment, support unconnected with dissolution of marriage, paternity, child support, custodial care of or access to children (except as otherwise provided by the Florida Rules of Juvenile Procedure), adoption, proceedings for emancipation of a minor, declaratory judgment actions related to premarital, marital, or post-marital agreements (except as otherwise provided, when applicable, by the Florida Probate Rules), injunctions for domestic and repeat violence, and all proceedings for modification, enforcement, and civil contempt of these actions. (2) The form, content, procedure, and time for pleading in all special statutory proceedings shall be as prescribed by the statutes governing the proceeding unless these rules or the Florida Rules of Civil Procedure, where applicable, specifically provide to the contrary. All actions governed by these rules also shall be governed by the Florida Evidence Code, which shall govern in cases where a conflict with these rules may occur. (b) Purpose. (1) These rules shall be construed to secure the just, speedy, and inexpensive determination of the procedures covered by them and shall be construed to secure simplicity in procedure and fairness in administration. (2) Nothing shall prohibit any intake personnel in family law divisions from assisting in the preparation of papers or forms to be filed in any action under these rules. (c) Title. These rules shall be known as the Florida Family Law Rules of Procedure and abbreviated as Fla. Fam. L.R.P. ------------------------------------------------------------------------ *1060 RULE 12.020. APPLICABILITY OF FLORIDA RULES OF CIVIL PROCEDURE The Florida Rules of Civil Procedure are applicable in all family law matters except as otherwise provided in these rules. These rules shall govern in cases where a conflict with the Florida Rules of Civil Procedure may occur. Whenever the Florida Rules of Civil Procedure apply to family matters, the use of the words plaintiff, defendant, and complaint within the context of the civil rules shall be interchangeable, where appropriate, with the words, petitioner, respondent, and petition, respectively. Commentary 1995 Adoption. To avoid confusion among members of the bar who practice in both family law and civil law areas, it is intended that as much uniformity as possible be maintained between the Florida Family Law Rules of Procedure and the Florida Rules of Civil Procedure. To assist in this effort, the Florida Supreme Court determined that the Florida Rules of Civil Procedure were to apply except as set forth herein. Exceptions and additions to the Florida Rules of Civil Procedure are contained in Florida Family Law Rules of Procedure that are numbered to correspond to their civil rule counterparts. For example, exceptions to Florida Rule of Civil Procedure 1.080 are contained in Florida Family Law Rule of Procedure 12.080. RULE 12.030. NONVERIFICATION OF PLEADINGS Verification of pleadings shall be governed by Florida Rule of Civil Procedure 1.030. ------------------------------------------------------------------------ RULE 12.050. WHEN ACTION COMMENCED Commencement of actions shall be governed by Florida Rule of Civil Procedure 1.050. ------------------------------------------------------------------------ RULE 12.060. TRANSFERS OF ACTIONS Transfers of actions shall be governed by Florida Rule of Civil Procedure 1.060. ------------------------------------------------------------------------ RULE 12.070. PROCESS (a) Family Law Actions Generally. Service of process upon the commencement of all family law actions except domestic and repeat violence shall be as set forth in Florida Rule of Civil Procedure 1.070, except that summons, cross-claim summons, and third-party summons in family law matters shall be patterned after Florida Family Law Form 12.910(a) and shall specifically contain the following language: WARNING: Rule 12.285, Florida Family Law Rules of Procedure, requires certain automatic disclosure of documents and information. Failure to comply can result in sanctions, including dismissal or striking of pleadings. (b) Domestic and Repeat Violence Injunctions. Service of process regarding domestic and repeat violence actions shall be governed by Florida Family Law Rule of Procedure 12.610. ------------------------------------------------------------------------ RULE 12.080. SERVICE OF PLEADINGS AND PAPERS (a) Service. (1) Family Law Actions Generally. Service of pleadings and papers after commencement of all family law actions except domestic and repeat violence shall be as set forth in *1061 Florida Rule of Civil Procedure 1.080, except that rule 1.080 shall be expanded as set forth in subdivisions (b) and (c) to include additional requirements for service of recommended orders and for service on defaulted parties. (2) Domestic and Repeat Violence Actions. Service of pleadings and papers regarding domestic and repeat violence actions shall be governed by Florida Family Law Rule of Procedure 12.610. (b) Service and Preparation of Orders and Judgments. (1) Family Law Actions Generally. A copy of all orders or judgments involving family law matters except domestic and repeat violence shall be transmitted by the court or under its direction to all parties at the time of entry of the order or judgment. The court may requires that recommended orders, orders, or judgments be prepared by a party. If the court requires that a party prepare the recommended order, order, or judgment, the party shall furnish the court with stamped, addressed envelopes to all parties for service of the recommended order, order, or judgment. The court also may require that any proposed recommended order, order, or judgment that is prepared by a party be furnished to all parties no less than 24 hours before submission to the court of the recommended order, order, or judgment. (2) Domestic and Repeat Violence Actions. Service and preparation of orders and judgments involving domestic and repeat violence shall be governed by Florida Family Law Rule of Procedure 12.610. (c) Defaulted Parties. No service need be made on parties against whom a default has been entered, except that: (1) Pleadings asserting new or additional claims against defaulted parties shall be served in the manner provided for service of summons contained in Florida Rule of Civil Procedure 1.070. (2) Notice of final hearings or trials and court orders shall be served on defaulted parties in the manner provided for service of pleadings and papers contained in Florida Rule of Civil Procedure 1.080. (3) Final judgments shall be served on defaulted parties as set forth in Florida Rule of Civil Procedure 1.080(h)(2). Commentary 1995 Adoption. This rule provides that the procedure for service shall be as set forth in Florida Rule of Civil Procedure 1.080 with the following exceptions or additions to that rule. First, subdivision (b) corresponds to and replaces subdivision (h)(1) of rule 1.080 and expands the rule to include recommended orders. Second, this rule expands items that must be served on defaulted parties to ensure that defaulted parties are at least minimally advised of the progress of the proceedings. This rule is not intended to require the furnishing of a proposed recommended order, proposed order, or proposed final judgment to a defaulted party. ------------------------------------------------------------------------ RULE 12.090. TIME Time shall be governed by Florida Rule of Civil Procedure 1.090. ------------------------------------------------------------------------ RULE 12.100. PLEADINGS AND MOTIONS Pleadings and motions shall be governed by Florida Rule of Civil Procedure 1.100. *1062 Commentary 1995 Adoption. This rule provides that pleadings and motions are to be governed by Florida Rule of Civil Procedure 1.100. The cover sheets and disposition forms described in that rule shall be the same cover sheets and disposition forms used in family law proceedings. ------------------------------------------------------------------------ RULE 12.105. SIMPLIFIED DISSOLUTION PROCEDURE (a) Requirements for Use. The parties to the dissolution may file a petition for simplified dissolution if they certify under oath that (1) there are no minor or dependent children of the parties and the wife is not now pregnant; (2) the parties have made a satisfactory division of their property and have agreed as to payment of their joint obligations; and (3) the other facts set forth in Florida Family Law Form 12.901(a) (Petition for Simplified Dissolution of Marriage) are true. (b) Consideration by Court. The clerk shall submit the petition to the court. The court shall consider the cause expeditiously. The parties shall appear before the court in every case and, if the court so directs, testify. The court, after examination of the petition and personal appearance of the parties, shall enter a judgment granting the dissolution (Florida Family Law Form 12.990(a)) if the requirements of this rule have been established and there has been compliance with the waiting period required by statute. (c) Financial Affidavit and Settlement Agreement. The parties must each file a financial affidavit (Family Law Form 12.901(d) or 12.901(e)), and a marital settlement agreement (Family Law Form 12.901(h)). (d) Final Judgment. Upon the entry of the judgment, the clerk shall furnish to each party a certified copy of the final judgment of dissolution, which shall be in substantially the form provided in Family Law Form 12.990(a). (e) Forms. The clerk or family law intake personnel shall provide forms for the parties whose circumstances meet the requirements of this rule and shall assist in the preparation of the petition for dissolution and other papers to be filed in the action. Commentary 1995 Adoption. This rule was previously contained in Florida Rule of Civil Procedure 1.611, which included several unrelated issues. Those issues are now governed by separate family law rules for automatic disclosure, central governmental depository, and this rule for simplified dissolution procedure. Under this rule, the parties must file a financial affidavit (Family Law Form 12.901(d) or 12.901(e)), depending on their income and expenses and a marital settlement agreement (Family Law Form 12.901(h)). ------------------------------------------------------------------------ RULE 12.110. GENERAL RULES OF PLEADING The general rules of pleading in Florida Rule of Civil Procedure 1.110 shall apply to these proceedings except that proceedings to modify a final judgment in a family law matter shall be initiated only pursuant to rule 1.110(h) and not by motion. Commentary 1995 Adoption. This rule clarifies that final judgment modifications must be initiated pursuant to a supplemental petition as set forth in rule 1.110(h), rather than through a *1063 motion. Rule 1.110(h) is to be interpreted to require service of process on a supplemental petition as set forth in Florida Family Law Rule of Procedure 12.070. ------------------------------------------------------------------------ RULE 12.120. PLEADING SPECIAL MATTERS Pleading of special matters shall be governed by Florida Rule of Civil Procedure 1.120. ------------------------------------------------------------------------ RULE 12.130. DOCUMENTS SUPPORTING ACTION OR DEFENSE Attachment of documents supporting an action or defense shall be governed by Florida Rule of Civil Procedure 1.130. ------------------------------------------------------------------------ RULE 12.140. DEFENSES Defenses shall be governed by Florida Rule of Civil Procedure 1.140. ------------------------------------------------------------------------ RULE 12.150. SHAM PLEADINGS Sham pleadings shall be governed by Florida Rule of Civil Procedure 1.150. ------------------------------------------------------------------------ RULE 12.160. MOTIONS Motions shall be governed by Florida Rule of Civil Procedure 1.160. ------------------------------------------------------------------------ RULE 12.170. CROSSCLAIMS Crossclaims shall be governed by Florida Rule of Civil Procedure 1.170. ------------------------------------------------------------------------ RULE 12.180. THIRD-PARTY PRACTICE Third-party practice shall be governed by Florida Rule of Civil Procedure 1.180. ------------------------------------------------------------------------ RULE 12.190. AMENDED AND SUPPLEMENTAL PLEADINGS Amended and supplemental pleadings shall be governed by Florida Rule of Civil Procedure 1.190. ------------------------------------------------------------------------ RULE 12.200. CASE MANAGEMENT AND PRETRIAL CONFERENCES (a) Case Management Conference. A case management conference may be ordered by the court at any time on the court's initiative. A party may request a case management conference 30 days after service of a petition or complaint. At such a conference the court may: (1) schedule or reschedule the service of motions, pleadings, and other papers; (2) set or reset the time of trials, subject to rule 12.440; (3) coordinate the progress of the action if complex litigation factors are present; *1064 (4) limit, schedule, order, or expedite discovery; (5) schedule disclosure of expert witnesses and the discovery of facts known and opinions held by such experts; (6) schedule or hear motions related to admission or exclusion of evidence; (7) pursue the possibilities of settlement; (8) require filing of preliminary stipulations if issues can be narrowed; (9) refer issues to a master for findings of fact, if consent is obtained as provided in rules 12.490 and 12.492 and if no significant history or domestic or repeat violence that would compromise the process is involved in the case; (10) refer the parties to mediation if no significant history or domestic or repeat violence that would compromise the mediation process is involved in the case and consider allocation of expenses related to the referral; or refer the parties to counseling if no significant history of domestic or repeat violence that would compromise the process is involved in the case and consider allocation of expenses related to the referral; (11) coordinate voluntary binding arbitration consistent with Florida law if no significant history of domestic or repeat violence that would compromise the process is involved in the case; (12) appoint court experts and allocate the expenses for the appointments; (13) refer the cause for a home study or psychological evaluation and allocate the initial expense for that study; (14) appoint an attorney or guardian ad litem for a minor child or children if required and allocate the expense of the appointment; and (15) schedule other conferences or determine other matters that may aid in the disposition of the action. (b) Pretrial Conference. After the action is at issue the court itself may or shall on the timely motion of any party require the parties to appear for a conference to consider and determine: (1) proposed stipulations and the simplification of the issues; (2) the necessity or desirability of amendments to the pleadings; (3) the possibility of obtaining admissions of fact and of documents that will avoid unnecessary proof; (4) the limitation of the number of expert witnesses; and (5) any matters permitted under subdivision (a) of this rule. (c) Notice. Reasonable notice shall be given for a case management conference, and 20 days' notice shall be given for a pretrial conference. On failure of a party to attend a conference, the court may dismiss the action, strike the pleadings, limit proof or witnesses, or take any other appropriate action. Any documents that the court requires for any conference shall be specified in the order. Orders setting pretrial conferences shall be uniform throughout the territorial jurisdiction of the court. *1065 (d) Case Management and Pretrial Order. The court shall make an order reciting the action taken at a conference and any stipulations made. The order shall control the subsequent course of the action unless modified to prevent injustice. Commentary 1995 Adoption. This rule addresses issues raised by decisions such as Dralus v. Dralus, 627 So.2d 505 (Fla. 2d DCA 1993); Wrona v. Wrona, 592 So.2d 694 (Fla. 2d DCA 1991); and Katz v. Katz, 505 So.2d 25 (Fla. 4th DCA 1987), regarding the cost of marital litigation. This rule provides an orderly method for the just, speedy, and inexpensive determination of issues and promotes amicable resolution of disputes. This rule replaces and substantially expands Florida Rule of Civil Procedure 1.200 as it pertained to family law matters. Under this rule, a court may convene a case management conference at any time and a party may request a case management conference 30 days after service of a petition or complaint. The court may consider the following additional items at the conference: motions related to admission or exclusion of evidence, referral of issues to a master if consent is obtained pursuant to the rules, referral of the parties to mediation, referral of the parties to counseling, coordination of voluntary binding arbitration, appointment of court experts, referral of the cause for a home study psychological evaluation, and appointment of an attorney or guardian ad litem for a minor child. ------------------------------------------------------------------------ RULE 12.210. PARTIES Parties to an action filed under the Florida Family Law Rules of Procedure shall be governed by Florida Rule of Civil Procedure 1.210, except that rule 1.210 shall not be read to require that a child is an indispensable party for a dissolution of marriage or child custody proceeding. ------------------------------------------------------------------------ RULE 12.230. INTERVENTIONS Interventions shall be governed by Florida Rule of Civil Procedure 1.230. ------------------------------------------------------------------------ RULE 12.240. INTERPLEADER Interpleaders shall be governed by Florida Rule of Civil Procedure 1.240. ------------------------------------------------------------------------ RULE 12.250. MISJOINDER AND NONJOINDER OF PARTIES Misjoinder and nonjoinder of parties shall be governed by Florida Rule of Civil Procedure 1.250. ------------------------------------------------------------------------ RULE 12.260. SURVIVOR; SUBSTITUTION OF PARTIES Survivors and the substitution of parties shall be governed by Florida Rule of Civil Procedure 1.260. ------------------------------------------------------------------------ RULE 12.270. CONSOLIDATION; SEPARATE TRIALS Consolidation or separation of trials shall be governed by Florida Rule of Civil Procedure 1.270. ------------------------------------------------------------------------ *1066 RULE 12.280. GENERAL PROVISIONS GOVERNING DISCOVERY Florida Rule of Civil Procedure 1.280 shall govern general provisions concerning discovery in family law matters with the following exceptions: (a) Supplementing of Responses. A party is under a duty to amend a prior response or disclosure if the party: (1) obtains information or otherwise determines that the prior response or disclosure was incorrect when made; (2) obtains information or otherwise determines that the prior response or disclosure, although correct when made, is no longer materially true or complete. (b) Time for Filing Supplemental Responses. Any supplemental response filed pursuant to this rule shall be filed as soon as possible after discovery of the incorrect information or change, but in no case shall the supplemental response be filed later than 24 hours before any applicable hearing absent a showing of good cause. (c) Documents Considered Confidential. A determination as to the confidentiality of a court record shall be made in accordance with Florida Rule of Judicial Administration 2.051. (d) Sealing of Records. Records found to be confidential under Florida Rule of Judicial Administration 2.051 shall be sealed on request of a party. Commentary 1995 Adoption. Florida Rule of Civil Procedure 1.280 is to govern the general discovery provisions in family law matters with the exceptions set forth above. Subdivision (a) of this rule alters rule 1.280(e) by placing a duty on parties in family law matters to supplement responses. Under rule 1.280(e), no supplemental response is required. Subdivisions (b), (c), and (d) of this rule are in addition to the general requirements of rule 1.280 and have no counterparts in the Rules of Civil Procedure. Subdivisions (c) and (d) have been implemented in recognition of the fact that family law cases often involve sensitive information that should be deemed confidential under Florida Rule of Judicial Administration 2.051. For instance, financial records filed may contain information regarding a family business, which, if public, could provide competitors with an advantage and adversely affect the family business. ------------------------------------------------------------------------ RULE 12.285. MANDATORY DISCLOSURE (a) Application. (1) Scope. This rule shall apply to all proceedings within the scope of these rules except proceedings involving adoption, simplified dissolution, enforcement, contempt, and injunctions for domestic or repeat violence. Additionally, no financial affidavit or other documents shall be required under this rule from a party seeking attorneys' fees, suit money, or costs, if the basis for the request is solely under section 57.105, Florida Statutes, or any successor statute. Except for the provisions as to financial affidavits, any portion of this rule may be modified by order of the court or agreement of the parties. (2) Original and Duplicate Copies. Unless otherwise agreed by the parties or ordered by the court, copies of documents required under this rule may be produced in lieu of originals. Originals, when available, shall be produced for inspection upon request. Parties shall not be required to serve duplicates of documents previously served. (b) Time for Production of Documents. (1) Temporary Financial Hearings. Any document required under this rule in any temporary financial relief proceeding shall be served on the other party for inspection and copying as follows. *1067 (A) The party seeking relief shall serve the required documents on the other party with the notice of temporary financial hearing, unless the documents have been served under subdivision (b)(2) of this rule. (B) The responding party shall serve the required documents on the party seeking relief on or before 5:00 p.m., 2 business days before the day of the temporary financial hearing if served by delivery or 7 days before the day of the temporary financial hearing if served by mail, unless the documents have been received previously by the party seeking relief under subdivision (b)(2) of this rule. A responding party shall be given no less than 12 days to serve the documents required under this rule, unless otherwise ordered by the court. If the 45-day period for exchange of documents provided for in subdivision (b)(2) of this rule will occur before the expiration of the 12 days, the provisions of subdivision (b)(2) control. (2) Initial and Supplemental Proceedings. Any document required under this rule for any initial or supplemental proceeding shall be served on the other party for inspection and copying within 45 days of service of the initial pleading on the respondent. (c) Parties Whose Annual Income and Expenses Are Less Than $50,000. Any party whose gross annual income from all sources is less than $50,000 and whose total annual expenses are less than $50,000 shall be required to serve the following documents in any proceeding for an initial or supplemental request for temporary or permanent financial relief, including, but not limited to, a request for child support, alimony, equitable distribution of assets or debts, or attorneys' fees, suit money, or costs: (1) A financial affidavit in substantial conformity with Family Law Form 12.901(d), which requirement cannot be waived by the parties. (2) All federal and state income tax returns, gift tax returns, and intangible personal property tax returns filed by the party or on the party's behalf for the past three years. (3) IRS forms W-2, 1099, and K-1 for the past year, if the income tax return for that year has not been prepared. (4) Pay stubs or other evidence of earned income for the 3 months prior to service of the financial affidavit. (5) A statement by the producing party identifying the amount and source of all income received from any source during the 3 months preceding the service of the financial affidavit required by this rule if not reflected on the pay stubs produced. (6) All loan applications and financial statements prepared or used within the 3 years preceding service of that party's financial affidavit required by this rule, whether for the purpose of obtaining or attempting to obtain credit or for any other purpose. (d) Parties Whose Annual Income or Expenses Are Equal To or Exceed $50,000. Any party whose gross annual income from all sources is equal to or exceeds $50,000 or whose total annual expenses are equal to or exceed $50,000 shall be required to serve the documents on the other party as follows. (1) Temporary Financial Relief. In any proceeding for temporary financial relief, the following documents shall be served on the other party: (A) A financial affidavit in substantial conformity with Family Law Form 12.901(e), which requirement cannot be waived by the parties. (B) All federal and state income tax returns, gift tax returns, and intangible personal property tax returns filed by the party or on the party's behalf for the past 3 years. (C) IRS forms W-2, 1099, and K-1 for the past year, if the income tax return for that year has not been prepared. *1068 (D) Pay stubs or other evidence of earned income for the 3 months prior to service of the financial affidavit. (E) A statement by the producing party identifying the amount and source of all income received from any source during the 3 months preceding the service of the financial affidavit required by this rule if not reflected on the pay stubs produced. (F) All loan applications and financial statements prepared or used within the 3 years preceding service of that party's financial affidavit required by this rule, whether for the purpose of obtaining or attempting to obtain credit or for any other purpose. (G) Corporate, partnership, and trust tax returns for the last tax year, if the producing party has an interest in a corporation, partnership, or trust greater than or equal to 30%. (2) Initial Proceedings. In any initial proceeding for permanent financial relief, including, but not limited to, a request for child support, alimony, equitable distribution of assets or debts, or attorneys' fees, suit money, or costs, the following documents shall be served on the other party: (A) All documents listed in subdivision (d)(1). (B) The answers to interrogatories found in Family Law Form 12.930(b). (C) All documents showing reimbursed expenses and in-kind payments that reduce the party's personal living expenses that were received by or made available to the party for the last 3 years. (D) All deeds, mortgages, promissory notes, and closing statements pertaining to real estate in which the party owns or owned an interest within the last 3 years, whether held in the party's name individually, in the party's name jointly with any other person, in the party's name as trustee or guardian for any other person, or in someone else's name on the party's behalf. (E) All periodic statements and passbooks from the last 3 years for all checking accounts, savings accounts, money market funds, certificates of deposit, and credit union accounts (regardless of whether or not the account has been closed), including those held in the party's name individually, in the party's name jointly with any other person or entity, in the party's name as trustee or guardian for any other person, or in someone else's name on the party's behalf. (F) All brokerage account statements in which either party to this action held within the last 3 years or holds an interest including those held in the party's name individually, in the party's name jointly with any person or entity, in the party's name as trustee or guardian for any other person, or in someone else's name on the party's behalf. (G) All title certificates, lease agreements, and registration certificates for all motor vehicles, boats, airplanes, and any other vehicle requiring registration that the party regularly uses, owns, or owned in the last 3 years. (H) The most recent statement for any profit sharing, retirement, or pension plan in which the party is a participant or alternate payee and the summary plan description for any retirement, profit sharing, or pension plan in which the party is a participant or an alternate payee (The summary plan description must be furnished to the party on request by the plan administrator as required by 29 U.S.C. § 1024(b)(4).) (I) All documents pertaining to any money owed to the party or spouse. (J) All life insurance policies insuring the party's life or the life of the party's spouse. *1069 (K) Corporate, partnership, and trust tax returns for the last 3 years if the party has an ownership or interest in a corporation, partnership, or trust greater than or equal to 30%. (L) Periodic statements, amortization schedules, or other records showing the party's indebtedness as of the date of the filing of this action and for the last 3 years. (M) All written premarital or marital agreements entered into at any time between the parties to this marriage, whether before or during the marriage. (N) All documents and tangible evidence supporting the producing party's claim of special equity or nonmarital status of an asset or debt for the time period from the date of acquisition of the asset or debt to the date of production or from the date of marriage, if based on premarital acquisition. (O) Any court orders directing a party to pay or receive spousal or child support. (3) Supplemental Proceedings. In any temporary or permanent supplemental proceeding regarding financial relief, documents shall be produced as set forth in subdivisions (d)(1) and (d)(2), respectively and shall be served as set forth in subdivision (b)(1). Additionally, in any modification proceeding, each party shall serve on the opposing party all written agreements entered into between them at any time since the order to be modified was entered. (e) Duty to Supplement Disclosure; Amended Financial Affidavit. (1) Parties have a continuing duty to supplement documents described in this rule, including financial affidavits, whenever a material change in their financial status occurs. (2) If an amended financial affidavit or an amendment to a financial affidavit is served, the amending party also shall serve any subsequently discovered or acquired documents supporting the amendments to the financial affidavit if the party falls within the provisions of subdivision (d). (f) Sanctions. Any document to be produced under this rule that is served on the opposing party fewer than 24 hours before a nonfinal hearing or in violation of the court's pretrial order shall not be admissible in evidence at that hearing unless the court finds good cause for the delay. In addition, the court may impose other sanctions authorized by rule 12.380 as may be equitable under the circumstances. The court may also impose sanctions upon the offending lawyer in lieu of imposing sanctions on a party. (g) Objections to Mandatory Automatic Disclosure. Objections to the mandatory automatic disclosure required by this rule shall be served in writing at least 5 days prior to the due date for the disclosure or the objections shall be deemed waived. For good cause shown, the court may extend the time for the filing of an objection or permit the filing of an otherwise untimely objection. (h) Certificate of Compliance. All parties subject to automatic mandatory disclosure shall file with the court a certificate of compliance identifying with particularity the documents which have been delivered and certifying the date of service of the financial affidavit and documents by that party. (i) Place of Production. (1) Unless otherwise agreed by the parties or ordered by the court, all production required by this rule shall take place in the county where the action is pending and in the office of the attorney for the party receiving production. Unless otherwise agreed by the parties or ordered by the court, if a party does not have an attorney or if the attorney does not have an office in the county where the action is pending, production shall take place in the county where the action is pending at a place designated in writing by the party receiving production, served at least 5 days before the due date for production. *1070 (2) If venue is contested, on motion by a party the court shall designate the place where production will occur pending determination of the venue issue. Commentary 1995 Adoption. This rule creates a procedure for automatic financial disclosure in family law cases. By requiring production at an early stage in the proceedings, it is hoped that the expense of litigation will be minimized. See Dralus v. Dralus, 627 So.2d 505 (Fla. 2d DCA 1993); Wrona v. Wrona, 592 So.2d 694 (Fla. 2d DCA 1991); and Katz v. Katz, 505 So.2d 25 (Fla. 4th DCA 1987). A limited number of requirements have been placed upon parties making and spending less than $50,000 annually unless otherwise ordered by the court. In cases where the income or expenses of a party are equal to or exceed $50,000 annually, the requirements are much greater. Except for the provisions as to financial affidavits, any portion of this rule may be modified by agreement of the parties or by order of the court. For instance, upon the request of any party or on the court's own motion, the court may order that the parties to the proceeding comply with some or all of the automatic mandatory disclosure provisions of this rule even though the parties do not meet the income requirements set forth in subdivision (d). Additionally, the court may, on the motion of a party or on its own motion, limit the disclosure requirements in this rule should it find good cause for doing so. ------------------------------------------------------------------------ RULE 12.290. DEPOSITIONS BEFORE ACTION OR PENDING APPEAL Depositions before an action or pending an appeal shall be governed by Florida Rule of Civil Procedure 1.290. ------------------------------------------------------------------------ RULE 12.300. PERSONS BEFORE WHOM DEPOSITIONS MAY BE TAKEN Provisions regarding who may take depositions shall be governed by Florida Rule of Civil Procedure 1.300. ------------------------------------------------------------------------ RULE 12.310. DEPOSITIONS UPON ORAL EXAMINATION Depositions upon oral examination shall be governed by Florida Rule of Civil Procedure 1.310. ------------------------------------------------------------------------ RULE 12.320. DEPOSITIONS UPON WRITTEN QUESTIONS Depositions upon written questions shall be governed by Florida Rule of Civil Procedure 1.320. ------------------------------------------------------------------------ RULE 12.330. USE OF DEPOSITIONS IN COURT PROCEEDINGS Use of depositions in court proceedings shall be governed by Florida Rule of Civil Procedure 1.330. ------------------------------------------------------------------------ RULE 12.340. INTERROGATORIES TO PARTIES Interrogatories to parties shall be governed generally by Florida Rule of Civil Procedure 1.340, with the following exceptions. (a) Initial Interrogatories. Initial interrogatories to parties shall be those set forth in Family Law Form 12.930(b). Parties governed by the mandatory disclosure requirements of *1071 rule 12.285(d) (income or expenses of $50,000 or more) shall automatically submit the answers to those interrogatories as provided in that rule. Parties governed by the mandatory disclosure requirements of rule 12.285(c) (income and expenses under $50,000), may serve the interrogatories set forth in Family Law Form 12.930(b) as set forth in rule 1.340. (b) Additional Interrogatories. Ten interrogatories, including subparts, may be sent to a party in addition to the standard interrogatories contained in Family Law Form 12.930(b). A party must obtain permission of the court to send more than ten additional interrogatories. Commentary 1995 Adoption. For parties governed under the disclosure requirements of rule 12.285(d) (income or expenses of $50,000 or more), the answers to the interrogatories contained in Form 12.930(b) must be automatically served on the other party. For parties governed under the disclosure requirements of rule 12.285(c) (income and expenses under $50,000), the service of the interrogatories contained in Form 12.930(b) is optional as provided in Florida Rule of Civil Procedure 1.340. Additionally, under this rule, 10 additional interrogatories, including subparts, may be submitted beyond those contained in Family Law Form 12.930(b). Leave of court is required to exceed 10 additional interrogatories. The provisions of Florida Rule of Civil Procedure 1.340 are to govern the procedures and scope of the additional interrogatories. ------------------------------------------------------------------------ RULE 12.350. PRODUCTION OF DOCUMENTS AND THINGS AND ENTRY UPON LAND FOR INSPECTION AND OTHER PURPOSES Production of documents and things and entry upon land for inspection and other purposes shall be governed by Florida Rule of Civil Procedure 1.350. ------------------------------------------------------------------------ RULE 12.351. PRODUCTION OF DOCUMENTS AND THINGS WITHOUT DEPOSITION Production of documents and things without deposition shall be governed by Florida Rule of Civil Procedure 1.351. ------------------------------------------------------------------------ RULE 12.360. EXAMINATION OF PERSONS Florida Rule of Civil Procedure 1.360 shall govern general provisions concerning the examination of persons in family law matters, except that examinations permitted under rule 1.360(a)(1) may include, but are not limited to, examinations involving physical or mental condition, employability or vocational testing, genetic testing, or any other type of examination related to a matter in controversy. Commentary 1995 Adoption. This rule expands Florida Rule of Civil Procedure 1.360 to specify common examinations in family law matters, but this rule is not intended to be an exclusive list of allowable examinations. Rule 1.360 should be interpreted to discourage subjecting children to multiple interviews, testing, and evaluations. ------------------------------------------------------------------------ RULE 12.370. REQUESTS FOR ADMISSION Requests for admission shall be governed by Florida Rule of Civil Procedure 1.370. ------------------------------------------------------------------------ *1072 RULE 12.380. FAILURE TO MAKE DISCOVERY; SANCTIONS Florida Rule of Civil Procedure 1.380 shall govern the failure to make discovery in family law matters and related sanctions, with the following addition. A party may apply for an order compelling discovery in the manner set forth in rule 1.380 for the failure of any person to comply with any discovery request or requirement under the family law rules, including, but not limited to, the failure to comply with Florida Family Law Rule of Procedure 12.285. ------------------------------------------------------------------------ RULE 12.390. DEPOSITIONS OF EXPERT WITNESSES Depositions of expert witnesses shall be governed by Florida Rule of Civil Procedure 1.390. ------------------------------------------------------------------------ RULE 12.400. CONFIDENTIALITY OF RECORDS AND PROCEEDINGS (a) Closure of Proceedings or Records. Closure of court proceedings or sealing of records may be ordered by the court only as provided by Rule of Judicial Administration 2.051. (b) In Camera Inspection. The court shall conduct an in camera inspection of any records sought to be sealed and consider the contents of the records in determining whether they should be sealed. Commentary 1995 Adoption. Judicial proceedings and records should be public except when substantial compelling circumstances, especially the protection of children or of business trade secrets, require otherwise. Family law matters frequently present such circumstances. It is intended that this rule be applied to protect the interests of minor children from offensive testimony and to protect children in a divorce proceeding. ------------------------------------------------------------------------ RULE 12.407. TESTIMONY AND ATTENDANCE OF MINOR CHILD No minor child shall be deposed or brought to a deposition, brought to court to appear as a witness or to attend a hearing, or subpoenaed to appear at a hearing without prior order of the court based on good cause shown unless in an emergency situation. This provision shall not apply to uncontested adoption proceedings. Commentary 1995 Adoption. This rule is intended to afford additional protection to minor children by avoiding any unnecessary involvement of children in family law litigation. While due process considerations prohibit an absolute ban on child testimony, this rule requires that a judge determine whether a child's testimony is necessary and relevant to issues before the court prior to a child being required to testify. ------------------------------------------------------------------------ RULE 12.410. SUBPOENA Subpoenas shall be governed by Florida Rule of Civil Procedure 1.410. ------------------------------------------------------------------------ RULE 12.420. DISMISSAL OF ACTIONS Dismissal of actions shall be governed by Florida Rule of Civil Procedure 1.420, with the following two exceptions. (a) Voluntary Dismissal. Unless otherwise specified in a notice or stipulation, a voluntary dismissal shall be without prejudice and shall not operate as an adjudication on the merits. *1073 (b) Costs. Costs shall be assessed as provided in rule 1.420(d), except that the court shall not require the payment of costs of a previously dismissed claim, which was based upon or included the same claim against the same adverse party as the current action. Commentary 1995 Adoption. Subdivision (a), which amends Florida Rule of Civil Procedure 1.420(a)(1), was added to eliminate the language of that subdivision which reads "except that a notice of dismissal operates as an adjudication on the merits when served by a plaintiff who has once dismissed in any court an action based on or including the same claim" and to specifically provide to the contrary. Subdivision (b), which amends rule 1.420(d), was added to prevent the discouragement of reconciliation. ------------------------------------------------------------------------ RULE 12.430. DEMAND FOR JURY TRIAL; WAIVER Demands for and waivers of jury trial shall be governed by Florida Rule of Civil Procedure 1.430. ------------------------------------------------------------------------ RULE 12.431. TRIAL JURY Trials by jury shall be governed by Florida Rule of Civil Procedure 1.431. ------------------------------------------------------------------------ RULE 12.440. SETTING ACTION FOR TRIAL Florida Rule of Civil Procedure 1.440 shall govern general provisions concerning setting an action for trial in family law matters, with the following exceptions and additions. (a) Setting for Trial. If the court finds the action ready to be set for trial, it shall enter an order setting the action for trial, fixing a date for trial, and setting a pretrial conference, if necessary. In the event a default has been entered, reasonable notice of not less than 10 days shall be given unless otherwise required by law. Trial shall be set within a reasonable time from the service of the notice for trial. At the pretrial conference, the parties should be prepared, consistent with Florida Family Law Rule of Procedure 12.200, to present any matter that will prepare the parties for trial and that can expedite the resolution of the case. The trial court may also direct the parties to reciprocally exchange and file with the court all documents relative to the outcome of the case; a list of all witnesses, all issues to be tried, and all undisposed motions; an estimate of the time needed to try the case; and any other information the court deems appropriate. This information should be served and filed no later than 72 hours before the pretrial conference or 30 days before the trial. (b) Sanctions. The failure to comply with the requirements of the order setting the action for trial shall subject the party or attorney to appropriate court sanctions. Commentary 1995 Adoption. This rule amends Florida Rule of Civil Procedure 1.440(c), Setting for Trial, and creates a procedure to facilitate setting an action for trial. Proper pretrial compliance will foster knowledgeable settlement discussion and expedite an orderly trial. The rule also adds a provision for sanctions. ------------------------------------------------------------------------ RULE 12.450. EVIDENCE Adverse witnesses, the record of excluded evidence, and the filing of evidence shall be governed by Florida Rule of Civil Procedure 1.450. ------------------------------------------------------------------------ *1074 RULE 12.460. CONTINUANCES Continuances shall be governed by Florida Rule of Civil Procedure 1.460. ------------------------------------------------------------------------ RULE 12.470. EXCEPTIONS UNNECESSARY Exceptions shall be governed by Florida Rule of Civil Procedure 1.470 except that no exception shall be necessary to an adverse ruling other than as provided in rules 12.490 and 12.492. Commentary 1995 Adoption. This rule amends subdivision (a) of rule 1.470 as it applies to family law matters to eliminate possible confusion between common law exceptions and exceptions to recommendations of a general master under rule 12.490 or a special master under rule 12.492. ------------------------------------------------------------------------ RULE 12.480. MOTION FOR A DIRECTED VERDICT Motions for directed verdict shall be governed by Florida Rule of Civil Procedure 1.480. ------------------------------------------------------------------------ RULE 12.481. VERDICTS Verdicts shall be governed by Florida Rule of Civil Procedure 1.481. ------------------------------------------------------------------------ RULE 12.490. GENERAL MASTERS (a) General Masters. Judges of the circuit court may appoint as many general masters from among the members of The Florida Bar in the circuit as the judges find necessary, and the general masters shall continue in office until removed by the court. The order making an appointment shall be recorded. Every person appointed as a general master shall take the oath required of officers by the Constitution and the oath shall be recorded before the master discharges any duties of that office. (b) Reference. (1) No matter shall be heard by a general master without an appropriate order of reference and the consent to the referral of all parties. Consent, as defined in this rule, to a specific referral, once given, cannot be withdrawn without good cause shown before the hearing on the merits of the matter referred. Consent may be express or may be implied in accordance with the requirements of this rule. (A) A written objection to the referral to a general master must be filed within 10 days of the service of the order of referral. (B) If the time set for the hearing is less than 10 days after service of the order of referral, the objection must be filed before commencement of the hearing. (C) If the order of referral is served within the first 20 days after the service of the initial process, the time to file an objection is extended to the time within which to file a responsive pleading. (D) Failure to file a written objection within the applicable time period is deemed to be consent to the order of referral. *1075 (2) The order of referral shall be in substantial conformity with Family Law Form 12.920(a), and shall contain the following language in bold type: A REFERRAL TO A GENERAL MASTER REQUIRES THE CONSENT OF ALL PARTIES. YOU ARE ENTITLED TO HAVE THIS MATTER HEARD BEFORE A JUDGE. IF YOU DO NOT WANT TO HAVE THIS MATTER HEARD BEFORE THE GENERAL MASTER, YOU MUST FILE A WRITTEN OBJECTION TO THE REFERRAL WITHIN 10 DAYS OF THE TIME OF SERVICE OF THIS ORDER. IF THE TIME SET FOR THE HEARING IS LESS THAN 10 DAYS AFTER THE SERVICE OF THIS ORDER, THE OBJECTION MUST BE MADE BEFORE THE HEARING. IF THIS ORDER IS SERVED WITHIN THE FIRST 20 DAYS AFTER SERVICE OF PROCESS, THE TIME TO FILE AN OBJECTION IS EXTENDED TO THE TIME WITHIN WHICH A RESPONSIVE PLEADING IS DUE. FAILURE TO FILE A WRITTEN OBJECTION WITHIN THE APPLICABLE TIME PERIOD IS DEEMED TO BE A CONSENT TO THE REFERRAL. REVIEW OF THE REPORT AND RECOMMENDATIONS MADE BY THE GENERAL MASTER SHALL BE BY EXCEPTIONS AS PROVIDED IN RULE 12.490(f), FLA.FAM.L.R.P. A RECORD, WHICH INCLUDES A TRANSCRIPT OF PROCEEDINGS, MAY BE REQUIRED TO SUPPORT THE EXCEPTIONS. (3) The order of referral shall state with specificity the matter or matters being referred and the name of the general master to whom the matter is referred. The order of referral also shall state whether electronic recording or a court reporter is provided by the court, or whether a court reporter, if desired, must be provided by the litigants. (4) When a reference is made to a general master, any party or the general master may set the action for hearing. (c) General Powers and Duties. Every general master shall perform all of the duties that pertain to the office according to the practice in chancery and rules of court and under the direction of the court except those duties related to domestic and repeat violence. A general master shall be empowered to administer oaths and conduct hearings, which may include the taking of evidence. All grounds for disqualification of a judge shall apply to general masters. (d) Hearings. (1) The general master shall assign a time and place for proceedings as soon as reasonably possible after the reference is made and give notice to each of the parties either directly or by directing counsel to file and serve a notice of hearing. If any party fails to appear, the general master may proceed ex parte or may adjourn the proceeding to a future day, giving notice to the absent party of the adjournment. The general master shall proceed with reasonable diligence in every reference and with the least delay practicable. Any party may apply to the court for an order to the general master to speed the proceedings and to make the report and to certify to the court the reason for any delay. (2) The general master shall take testimony and establish a record which may be by electronic means as provided by Florida Rule of Judicial Administration 2.070(d) or by a court reporter. The parties may not waive this requirement. (3) The general master shall have authority to examine under oath the parties and all witnesses upon all matters contained in the reference to require production of all books, papers, writings, vouchers, and other documents applicable to it, and to examine on oath orally all witnesses produced by the parties. The general master may take all actions concerning evidence that can be taken by the circuit court and in the same manner. The general master shall have the same powers as a circuit judge to utilize communications equipment as defined and regulated by Florida Rule of Judicial Administration 2.071. (4) The notice or order setting the cause for hearing shall be in substantial conformity with Family Law Form 12.920(b) and shall contain the following language in bold type: SHOULD YOU WISH TO SEEK REVIEW OF THE REPORT AND RECOMMENDATION MADE BY THE GENERAL MASTER, YOU MUST FILE EXCEPTIONS IN ACCORDANCE WITH RULE 12.490(f), FLA.FAM.L.R.P. YOU WILL BE REQUIRED *1076 TO PROVIDE THE COURT WITH A RECORD SUFFICIENT TO SUPPORT YOUR EXCEPTIONS OR YOUR EXCEPTIONS WILL BE DENIED. A RECORD ORDINARILY INCLUDES A WRITTEN TRANSCRIPT OF ALL RELEVANT PROCEEDINGS. THE PERSON SEEKING REVIEW MUST HAVE THE TRANSCRIPT PREPARED IF NECESSARY FOR THE COURT'S REVIEW. (5) The notice or order setting a matter for hearing shall state whether electronic recording or a court reporter is provided by the court. If the court provides electronic recording, the notice also shall state that any party may provide a court reporter at that party's expense. (e) General Master's Report. The general master shall file a report that includes findings of fact and conclusions of law, together with recommendations. If a court reporter was present, the report shall contain the name and address of the reporter. (f) Filing Report; Notice; Exceptions. The general master shall file the report and recommendations and serve copies on all parties. The parties may serve exceptions to the report within 10 days from the time it is served on them. Any party may file cross-exceptions within 5 days from the service of the exceptions, provided, however, that the filing of cross-exceptions shall not delay the hearing on the exceptions unless good cause is shown. If no exceptions are filed within that period, the court shall take appropriate action on the report. If exceptions are filed, they shall be heard on reasonable notice by either party or the court. (g) Record. For the purpose of the hearing on exceptions, a record, substantially in conformity with this rule, shall be provided to the court by the party seeking review if necessary for the court's review. (1) The record shall consist of the court file, including the transcript of the relevant proceedings before the general master and all depositions and evidence presented to the general master. (2) The transcript of all relevant proceedings, if any, shall be delivered to the judge and provided to all other parties not less than 48 hours before the hearing on exceptions. If less than a full transcript of the proceedings taken before the general master is ordered prepared by the excepting party, that party shall promptly file a notice setting forth the portions of the transcript that have been ordered. The responding parties shall be permitted to designate any additional portions of the transcript necessary to the adjudication of the issues raised in the exceptions or cross-exceptions. (3) The cost of the original and all copies of the transcript of the proceedings shall be borne initially by the party seeking review, subject to appropriate assessment of suit monies. Should any portion of the transcript be required as a result of a designation filed by the responding party, the party making the designation shall bear the initial cost of the additional transcript. Commentary 1995 Adoption. This rule is a modification of Florida Rule of Civil Procedure 1.490. That rule governed the appointment of both general and special masters. The appointment of special masters is now governed by Florida Family Law Rule of Procedure 12.492. This rule is intended to clarify procedures that were required under rule 1.490, and it creates additional procedures. The use of general masters should be implemented only when such use will reduce costs and expedite cases in accordance with Dralus v. Dralus, 627 So.2d 505 (Fla. 2d DCA 1993), Wrona v. Wrona, 592 So.2d 694 (Fla. 2d DCA 1991), and Katz v. Katz, 505 So.2d 25 (Fla. 4th DCA 1987). RULE 12.491. CHILD SUPPORT ENFORCEMENT (a) Limited Application. This rule shall be effective only when specifically invoked by administrative order of the chief justice for use in a particular county or circuit. *1077 (b) Scope. This rule shall apply to proceedings for the establishment, enforcement, or modification of child support wherein the party seeking support is receiving services pursuant to Title IV-D of the Social Security Act (42 U.S.C. §§ 651 et seq.) and to non-Title IV-D proceedings upon administrative order of the chief justice. (c) Support Enforcement Hearing Officers. The chief judge of each judicial circuit shall appoint such number of support enforcement hearing officers for the circuit or any county within the circuit as are necessary to expeditiously perform the duties prescribed by this rule. A hearing officer shall be a member of The Florida Bar unless waived by the chief justice and shall serve at the pleasure of the chief judge and a majority of the circuit judges in the circuit. (d) Referral. Upon the filing of a cause of action or other proceeding for the establishment, enforcement, or modification of support to which this rule applies, the court or clerk of the circuit court shall refer such proceedings to a support enforcement hearing officer, pursuant to procedures to be established by administrative order of the chief judge. (e) General Powers and Duties. The support enforcement hearing officer shall be empowered to issue process, administer oaths, require the production of documents, and conduct hearings for the purpose of taking evidence. A support enforcement hearing officer does not have the authority to hear contested paternity cases. Upon the receipt of a support proceeding, the support enforcement hearing officer shall: (1) assign a time and place for an appropriate hearing and give notice to each of the parties as may be required by law; (2) take testimony and establish a record, which record may be by electronic means as provided by Florida Rule of Judicial Administration 2.070(d); (3) accept voluntary acknowledgment of paternity and support liability and stipulated agreements setting the amount of support to be paid; and (4) evaluate the evidence and promptly make a recommended order to the court. Such order shall set forth findings of fact. (f) Entry of Order and Relief from Order. Upon receipt of a recommended order, the court shall review the recommended order and shall enter an order promptly unless good cause appears to amend the order, conduct further proceedings, or refer the matter back to the hearing officer to conduct further proceedings. Any party affected by the order may move to vacate the order by filing a motion to vacate within 10 days from the date of entry. Any party may file a cross-motion to vacate within 10 days from the date of rendition; an additional 5 days shall be allowed if the order was served by mail. Any party may file a cross-motion to vacate within 5 days of service of a motion to vacate, provided, however, that the filing of a cross-motion to vacate shall not delay the hearing on the motion to vacate unless good cause is shown. A motion to vacate the order shall be heard within 10 days after the movant applies for hearing on the motion. (g) Modification of Order. Any party affected by the order may move to modify the order at any time. (h) Record. For the purpose of hearing on a motion to vacate, a record, substantially in conformity with this rule, shall be provided to the court by the party seeking review. (1) The record shall consist of the court file, including the transcript of the proceedings before the hearing officer, if filed, and all depositions and evidence presented to the hearing officer. (2) The transcript of all relevant proceedings shall be delivered to the judge and provided to opposing counsel not less than 48 hours before the hearing on the motion to vacate. If less than a full transcript of the proceedings taken before the hearing officer is ordered prepared by the moving party, that party shall promptly file a notice setting forth the portions of the *1078 transcript that have been ordered. The responding party shall be permitted to designate any additional portions of the transcript necessary to the adjudication of the issues raised in the motion to vacate or cross-motion to vacate. (3) The cost of the original and all copies of the transcript of the proceedings shall be borne initially by the party seeking review, subject to appropriate assessment of suit monies. Should any portion of the transcript be required as a result of a designation filed by the responding party, the party making the designation shall bear the initial cost of the additional transcript. Commentary 1995 Adoption. Previously, this rule was contained in Florida Rule of Civil Procedure 1.491. The new rule is substantially the same as previous rule 1.491, with the following additions. It is intended that any administrative order issued by the chief justice of the Florida Supreme Court under rule 1.491(a) shall remain in full force and effect as though such order was rendered under this rule until changed by order of that same court. Subdivision (e) now makes clear that contested paternity cases are not to be heard by support enforcement hearing officers. Subdivision (h) has been added to provide requirements for a record. The following notes and commentary have been carried forward from rule 1.491. 1988 Adoption. Title: The terminology "hearing officer" is used rather than "master" to avoid confusion or conflict with rule 1.490. Subdivision (a): The rule is intended as a fall back mechanism to be used by the chief justice as the need may arise. Subdivision (b): The expedited process provisions of the applicable federal regulations apply only to matters which fall within the purview of Title IV-D. The committee recognizes, however, that the use of hearing officers could provide a useful case flow management tool in non-Title IV-D support proceedings. It is contemplated that a circuit could make application to the chief justice for expansion of the scope of the rule upon a showing of necessity and good cause. It is the position of the representative of the Family Law Section of The Florida Bar that reference of non-Title IV-D proceedings should require the consent of the parties as is required by rule 1.490(c). Subdivision (c): It is the position of the committee that hearing officers should be members of the Bar in that jurisdictional and other legal issues are likely to arise in proceedings of this nature. The waiver provision is directed to small counties in which it may be difficult or impossible to find a lawyer willing to serve and to such other special circumstances as may be determined by the chief justice. Subdivision (d): This paragraph recognizes that the mechanics of reference and operation of a program are best determined at the local level. Subdivision (e): This paragraph is intended to empower the hearing officer to fully carry out his or her responsibilities without becoming overly complicated. The authority to enter defaults which is referred to in the federal regulations is omitted, the committee feeling that the subject matter is fully and adequately covered by rule 1.500. The authority to accept voluntary acknowledgments of paternity is included at the request of the Department of Health and Rehabilitative Services. Findings of fact are included in the recommended order to provide the judge to whom the order is referred basic information relating to the subject matter. Subdivision (f): Expedited process is intended to eliminate or minimize delays which are perceived to exist in the normal processing of cases. This paragraph is intended to require the prompt entry of an order and to guarantee due process to the obligee. *1079 General Note: This proposed rule, in substantially the same form, was circulated to each of the chief judges for comment. Five responses were received. Two responding endorsed the procedure, and 3 responding felt that any rule of this kind would be inappropriate. The committee did not address the question of funding, which included not only salaries of hearing officers and support personnel, but also capital outlay for furniture, fixtures, equipment and space, and normal operating costs. The committee recognizes that the operational costs of such programs may be substantial and recommends that this matter be addressed by an appropriate body. RULE 12.492. SPECIAL MASTERS (a) Special Masters. The court may appoint members of The Florida Bar as special masters for any particular service required by the court in a family law matter other than those involving domestic and repeat violence. The special masters shall be governed by all the provisions of law and rules relating to general masters except as otherwise provided by this rule. Additionally, they shall not be required to make oath or give bond unless specifically required by the order appointing them. Upon a showing that the appointment is advisable, a person other than a member of The Florida Bar may be appointed. (b) Reference. No reference shall be to a special master without the express prior consent of the parties, except that the court upon good cause shown and without consent of the parties may appoint an attorney as a special master to preside over depositions and rule upon objections. (c) General Powers and Duties. Every special master shall perform all of the duties that pertain to the office according to the practice in chancery and rules of court and under the direction of the court. Hearings before any special master shall be held in the county where the action is pending, but hearings may be held at any place by order of the court within or without the state to meet the convenience of the witnesses or the parties. All grounds for disqualification of a judge shall apply to special masters. (d) Bond. When not otherwise provided by law, the court may require special masters who are appointed to dispose of real or personal property to give bond and surety conditioned for the proper payment of all moneys that may come into their hands and for the due performance of their duties as the court may direct. The bond shall be made payable to the State of Florida and shall be for the benefit of all persons aggrieved by any act of the special master. (e) Hearings. When a reference is made to a special master, any party or the special master may set the action for hearing. The special master shall assign a time and place for proceedings as soon as reasonably possible after the reference is made and give notice to each of the parties either directly or by requiring counsel to file and serve a notice of hearing. If any party fails to appear, the special master may proceed ex parte or may adjourn the proceeding to a future day, giving notice to the absent party of the adjournment. The special master shall proceed with reasonable diligence in every reference and with the least delay practicable. Any party may apply to the court for an order to the special master to speed the proceedings and to make the report and to certify to the court the reason for any delay. Unless otherwise ordered by the court, or agreed to by all parties, all parties shall equally share the cost of the presence of a court reporter at a special master's proceedings. If all parties waive the presence of a court reporter, they must do so in writing. The special master shall have authority to examine the parties and all witnesses under oath upon all matters contained in the reference and to require production of all books, papers, writings, vouchers, and other documents applicable to it. The special master shall admit evidence by deposition or that is otherwise admissible in court. The special master may take all actions concerning evidence that can be taken by the court and in the same manner. All parties accounting before a special master shall bring in their accounts in the form of accounts payable and receivable, and any other parties who are not satisfied with the account may examine the accounting party orally or by interrogatories or deposition as the special master directs. All depositions and documents that have been taken or used previously in the action may be used before the special master. *1080 (f) Special Master's Report. The special master shall file a report that includes findings of fact and conclusions of law, together with recommendations. In the report made by the special master no part of any statement of facts, account, charge, deposition, examination, or answer used before the special master need be recited. The matters shall be identified to inform the court what items were used. The report shall include the name and address of the court reporter present, if any. (g) Filing Report; Notice; Exceptions. The special master shall file the report and recommendations and serve copies on the parties. The parties may serve exceptions to the report within 10 days from the time it is served on them. If no exceptions are filed within that period, the court shall take appropriate action on the report. Any party may file cross-exceptions within 5 days from the service of the exceptions, provided, however, that the filing of cross-exceptions shall not delay the hearing on the exceptions unless good cause is shown. If exceptions are filed, they shall be heard on reasonable notice by either party. The party seeking to have exceptions heard shall be responsible for the preparation of the transcript of proceedings before the special master. (h) Expenses of Special Master. The costs of a special master may be assessed as any other suit money in family proceedings and all or part of it may be ordered prepaid by order of the court. Commentary 1995 Adoption. Originally, both general and special masters were governed under Florida Rule of Civil Procedure 1.490. General and special masters are now governed under Florida Family Law Rules of Procedure 12.490 and 12.492, respectively. The requirements for appointing special masters are essentially the same as under the previous rule; but this rule eliminates the need for consent for the court to appoint an attorney/special master to preside over depositions and rule on objections. It also provides for the assessment of suit monies and allows for the filing of cross-exceptions. ------------------------------------------------------------------------- RULE 12.500. DEFAULTS AND FINAL JUDGMENTS THEREON Defaults and final judgments thereon shall be governed by Florida Rule of Civil Procedure 1.500. ------------------------------------------------------------------------- RULE 12.510. SUMMARY JUDGMENT Summary judgment shall be governed by Florida Rule of Civil Procedure 1.510. ------------------------------------------------------------------------ RULE 12.520. VIEW Upon motion of either party or on the court's own motion, the trier of fact may view the premises or place in question or any property, matter, or thing relating to the controversy between the parties when it appears that view is necessary to a just decision. Commentary 1995 Adoption. This rule replaces Florida Rule of Civil Procedure 1.520 and eliminates the advancement of costs imposed by rule 1.520. ------------------------------------------------------------------------ RULE 12.530. MOTIONS FOR NEW TRIAL AND REHEARING; AMENDMENTS OF JUDGMENTS Motions for new trial and rehearing and amendments of judgments shall be governed by Florida Rule of Civil Procedure 1.530. *1081 ------------------------------------------------------------------------ RULE 12.540. RELIEF FROM JUDGMENT, DECREES, OR ORDERS Florida Rule of Civil Procedure 1.540 shall govern general provisions concerning relief from judgment, decrees, or orders, except that there shall be no time limit for motions based on fraudulent financial affidavits in marital or paternity cases. Commentary 1995 Adoption. Under this provision, Florida Rule of Civil Procedure 1.540 applies to all family law issues involving relief from judgment, decrees, or orders, except that there shall be no time limit for motions filed under rule 1.540(b) based on fraudulent financial affidavits in marital or paternity cases. Rule 1.540 was expanded to include marital cases through the rule making procedure subsequent to the Florida Supreme Court's decision in DeClaire v. Yohanan, 453 So.2d 375 (Fla. 1984). ------------------------------------------------------------------------ RULE 12.550. EXECUTIONS AND FINAL PROCESS Executions and final process shall be governed by Florida Rule of Civil Procedure 1.550. ------------------------------------------------------------------------ RULE 12.560. DISCOVERY IN AID OF EXECUTION Discovery in aid of execution shall be governed by Florida Rule of Civil Procedure 1.560. ------------------------------------------------------------------------- RULE 12.570. ENFORCEMENT OF JUDGMENTS Enforcement of judgments shall be governed by Florida Rule of Civil Procedure 1.570. Money judgments, as governed by rule 1.570(a) shall include, but not be limited to, judgments for alimony, child support, attorneys' fees, suit money, and costs, and equitable distribution. Commentary 1995 Adoption. Nothing in this rule or Florida Rule of Civil Procedure 1.570 should be read to preclude the use of other remedies to enforce judgments. ------------------------------------------------------------------------ RULE 12.580. WRIT OF POSSESSION Writs of possession shall be governed by Florida Rule of Civil Procedure 1.580. ------------------------------------------------------------------------ RULE 12.590. PROCESS IN BEHALF OF AND AGAINST PERSONS NOT PARTIES Process in behalf of and against persons not parties shall be governed by Florida Rule of Civil Procedure 1.590. ------------------------------------------------------------------------ RULE 12.600. DEPOSITS IN COURT Deposits in court shall be governed by Florida Rule of Civil Procedure 1.600, with the following addition. The party depositing money or depositing the thing capable of delivery shall pay any fee imposed by the clerk of the court, unless the court orders otherwise. *1082 Commentary 1995 Adoption. The addition to Florida Rule of Civil Procedure 1.600 included in this rule is intended to clarify responsibility for the payment of clerk's fees. ------------------------------------------------------------------------ RULE 12.610 INJUNCTIONS FOR DOMESTIC AND REPEAT VIOLENCE (a) Application. This rule shall apply only to temporary and permanent injunctions for protection against domestic violence and temporary and permanent injunctions for protection against repeat violence. All other injunctive relief sought in cases to which the Family Law Rules apply shall be governed by Florida Rule of Civil Procedure 1.610. (b) Petitions. (1) Requirements for Use. (A) Domestic Violence. Any person may file a petition for an injunction for protection against domestic violence if they certify under oath that (i) the party filing the injunction and the party against whom the injunction is sought are spouses, former spouses, persons related by blood or marriage, persons who are presently residing together as if a family or who have resided together in the past as if a family, or persons who have a child in common regardless of whether they have been married or have resided together at any time; (ii) the party filing the petition was the victim of, or has reasonable cause to believe he or she may become the victim of an assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, or any criminal offense resulting in physical injury or death perpetrated by the party against whom the injunction is sought; and (iii) the specific facts and circumstances upon the basis of which relief is sought are true. (B) Repeat Violence. Any person may file a petition for an injunction for protection against repeat violence if they certify under oath that (i) two incidents of violence, defined as any assault, battery, sexual battery or stalking, one of which must have occurred within 6 months of the filing of the petition, have been committed by the person against whom the injunction is sought against the petitioner or the petitioner's immediate family member; and (ii) the specific facts and circumstances upon the basis of which relief is sought are true. (2) Service of Petitions. (A) Domestic Violence. Personal service by a law enforcement agency is required. The clerk of the court shall furnish a copy of the petition for an injunction for protection against domestic violence, financial affidavit (if support is sought), Uniform Child Custody Jurisdiction Act affidavit (if custody is sought), temporary injunction (if one has been entered), and notice of hearing to the appropriate sheriff or law enforcement agency of the county where the respondent resides or can be found for expeditious service of process. (B) Repeat Violence. Personal service by a law enforcement agency is required. The clerk of the court shall furnish a copy of the petition for an injunction for protection against repeat violence, temporary injunction (if one has been entered), and notice of hearing to the appropriate sheriff or law enforcement agency of the county where the respondent resides or can be found for expeditious service of process. (C) Additional Documents. Service of pleadings in cases of domestic or repeat violence other than the petition and orders granting injunctions shall be governed by rules 12.070 and 12.080. *1083 (3) Consideration by Court. Upon the filing of a petition, the court shall set a hearing to be held at the earliest possible time. A denial of a petition for an ex parte injunction shall be by written order noting the legal grounds for denial. When the only ground for denial is no appearance of an immediate and present danger of domestic violence, the court shall set a full hearing on the petition for injunction with notice at the earliest possible time. Nothing herein affects a petitioner's right to promptly amend any petition, or otherwise be heard in person on any petition consistent with these rules. (4) Forms. (A) Provision of Forms. The clerk of the court or family or domestic/repeat violence intake personnel shall provide simplified forms, including instructions for completion, for any person whose circumstances meet the requirements of this rule and shall assist the petitioner in obtaining an injunction for protection against domestic or repeat violence as provided by law. (B) Confidential Filing of Address. A petitioner's address may be furnished to the court in a confidential filing separate from a petition or other form if, for safety reasons, a petitioner believes that the address should be concealed. The ultimate determination of a need for confidentiality must be made by the court as provided in Florida Rule of Judicial Administration 2.051. (c) Orders of Injunction. (1) Consideration by Court. (A) Temporary Injunction. For the injunction for protection to be issued ex parte, it must appear to the court that an immediate and present danger of domestic or repeat violence exists. In an ex parte hearing for the purpose of obtaining an ex parte temporary injunction, the court may limit the evidence to the verified pleadings or affidavits or may receive additional testimony under oath if necessary for a determination of whether an immediate and present danger of domestic or repeat violence exists. If the respondent appears at the hearing or has received reasonable notice of the hearing, the court may hold a hearing on the petition. (B) Permanent Injunction. A full evidentiary hearing shall be conducted. (2) Issuing of Injunction. No bond shall be required by the court for the entry of an injunction for protection against domestic or repeat violence. The clerk of the court shall provide the parties with sufficient certified copies of the order of injunction for service. (3) Service of Injunctions. (A) Temporary Injunction. A temporary injunction for protection against domestic or repeat violence must be personally served. When the respondent has been served previously with the temporary injunction and has failed to appear at the initial hearing on the temporary injunction, any subsequent pleadings seeking an extension of time may be served on the respondent by the clerk of the court by certified mail in lieu of personal service by a law enforcement officer. If the temporary injunction was issued after a hearing because the respondent was present at the hearing or had reasonable notice of the hearing, the injunction may be served in the manner provided for a permanent injunction. (B) Permanent Injunction. (i) Party Present at Hearing. The parties may acknowledge receipt of the permanent injunction for protection against domestic or repeat violence in writing on the face of the original order. If a party is present at the hearing and that party fails or refuses to acknowledge the receipt of a certified copy of the injunction, the clerk shall cause the order to be served by mailing certified copies of the injunction to the parties who were present at hearing at the last known address of each party. Service by mail is complete upon mailing. When an order is served pursuant to this subdivision, the clerk shall prepare a written *1084 certification to be placed in the court file specifying the time, date, and method of service and within 24 hours shall forward a copy of the injunction and the clerk's affidavit of service to the sheriff with jurisdiction over the residence of the petitioner. This procedure applies to service of orders to modify or vacate injunctions for protection against domestic or repeat violence. (ii) Party not Present at Hearing. Within 24 hours after the court issues, continues, modifies, or vacates an injunction for protection against domestic or repeat violence, the clerk shall forward a copy of the injunction to the sheriff with jurisdiction over the residence of the petitioner for service. (4) Duration. (A) Temporary Injunction. Any temporary injunction shall be effective for a fixed period not to exceed 15 days. A full hearing shall be set for a date no later than the date when the temporary injunction ceases to be effective. The court may grant a continuance of the temporary injunction and of the full hearing for good cause shown by any party, or upon its own motion for good cause, including failure to obtain service. (B) Permanent Injunction. Any relief granted by an injunction for protection against domestic or repeat violence shall be granted for a fixed period not to exceed 1 year. Such relief may be granted in addition to other civil and criminal remedies. Upon petition of the victim, the court may extend the injunction for successive fixed periods not to exceed 1 year. Broad discretion resides with the court to grant an extension after considering the circumstances. No specific allegations are required. (5) Enforcement. The court may enforce violations of an injunction for protection against domestic or repeat violence in civil contempt proceedings, which are governed by rule 12.570 or in criminal contempt proceedings, which are governed by Florida Rule of Criminal Procedure 3,840, or, if the violation meets the statutory criteria, it may be prosecuted as a crime under Florida Statutes. (6) Motion to Modify or Vacate Injunction. The petitioner or respondent may make a motion to the court to modify or vacate an injunction at any time. Motions to modify or vacate an injunction shall be governed by the Florida Rules of Civil Procedure. (7) Forms. The clerk of the court or family or domestic/repeat violence intake personnel shall provide simplified forms including instructions for completion, for the persons whose circumstances meet the requirements of this rule and shall assist in the preparation of the affidavit in support of the violation of an order of injunction for protection against domestic or repeat violence. Commentary 1995 Adoption. A cause of action for an injunction for protection against domestic violence and repeat violence has been created by section 741.30, Florida Statutes (Supp. 1994) (modified by chapter 95-195, Laws of Florida), and section 784.046, Florida Statutes (Supp. 1994), respectively. This rule implements those provisions and is intended to be consistent with the procedures set out in those provisions except as indicated in this commentary. To the extent a domestic or repeat violence matter becomes criminal or is to be enforced by direct or indirect criminal contempt, the appropriate Florida Rules of Criminal Procedure will apply. The facts and circumstances to be alleged under subdivision 12.610(b)(1)(A) include those set forth in Florida Family Law Form 12.980(b). An injunction for protection against domestic or repeat violence may be sought whether or not any other cause of action is currently pending between the parties. However, the pendency of any such cause of action must be alleged in the petition. The relief the court may grant in a temporary or permanent injunction against domestic violence is set forth in section 741.30(6). *1085 The facts and circumstances to be alleged under subdivision (b)(1)(B) include those set forth in Florida Family Law Form 12.980(d). The relief the court may grant in a temporary or permanent injunction against repeat violence is set forth in section 784.046(7), Florida Statutes. Subdivision (b)(4) expands sections 741.30(2)(c)1 and (2)(c)2, Florida Statutes, to provide that the responsibility to assist the petitioner may be assigned not only to the clerk of court but also to the appropriate intake unit of the court. Family Law Form 12.980(b) provides the form for a petition for injunction against domestic violence. If the custody of a child is at issue, a Uniform Child Custody Jurisdiction Act affidavit must be provided and completed in conformity with Family Law Form 12.901(f). If alimony or child support is sought a Financial Affidavit must be provided and completed in conformity with Family Law Form 12.901(d) or 12.901(e). Subdivision (c)(1)(A) expands chapter 95-195, Laws of Florida, and section 784.046(6)(a), Florida Statutes, to make the limitation of evidence presented at an ex parte hearing permissive rather than mandatory given the due process concerns raised by the statutory restrictions on the taking of evidence. Unlike traditional injunctions, under subdivision (c)(2), no bond will be required for the issuance of injunctions for protection against domestic or repeat violence. This provision is consistent with the statutes except that, unlike the statutes, it does not set a precise number of copies to be provided for service. Subdivision (c)(3)(A) makes the procedure for service of a temporary order of injunction for protection against domestic violence and repeat violence consistent. This is intended to replace the differing requirements contained in sections 741.30(7)(b)3 and (7)(c)1 and 784.046(8)(a)1, Florida Statutes. Subdivision (c)(3)(B) makes the procedure for service of a permanent order of injunction for protection against domestic violence and repeat violence consistent. This is intended to replace the differing requirements contained in sections 741.30(7)(a)3 and (7)(c)1 and 784.046(8)(c)1, Florida Statutes, and to specifically clarify that service of the permanent injunction by mail is only effective upon a party who is present at the hearing which resulted in the issuance of the injunction. Subdivision (c)(4)(A) restates sections 741.30(5)(c) and 784.046(6)(c), Florida Statutes, with some expansion. This subdivision allows the court upon its own motion to extend the protection of the temporary injunction for protection against domestic or repeat violence for good cause shown, which shall include, but not be limited to, failure to obtain service. This subdivision also makes the procedures in cases of domestic and repeat violence identical, resolving the inconsistencies in the statutes. Subdivision (c)(4)(B) makes the procedures in cases of domestic and repeat violence identical, resolving inconsistencies in the statutes. As stated in section 741.30(1)(c), Florida Statutes, in the event a subsequent cause of action is filed under chapter 61, Florida Statutes, any orders entered therein shall take precedence over any inconsistent provisions of an injunction for protection against domestic violence which addresses matters governed by chapter 61, Florida Statutes. Subdivision (c)(5) implements a number of statutes governing enforcement of injunctions against domestic or repeat violence. It is intended by these rules that procedures in cases of domestic and repeat violence be identical to resolve inconsistencies in the statutes. As such, the procedures set out in section 741.31(1), Florida Statutes, are to be followed for violations of injunctions for protection of both domestic and repeat violence. Pursuant to that statute, the petitioner may contact the clerk of the court of the circuit court of the county in which the violation is alleged to have occurred to obtain information regarding enforcement. Subdivision (c)(7) expands sections 741.30(2)(c)1 and (2)(c)2, Florida Statutes, to provide that the responsibility to assist a petitioner may not only be assigned to the clerk of court but also to the appropriate intake unit of the court. This subdivision makes the procedures in *1086 cases of domestic and cases of repeat violence identical to resolve inconsistencies in the statutes. ------------------------------------------------------------------------- RULE 12.611. CENTRAL GOVERNMENTAL DEPOSITORY (a) Administrative Order. If the chief judge of the circuit by administrative order authorizes the creation of a central governmental depository for the circuit or county within the circuit to receive, record, and disburse all support alimony or maintenance payments, as provided in section 61.181, Florida Statutes (1983), the court may direct that payment be made to the officer designated in the administrative order. (b) Payments to Public Officer. (1) If the court so directs, the payments shall be made to the officer designated. (2) The officer shall keep complete and accurate accounts of all payments received. Payments shall be made by cash, money order, cashier's check, or certified check. The officer shall promptly disburse the proceeds to the party entitled to receive them under the judgment or order. (3) Payment may be enforced by the party entitled to it or the court may establish a system under which the officer issues a motion for enforcement and a notice of hearing in the form approved by the supreme court. The motion and notice shall be served on the defaulting party in person or by mail. At the hearing the court shall enter an appropriate order based on the testimony presented to it. Commentary 1995 Adoption. This rule is a remnant of Florida Rule of Civil Procedure 1.611, which contained several unrelated issues. Those issues are now governed by separate rules for automatic disclosure, simplified dissolution procedure, and this rule for central governmental depository. ------------------------------------------------------------------------ RULE 12.620. RECEIVERS Receivers shall be governed by Florida Rule of Civil Procedure 1.620. ------------------------------------------------------------------------ RULE 12.625. PROCEEDINGS AGAINST SURETY ON JUDICIAL BONDS Proceedings against sureties on judicial bonds shall be governed by Florida Rule of Civil Procedure 1.625. ------------------------------------------------------------------------ RULE 12.630. EXTRAORDINARY REMEDIES Extraordinary remedies shall be governed by Florida Rule of Civil Procedure 1.630. ------------------------------------------------------------------------ RULE 12.740. FAMILY MEDIATION (a) Applicability. This rule governs mediation of family matters and related issues. (b) Referral. Except as provided by law and this rule, all contested family matters and issues may be referred to mediation. Every effort shall be made to expedite mediation of family issues. *1087 (c) Limitation on Referral to Mediation. Unless otherwise agreed by the parties, family matters and issues may be referred to a mediator or mediation program which charges a fee only after the court has determined that the parties have the financial ability to pay such a fee. This determination may be based upon the parties' financial affidavits or other financial information available to the court. When the mediator is compensated in whole or part by the parties, the presiding judge may determine the reasonableness of the fees charged by the mediator. In the absence of a written agreement providing for the mediator's compensation, the mediator shall be compensated at the hourly rate set by the presiding judge in the referral order. When appropriate, the court shall apportion mediation fees between the parties and shall state each party's share in the order of referral. Parties may object to the rate of the mediator's compensation within 15 days of the order of referral by serving an objection on all other parties and the mediator. (d) Appearances. Unless otherwise stipulated by the parties, a party is deemed to appear at a family mediation convened pursuant to this rule if the named party is physically present at the mediation conference. In the discretion of the mediator and with the agreement of the parties, family mediation may proceed in the absence of counsel unless otherwise ordered by the court. (e) Completion of Mediation. Mediation shall be completed within 75 days of the first mediation conference unless otherwise ordered by the court. (f) Report on Mediation. (1) If agreement is reached as to any matter or issue, including legal or factual issues to be determined by the court, the agreement shall be reduced to writing, signed by the parties and their counsel, if any and if present, and submitted to the court unless the parties agree otherwise. By stipulation of the parties, the agreement may be electronically or stenographically recorded and made under oath or affirmed. In such event, an appropriately signed transcript may be filed with the court. If counsel for any party is not present when the agreement is reached, the mediator shall cause to be mailed a copy of the agreement to counsel within 5 days. Counsel shall have 10 days from service of a copy of the agreement to serve a written objection on the mediator, unrepresented parties, and counsel. Absent a timely written objection, the agreement is presumed to be approved by counsel and shall be filed with the court by the mediator. (2) After the agreement is filed, the court shall take action as required by law. When court approval is not necessary, the agreement shall become binding upon filing. When court approval is necessary, the agreement shall become binding upon approval. In either event, the agreement shall be made part of the final judgment or order in the case. (3) If the parties do not reach an agreement as to any matter as a result of mediation, the mediator shall report the lack of an agreement to the court without comment or recommendation. With the consent of the parties, the mediator's report may also identify any pending motions or outstanding legal issues, discovery process, or other action by any party which, if resolved or completed, would facilitate the possibility of a settlement. Commentary 1995 Adoption. This rule is similar to former Florida Rule of Civil Procedure 1.740. All provisions concerning the compensation of the mediator have been incorporated into this rule so that all mediator compensation provisions are contained in one rule. Additionally, this rule clarifies language regarding the filing of transcripts, the mediator's responsibility for mailing a copy of the agreement to counsel, and counsel's filing of written objections to mediation agreements. ------------------------------------------------------------------------- RULE 12.741. MEDIATION RULES (a) Discovery. Unless stipulated by the parties or ordered by the court, the mediation process shall not suspend discovery. *1088 (b) General Procedures. (1) Interim or Emergency Relief. A party may apply to the court for interim or emergency relief at any time. Mediation shall continue while such a motion is pending absent a contrary order of the court, or a decision of the mediator to adjourn pending disposition of the motion. Time for completing mediation shall be tolled during any periods when mediation is interrupted pending resolution of such a motion. (2) Sanctions for Failure to Appear. If a party fails to appear at a duly noticed mediation conference without good cause, the court upon motion shall impose sanctions, including an award of mediator and attorneys' fees and other costs, against the party failing to appear. (3) Adjournments. The mediator may adjourn the mediation conference at any time and may set times for reconvening the adjourned conference. No further notification is required for parties present at the adjourned conference. (4) Counsel. Counsel shall be permitted to communicate privately with their clients. The mediator shall at all times be in control of the mediation and the procedures to be followed in the mediation. (5) Communication with Parties. The mediator may meet and consult privately with any party or parties or their counsel. (6) Appointment of the Mediator. (A) Within 10 days of the order of referral, the parties may agree upon a stipulation with the court designating: (i) a certified mediator; or (ii) a mediator who does not meet the certification requirements of these rules but who, in the opinion of the parties and upon review by the presiding judge, is otherwise qualified by training or experience to mediate all or some of the issues in the particular case. (B) If the parties cannot agree upon a mediator within 10 days of the order of referral, the plaintiff or petitioner shall so notify the court within 10 days of the expiration of the period to agree on a mediator, and the court shall appoint a certified mediator selected by rotation or by such other procedures as may be adopted by administrative order of the chief judge in the circuit in which the action is pending. (C) If a mediator agreed upon by the parties or appointed by a court cannot serve, a substitute mediator can be agreed upon or appointed in the same manner as the original mediator. A mediator shall not mediate a case assigned to another mediator without the agreement of the parties or approval of the court. A substitute mediator shall have the same qualifications as the original mediator. Commentary 1995 Adoption. This rule combines and replaces Florida Rules of Civil Procedure 1.710, 1.720, and 1.730. The rule, as combined, is substantially similar to those three previous rules, with the following exceptions. This rule deletes subdivisions (a) and (b) of rule 1.710 and subdivisions (b) and (c) of rule 1.730. This rule compliments Florida Family Law Rule of Procedure 12.740 by providing direction regarding various procedures to be followed in family law mediation proceedings. *1089 SECTION II FAMILY LAW FORMS, COMMENTARY, INSTRUCTIONS, AND APPENDICES INTRODUCTION On the page before each form you will find explanations of how that form is used in the court case, help in filling out the form, and a list of other forms you may need to fill out. The instructions for each form also say if there are any laws or court rules that could help you understand the form and its use in your case. The instructions are not the only place that you can get information about how a court case works or how that form is used and you may want to look at other law books for more help. The Florida Statutes, Florida Family Law Rules of Procedure, Florida Rules of Civil Procedure, and other legal information books may be found in a law library at your county courthouse or a law school in your area. There are five (5) appendices at the end of the forms. You should read the appendices that deal with the type of court case that you are a party to. There are also instructions with each form to help you fill out that form. Read each form carefully, it may tell you that there are other forms that need to be filled out and filed with the court. If you find out there is something you need to do in your case and you do not find the right form here, check the forms at the end of the Florida Rules of Civil Procedure and you may find the form you need there. Appendix 1-Simplified Dissolution of Marriage Appendix 2-Regular Dissolution of Marriage Appendix 3-Child Support Appendix 4-Injunction for Protection Appendix 5-Stepparent Adoption Commentary 1995 Adoption. To help the many people in family law court cases who do not have attorneys to represent them (pro se litigants), the Florida Supreme Court added these simplified forms and directions to the Florida Family Law Rules of Procedure. The directions refer to the Florida Family Law Rules of Procedure or the Florida Rules of Civil Procedure. Many of the forms were adapted from the forms accompanying the Florida Rules of Civil Procedure. Practitioners should refer to the committee notes for those forms for rule history. The forms were adopted by the Court pursuant to Family Law Rules of Procedure, ___ So.2d ___ (Fla. 1995); In re Petition for Approval of Forms Pursuant to Rule 10-1.1(b) of the Rules Regulating The Florida Bar — Stepparent Adoption Forms, 613 So.2d 900 (Fla. 1992); Rules Regulating The Florida Bar — Approval of Forms, 581 So.2d 902 (Fla. 1991). Although the forms are part of these rules, they are not all inclusive and additional forms, as necessary, should be taken from the Florida Rules of Civil Procedure as provided in Florida Family Law Rules of Procedure. Also, the following notice has been included to strongly encourage individuals to seek the advice, when needed, of an attorney who is a member in good standing of the Florida Bar. NOTICE TO PARTIES WHO ARE NOT REPRESENTED BY AN ATTORNEY WHO IS A MEMBER IN GOOD STANDING OF THE FLORIDA BAR IF YOU HAVE QUESTIONS OR CONCERNS ABOUT THESE FORMS, COMMENTARY, INSTRUCTIONS, AND APPENDICES, THE USE OF THE FORMS, OR YOUR LEGAL RIGHTS, IT IS STRONGLY RECOMMENDED THAT YOU TALK TO AN ATTORNEY. IF YOU DO NOT KNOW AN ATTORNEY, YOU SHOULD CALL THE LAWYER REFERRAL SERVICE LISTED IN THE YELLOW PAGES OF THE TELEPHONE BOOK. IF YOU DO NOT HAVE THE MONEY TO HIRE AN ATTORNEY, YOU SHOULD CALL THE LEGAL AID OFFICE IN YOUR AREA. BECAUSE THE LAW DOES CHANGE, THE FORMS AND INFORMATION ABOUT THEM MAY HAVE BECOME OUTDATED. YOU SHOULD BE AWARE THAT *1090 CHANGES MAY HAVE HAPPENED IN THE LAW OR COURT RULES THAT WOULD AFFECT THE ACCURACY OF THE FORMS, COMMENTARY, INSTRUCTIONS OR APPENDICES. IN NO EVENT WILL THE FLORIDA SUPREME COURT, THE FLORIDA BAR, OR ANYONE CONTRIBUTING TO THE PRODUCTION OF THESE FORMS, COMMENTARY, INSTRUCTIONS, AND APPENDICES BE LIABLE FOR ANY DIRECT, INDIRECT, OR CONSEQUENTIAL DAMAGES RESULTING FROM THEIR USE. INDEX TO FAMILY LAW FORMS INTRODUCTION AND COMMENTARY 12.900-12.909 PETITIONS AND SUPPORTING DOCUMENTS 12.900 Disclosure of Nonlawyer 12.901(a) Simplified Petition for Dissolution of Marriage (b) Petition for Dissolution of Marriage (c) Affidavit of Insolvency (d) Family Law Financial Affidavit (Short Form) (e) Family Law Financial Affidavit (Long Form) (f) Uniform Child Custody Jurisdiction Act (UCCJA) (g) Child Support Guidelines Worksheet (h) Marital Settlement Agreement (i) Affidavit of Corroborating Witness 12.902(a) Answer/Response to and Counterpetition for Dissolution of Marriage (b) Answer/Response to Counterpetition for Dissolution of Marriage 12.903(a) Supplemental Petition/Request to Modify/Change Visitation (b) Petition/Request to Modify/Change Primary Residency/Custody of Child(ren) 12.904(a) Petition/Request for Support Unconnected with Dissolution of Marriage (b) Petition for Modification of Child Support and Other Relief 12.905 Petition/Request for Grandparent Visitation 12.910-12.919 SERVICE 12.910(a) Summons: Personal Service on Individual (b) Process Service Memorandum 12.911(a) Order to Perfect Service (b) Order of Dismissal for Failure to Perfect Service (120 days) 12.912(a) Memorandum for Certificate of Military Service (b) Nonmilitary Affidavit 12.913(a) Notice of Action Dissolution of Marriage (b) Affidavit for Service by Publication 12.914 Certificate of Service (General Form) 12.920-12.929 PROCEDURAL 12.920(a) Order of Referral to General Master (b) Notice of Hearing Before General Master 12.921 Order Setting Matter for Uncontested Hearing or Status Conference 12.922(a) Request to Enter Default (b) Default 12.923 Notice of Hearing (General Form) 12.930-12.939 DISCOVERY 12.930(a) Notice of Service of Standard Family Law Interrogatories (b) Standard Family Law Interrogatories 12.931(a) Notice of Production from Non-Party (b) Subpoena for Production of Documents (c) Request for Documents Produced by Subpoena 12.940-12.949 MOTIONS 12.940(a) Motion for Health Insurance Coverage (b) Order of Health Insurance Coverage (c) Employer's Declaration of Health Insurance Coverage *1091 12.941(a) Motion for Temporary Injunction to Prevent Removal of Children and for Denial of Passports (b) Affidavit in Support of Motion for Temporary Injunction to Prevent Removal of Child(ren) and for Denial of Passport 12.942(a) Motion for Appointment of Guardian ad Litem (b) Order Appointing Guardian ad Litem 12.950-12.959} AVAILABLE FOR 12.960-12.969} FUTURE 12.970-12.979} CATEGORIES 12.980-12.989 SPECIAL CASES Domestic and Repeat Violence 12.980(a) Affidavit and Waiver of Fees for Petition for Injunction for Protection Against Domestic Violence (b) Petition for Injunction for Protection Against Domestic Violence (c) Order Denying Petition for Temporary Injunction for Protection Against Domestic Violence (d) Temporary Injunction for Protection Against Domestic Violence (e) Injunction for Protection Against Domestic Violence (After Notice) (f) Final Order of Dismissal of Injunction for Protection Against Domestic Violence (g) Petition for Injunction for Protection Against Repeat Violence Adoption 12.981(a) Petition for Stepparent Adoption (b) Stepparent Adoption: Consent and Waiver of Parent (c) Stepparent Adoption: Consent of Adoptee (d) Stepparent Adoption: Affidavit of Diligent Search (e) Final Judgment of Stepparent Adoption (f) Petition for Adoption Information (g) Order Releasing Adoption Information Name change 12.982 Petition for Name Change 12.900-12.999 JUDGMENTS 12.990(a) Final Judgment of Simplified Dissolution of Marriage (b) Final Judgment of Dissolution of Marriage (c) Order of Dismissal due to Reconciliation (d) Final Default Judgment of Dissolution of Marriage 12.991(a) Order Requiring Payment of Child Support through the Central Depository (b) Child Support Income Deduction Order 12.993 Final Judgment of Modification of Parental Responsibility and Visitation 12.994(a) Final Judgment Support Unconnected with Dissolution of Marriage (b) Final Judgment Modifying Child Support APPENDICES Appendix 1-Simplified Dissolution of Marriage Appendix 2-Regular Dissolution of Marriage Appendix 3-Child Support Appendix 4-Injunction for Protection Appendix 5-Stepparent Adoption INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.900, DISCLOSURE FROM NONLAWYERS When the term nonlawyer is used on the Florida Family Law forms and instructions, it means anyone who is NOT an attorney and a member in good standing of the Florida Bar. Attorneys who are licensed to practice in other states but not in Florida and attorneys who have been disbarred or suspended from the practice of law in Florida are nonlawyers for purposes of the Florida Family Law forms and instructions. If a person who is a nonlawyer (under the meaning just given) helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. *1092 Both you and the nonlawyer helping you must sign this disclosure form. You should keep a copy and the nonlawyer helping you should keep a copy. This disclosure form does NOT act as or constitute a waiver, disclaimer, or limitation of liability. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. FLORIDA FAMILY LAW FORM 12.900, DISCLOSURE FROM NONLAWYER [ fill in nonlawyer's name in all blanks] ____________________________ told me that he/she is not an attorney who is a member in good standing of the Florida Bar and that he/she may not give me legal advice or represent me in court. ____________________________ told me that he/she may only help me fill out a form approved by the Supreme Court of Florida. ____________________________ may only help me by asking me questions to fill in the form. ____________________________ may also tell me how to file the form. ____________________________ told me that he/she is not an attorney who is a member in good standing of the Florida Bar and cannot tell me what my rights or remedies are or how to testify in court. [✓ one only] ____ I can read English. ____ I cannot read English but this notice was read to me by [ fill in all blanks] _____________________________ in ___________________________. Nonlawyer's name language _________________________, 19__. date PARTY NONLAWYER Signature __________________________ Signature __________________________ Printed Name _______________________ Printed Name _______________________ Address ____________________________ Address ____________________________ ____________________________________ ____________________________________ City State Zip City State Zip Telephone No. ______________________ Telephone No. ______________________ Telefax No. ________________________ Telefax No. ________________________ INSTRUCTIONS FOR FLORIDA FAMILY LAW FORMS FORM 12.901(a), SIMPLIFIED PETITION FOR DISSOLUTION OF MARRIAGE You may use Form 12.901(a) to ask for a Simplified Dissolution of Marriage. This form may only be used if all of the following statements are true. If any one of the statements is not true, you cannot use this form. ✓ We have no minor (under 18 years old) children or dependent children. ✓ We have no adopted children under 18 years of age. ✓ The wife is not pregnant. ✓ At least one of us has lived in Florida for the past 6 months. ✓ We have worked out how we will divide the things we own (our assets/property) and who will pay what part of the money we owe (our debts) and we are satisfied with it. *1093 ✓ We have both signed the joint petition and all other papers needed to get a simplified dissolution and paid the required fees to the clerk of the circuit court. ✓ We both want to end the marriage because of serious permanent differences (we cannot get along and cannot fix what is wrong). ✓ We both want to use the simplified dissolution of marriage procedure instead of a regular dissolution. ✓ We both know that: ◂ after the dissolution of marriage becomes final, neither of us has any right to expect money or support from the other, except what is in the Marital Settlement Agreement (Family Law Form 12.901(h)); and ◂ by choosing the simplified dissolution of marriage procedure, we give up certain legal rights that we would have if we had used the regular dissolution Procedure. The Marital Settlement Agreement referred to in Form 12.901(a) is Florida Family Law Form 12.901(h). Please see Simplified Dissolution of Marriage, Appendix 1 for other information on simplified dissolutions generally. You also may read Chapter 61, Florida Statutes, for more information. NOTE: You or the clerk will need to complete a Civil Cover Sheet (Form 1.997, Florida Rules of Civil Procedure) when this Petition for Simplified Dissolution of Marriage form is filed with the clerk of the court. The clerk's office can provide the Civil Cover Sheet form. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR _________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ __________________________________, Petitioner and __________________________________, Respondent. ________________________________\ PETITION BY PARTIES FOR SIMPLIFIED DISSOLUTION OF MARRIAGE There are no children of the marriage under 18 years of age and a marital settlement agreement, Florida Family Law Form 12.901(h), has been reached by the parties. [ fill in all blanks] We, {name} ________________, Husband and {name} ___________________, Wife, together file this petition/request and say: 1. We both are asking the court for a dissolution of our marriage. (we want it ended) 2. The Husband lives in {name} ____________ County, Florida, and has lived there since {date} __________. The Wife lives in {name} ____________________ County, Florida, and has lived there since {date} ___________. *1094 3. We were married to each other on {date} _______ in the city of {place} _______________ county of, {name} _____________, state or country of {name} _________________, 4. Our marriage is irretrievably broken. (it cannot be fixed) 5. Together, we have no minor (under 18) or dependent children and the Wife is not pregnant. 6. We have made a marital settlement agreement dividing our assets and our debts (what we own and what we owe). We are satisfied with this agreement. The marital settlement agreement (Florida Family Law Form 12.901(h)) is attached and was signed freely and voluntarily by each of us, and we intend to be bound by it. 7. We have each filled out and signed financial affidavits (Florida Family Law Form 12.901(d) or 12.901(e)), that are attached to this petition. 8. [✓ one only] ____ yes or ____ no The wife wants to have her former name of {name} _________________ back. 9. We each certify that we have not been threatened or pressured into signing this request. We each understand that the result of signing this request may be a final judgment ending our marriage allowing no further relief. 10. We each understand that we both must come to the judge to testify about the things we are asking for in this petition/request. 11. We understand that we each may have legal rights against each other because of the marriage and that by signing this request we may be giving up those rights. 12. Neither of us is a member of the military. 13. We ask the court to end our marriage and approve the marital settlement agreement. HUSBAND DATED: _______________________ ______________________________________ Signature of husband Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} __________________________. Sworn to (or affirmed) and subscribed before me on {date} _______, 19__ by {name of husband} _____________. ______________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] *1095 [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [✓ fill in all blanks] I, {name of nonlawyer} _________, a nonlawyer, located at {street} _________________ {city} _______________ {state} ____, {phone} __________, helped {husband} _________, who is the [✓ one only] ______ petitioner or ______ respondent, fill out this form. WIFE DATED: __________________________ ______________________________________ Signature of wife Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ____________________________. Sworn to (or affirmed) and subscribed before me on {date} _____________, 19__ by {name of wife} ______________________. ___________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _____________, a nonlawyer, located at {street} _________________ {city} __________________ {state} ______, {phone} _______, helped {name of wife} ________________, fill out this form. INSTRUCTIONS FAMILY LAW FORM 12.901(b), PETITION FOR DISSOLUTION OF MARRIAGE When you decide that you cannot or do not wish to get a Simplified Dissolution of Marriage, you can use this form to ask for a Regular Dissolution of Marriage. However, this form is to be used only if all of the following statements are true: ✓ At least one spouse has lived in Florida for the past 6 months. ✓ The marriage is irretrievably broken (you want to end the marriage because of serious permanent differences, it is broken and cannot be fixed) or my spouse has been adjudicated mentally incapacitated for a period of at least three years (see section 61.052(1)(b), Florida Statutes). See appendices 1, 2, 3, and Chapter 61, Florida Statutes, for further information. *1096 NOTE: You or the clerk will need to complete a Civil Cover Sheet (Form 1.997, Florida Rules of Civil Procedure) when this Petition for Dissolution of Marriage form is filed with the clerk of the court. The clerk's office can provide this Civil Cover Sheet form. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ __________________________________, Petitioner and __________________________________, Respondent. ________________________________\ PETITION FOR DISSOLUTION OF MARRIAGE [ fill in all blanks that apply] 1. JURISDICTION/RESIDENCE _________ Husband ________ Wife has/have lived in Florida for at least 6 months before, and in this county right before, the filing of this Petition for Dissolution of Marriage and neither party is a member of the military service. The parties lived last as Husband and Wife in {name} ______________ County, Florida. 2. STATISTICAL FACTS. Date of marriage: _____________________________ Place of marriage: ____________________________ Date of separation, if applicable: ____________ 3. MARITAL AND NONMARITAL* ASSETS AND DEBTS AS PRESENTLY KNOWN [✓ one only] a. ____ There are no marital assets or debts. b. ____ All marital assets and debts have been divided by written agreement, which is attached. c. ____ All assets and debts are listed in the Financial Affidavit to be completed and filed with this petition (Florida Family Law Form 12.901(d) or 12.901(e)). d. Pension/Retirement plans [✓ all that apply] ____ The husband has pension/retirement benefits that accrued during the marriage ____ The wife has pension/retirement benefits that accrued during the marriage ____ The husband should keep all of his pension/retirement benefits that accrued during the marriage ____ The wife should keep all of her pension/retirement benefits that accrued during the marriage ____ The court should divide the parties' pension/retirement benefits by a qualified domestic relations order to be file separately with this court. * See Appendix 2 for what is marital and what is nonmarital *1097 4. SPOUSAL SUPPORT (ALIMONY) ____ spousal support is needed by the [✓ one only] _____ husband or _____ wife and the [✓ one only] ____ husband or ______ wife is able to pay that support. 5. MINOR (under 18) CHILDREN OF THIS MARRIAGE [✓ one only] a. ____ There are no minor children. b. ____ The wife is pregnant. {due date} _________ c. ____ The wife is not pregnant. d. ____ The minor children are: Name Birth Date Age Sex ____________________ ______________________ _____________ ____________ ____________________ ______________________ _____________ ____________ ____________________ ______________________ _____________ ____________ ____________________ ______________________ _____________ ____________ e. A Uniform Child Custody Jurisdiction Act Affidavit is being filed with this petition. IF THERE ARE MINOR CHILDREN (under 18), you must fill out and file with this petition/request a Uniform Child Custody Jurisdiction Affidavit form (Florida Family Law Form 12.901(f)). 6. PETITIONER REQUESTS THE FOLLOWING RELIEF FROM THE COURT, including injunctive and other orders as may be proper, that: [ fill in all blanks that apply] a. ____ The marriage be dissolved (ended). [✓ one only] ____ Marriage irretrievably broken. (cannot be fixed) ____ One of the parties has been adjudged mentally incapacitated for a period of 3 years prior to the filing of this petition. b. ____ Child custody (primary residence) of child(ren) be [✓ one only] with: ____ Husband ____ or Wife or ____ Other (specify) ________ This is in the child(ren)'s best interest because: ______________________ ___________________________________________________________________________ __________________________________________________________________________. c. ____ Parental responsibility [✓ one only] ____ Shared to: ____ Husband ____ Wife ____ Other (e.g., certain decisions with one parent such as education, medical, religious training etc.) ____ Sole to: ____ Husband ____ Wife This is in the child(ren)'s best interest because: ______________________ ___________________________________________________________________________ __________________________________________________________________________. d. ____ Child visitation: [✓ one only] ____ to be decided by the court. ____ as agreed to by the parties (schedule attached). ____ should be _________________________________________________. *1098 This is in the child(ren)'s best interest because: ______________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________________________________________________________________. e. ____ Child support should be set by Florida's child support guidelines (see section 61.30, Florida Statutes). f. ____ Child support should NOT be set by Florida's child support guidelines (see section 61.30, Florida Statutes). The court should do this because: _______________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ g. ____ Unusual or uninsured medical/dental expenses for the children be provided by: [✓ one only] ____ Husband or ____ Wife or ____ Husband and wife each pay one-half. h. ____ Medical/dental insurance ____ is or ____ is not reasonably available to the ____ husband or ____ wife for the child(ren) and ____ husband or ____ wife should be required to provide it. i. ____ Life insurance be provided by: ____ Husband ____ Wife. j. ____ Spousal support be paid to: ____ Husband ____ Wife. The court should do this because: _______________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ k. ____ Equitable distribution of marital assets and debts be decided by the court. ____ Personal property or interests (attach schedule in accordance with paragraph 3) ____ Real property (attach legal descriptions) ____ Debts (attach list) l. ____ Pension/Retirement plan to be awarded or distributed m. ____ Attorneys' fees, suit money, and costs be awarded to: ____ Husband ____ Wife The court should do this because: _______________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ n. ____ Wife's former name restored o. ____ Other relief. If injunctive relief is sought, state the facts which support irreparable damage or injury. p. ____ The petitioner needs and the respondent is able to pay all of the money asked for in this petition. DATED: __________________________ *1099 ______________________________________ Signature of party signing certificate and pleading Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ___________________ Sworn to (or affirmed) and subscribed before me on {date} ______, 19__ by {name} ________________________. ______________________________________ NOTARY PUBLIC — STATE OF FLORIDA ______________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ______________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ___________________, a nonlawyer, located at {street} _________________ {city} _________________ {state} _____, {phone} _________, helped {name} _____________, who is the [✓ one only] _____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FAMILY LAW FORM 12.901(c), AFFIDAVIT OF INSOLVENCY $ If you have been sued or if you wish to sue someone and you cannot afford to pay court fees and costs, you may ask that those fees and costs be waived. To make this request, fill out this form and file it with the court. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: _______________________________ Division: _______________________________ *1100 ___________________________________, Petitioner and ____________________________________, Respondent. ___________________________________\ AFFIDAVIT OF INSOLVENCY [✓ check all which apply, fill in all blanks that apply] STATE OF FLORIDA COUNTY OF {name} __________________ BEFORE ME personally appeared {name} _______________ who, after being sworn, states: I am insolvent and unable to pay the charges, costs, or fees otherwise payable by law to any clerk, or sheriff in this civil action because [✓ one only]: ____ a. I am currently receiving public assistance: $ _________ per _______ Case No. ______________. ____ b. I am unable to pay those clerk's fees and costs because of indigency, based on the following facts: INCOME: ________________________________________________________________ Employer name and address ___________________________ Length of employment $ ___________ $ __________ Avg. gross pay Avg. net pay per ______ week _________ month _______ 2 weeks ASSETS: What I own. State value of car, home, bank deposits, bonds, stocks, etc. _______________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ DEBTS/BILLS: What I owe. List item by item your monthly rent, installment payments, mortgage payments, child support, etc. Amount of Payment each month Who I pay it to ____________________________ _______________________________________ ____________________________ _______________________________________ ____________________________ _______________________________________ ____________________________ _______________________________________ ____________________________ _______________________________________ ____________________________ _______________________________________ DATED: ______________________________ ____________________________________ Signature of party signing affidavit Printed name _______________________ Address ____________________________ ____________________________________ City State Zip ____________________________________ Telephone (area code and number) ____________________________________ Telefax (area code and number) *1101 STATE OF FLORIDA COUNTY OF {name} ___________________ Sworn to (or affirmed) and subscribed before me on {date} ________, 19__ by {name} __________________. ___________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________, a nonlawyer, located at {street} _________________ {city} _______________ {state} _____, {phone} _________, helped {name} _______________, who is the [✓ one only] _____ petitioner or _____ respondent, fill out this form. INSTRUCTIONS FLORIDA FAMILY LAW FORMS 12.901(d) AND 12.901(e), FINANCIAL AFFIDAVITS $ Filling out these forms makes you figure out how much money you are paid, how much it costs you to live, what you own and what its worth, and what you owe. You should use Florida Family Law Form 12.901(d) if the money you get each year (your annual gross income), and the money you spend each year (annual expenses) ARE LESS THAN $50,000. You should use Florida Family Law Form 12.901(e) if the money you get each year (your annual gross income) or the money you spend each year (annual expenses) IS $50,000 OR IS MORE THAN $50,000. See Florida Family Law Rule of Procedure 12.285. SOME WORDS YOU NEED TO KNOW: Affiant: the person who is signing the financial affidavit. Assets*: what you own. Debts/Liabilities*: what you owe. * See Appendix 2 for more on what is a marital or nonmarital asset and debt. The court needs the facts in your financial affidavit to decide your case. It is very important that you fill in all the information as correctly and completely as you can. ◂ To order alimony, the court must decide that the person who is asking for the alimony really needs the money and that the person being asked to pay it can afford to. The court must be able to write down facts that prove this. When filled out, the financial affidavit shows the court what your bills are and how much money there is to pay them. The court must make specific, written findings of fact that address the factors listed in section 61.08, Florida Statutes, when granting or denying a request for alimony. ◂ To decide child support, the court must find out how much money each parent earns and any special needs the child(ren) may have. The court must be able to write these facts down in its order. When filled out, the financial affidavit gives the court these facts. The court must make specific, written findings (say in its order exactly) why awarding the amount of child support required by section 61.30, Florida Statutes would be unjust or inappropriate if the amount awarded is different from the child support guidelines amount by plus or minus five percent (5%). ◂ The court must write down in its order what you and your spouse own and owe and what it is worth to decide equitable distribution (the fair way to divide things between you) of your marital assets and debts*. The court also must write down all its reasons if it does not give each of you 1/2 of the assets and 1/2 of the debts. The financial affidavit tells the court about your assets and debts so it has the facts it needs to decide your case. *1102 The court must make specific, written findings of fact that identify which assets are marital and which are nonmarital*, identify each person's ownership interests, identify the value of each significant asset, state who will take what and address the factors listed in section 61.075, Florida Statutes, explaining why the marital* assets and debts are being divided the way the order says and if the division is not equal, the exact reason(s) why it is not. ◂ To decide attorneys' fees, costs and suit money, the court needs to know that the person who is asking for the fees and costs really needs the money and that the person being asked to pay it can afford to. When filled out, the financial affidavit shows the court what your bills are and how much money there is to pay them. The court must make specific, written findings of fact explaining why attorneys' fees are being granted and explaining the basis of the amount awarded. DOING THE MATH These affidavits are based on MONTHLY paychecks and bills. Many people are not paid monthly and many bills (like daycare) are not paid monthly. To help you figure out what the MONTHLY payment is for something that is paid weekly or hourly do this: Hourly wage × hours per week, × weeks per year, ÷ 12 = monthly wage Daily wage × days per week, × weeks per year, ÷ 12 = monthly wage Weekly wage × weeks per year, ÷ 12 = monthly wage Bi-weekly wage × 26, ÷ 12 = monthly wage Semi-monthly wage × 24, ÷ 12 = monthly wage Bi-monthly wage × 6, ÷ 12 = monthly wage Quarterly wage × 4, ÷ 12 = monthly wage Semi-annual wage × 2, ÷ 12 = monthly wage Annual wage ÷ 12 = monthly wage ---------------------------------------------------------------------------- HELPFUL FACTS ×: multiplied by, times ÷ : divided by wages: gross income, the money paid to a person before taxes, benefits or debts are taken out There are 40 hours in the regular full time work week. There are 52 weeks in a year. There are 12 months in a year. There are 7 days in a week. ---------------------------------------------------------------------------- A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. *1103 IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ___________________________ Division: ___________________________ __________________________________, Petitioner and __________________________________, Respondent. __________________________________\ FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) STATE OF FLORIDA COUNTY OF {name} ____________________ BEFORE ME, this day personally appeared _______________________, who being duly sworn, deposes and says that the following information is true and correct according to his/her best knowledge and belief: EMPLOYMENT AND INCOME OCCUPATION: _____________________________________________________________ EMPLOYED BY: _____________________________________________________________ ADDRESS: _____________________________________________________________ _____________________________________________________________ SOC. SEC. # _____________________________________________________________ DATE OF BIRTH: _____________________________________________________________ PAY PERIOD: _____________________________________________________________ RATE OF PAY: _____________________________________________________________ If you are employed, but expecting soon to become unemployed or change jobs, describe the change you expect and why and how it will affect your income. If currently unemployed, describe your efforts to find employment, how soon you expect to be employed, and the pay you expect to receive. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ EXCEPT IN PROCEEDINGS FOR ADOPTION, SIMPLIFIED DISSOLUTION OF MARRIAGE, ENFORCEMENT, CONTEMPT, AND INJUNCTIONS FOR DOMESTIC OR REPEAT VIOLENCE, ALL OF THE FOLLOWING MUST BE ATTACHED TO THE COPY OF THIS FINANCIAL AFFIDAVIT SERVED ON THE OPPOSING PARTY. THE ATTACHMENTS SHALL NOT BE FILED WITH THE COURT: Your 3 most recent pay stubs, your most recent Federal tax return, and the most recent W-2 forms. If last year's Federal income tax return has not yet been filed, attach W-2s, 1099s, K-1s, and any other document to be attached to your tax return. If the attachments are not made to the copy served on the opposing party, an explanation is required, UNLESS THE PARTIES HAVE AGREED THAT THEY WILL NOT GIVE EACH OTHER THESE DOCUMENTS. See also Florida Family Law Rule of Procedure 12.285. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ [✓ one only] _____ YES OR _____ NO: WE HAVE AGREED TO WAIVE THE REQUIREMENTS OF FLORIDA FAMILY LAW RULE OF PROCEDURE 12.285. *1104 LAST YEAR'S INCOME Yours Other Party's (if known) 1. Gross earned income last calendar year (19__) $ _______________ $ _______________ 2. All other income (same year) $ _______________ $ _______________ 3. Total income taxes paid on above income (incl. Fed., FICA) $ _______________ $ _______________ 4. Net Income $ _______________ $ _______________ AVERAGE GROSS MONTHLY INCOME FROM EMPLOYMENT See Appendix 3 for how to figure out money amounts for anything that is NOT paid monthly. Attach more paper, if needed. Items included under "other" should be listed separately with separate dollar amounts. Present gross income from employment $ ____ Bonuses, commissions, allowances, overtime, tips, and similar payment ____ Business income from sources such as self-employment, partnership, close corporations, and/or independent contracts (gross receipts minus ordinary and necessary expenses required to produce income) ____ Disability benefits ____ Workers' Compensation ____ Unemployment Compensation ____ Pension, retirement, or annuity payments ____ Social Security benefits ____ Spousal support received from previous marriage ____ Interest and dividends ____ Rental income (gross receipts minus ordinary and necessary expenses required to produce income) ____ Income from royalties, trust, or estates ____ Reimbursed expenses and in kind payments to the extent that they reduce personal living expenses ____ Gains derived from dealing in property (not including nonrecurring gains) ____ Itemize any other income of a recurring nature ____ TOTAL MONTHLY INCOME $ ____ LESS MONTHLY DEDUCTIONS See Appendix for how to figure out money amounts for anything that is NOT paid monthly. Attach more paper, if needed. Items included under "other" should be listed separately with separate dollar amounts. Federal, state, and local income taxes (corrected for filing status and actual number of withholding allowances) ____ FICA or self-employment tax (annualized) ____ Mandatory union dues ____ Mandatory retirement ____ Health insurance payments ____ Court ordered support payments for the children actually paid ____ TOTAL DEDUCTIONS $ ____ TOTAL NET INCOME $ ____ *1105 AVERAGE MONTHLY EXPENSES HOUSEHOLD: Barber/beauty parlor _____ Cosmetics/toiletries _____ Mtg. or rent payments $ ___ Gifts for special holidays _____ Property taxes & insurance _____ Other expenses: Electricity _____ __________________________ _____ Water, garbage, & sewer _____ __________________________ _____ Telephone _____ Fuel oil or natural gas _____ INSURANCES: Repairs and maintenance _____ Lawn and pool care _____ Health _____ Pest control _____ Life _____ Misc. household _____ Other insurance Food and household items _____ __________________________ _____ Meals outside home _____ Other: AUTOMOBILE: OTHER EXPENSES NOT LISTED ABOVE: Gasoline and oil $ ___ Repairs _____ Dry cleaning and laundry _____ Auto tags and license _____ Affiant's clothing _____ Insurance _____ Affiant's medical, dental Other: prescriptions _____ ____________________________ _____ Affiant's grooming _____ ____________________________ _____ Affiant's gifts _____ Pets: Grooming _____ Veterinarian _____ CHILDREN'S EXPENSES: Membership dues _____ Professional dues _____ Nursery or babysitting $ ___ Social dues _____ School tuition _____ Entertainment _____ School supplies _____ Vacations _____ Lunch money _____ Publications _____ Allowance _____ Religious organizations _____ Clothing _____ Charities _____ Medical, dental, prescriptions _____ Bank charges/credit card fees _____ Vitamins _____ Miscellaneous _____ OTHER EXPENSES: __________________________ _____ __________________________ _____ __________________________ _____ TOTAL ABOVE EXPENSES $ ____ PAYMENTS TO CREDITORS: TO WHOM: BALANCE MONTHLY DUE PAYMENTS: ____________________________ $ _________ $ __________________________ ____________________________ ___________ _____________________________ ____________________________ ___________ _____________________________ ____________________________ ___________ _____________________________ ____________________________ ___________ _____________________________ ____________________________ ___________ _____________________________ ____________________________ ___________ _____________________________ ____________________________ ___________ _____________________________ ____________________________ ___________ _____________________________ ____________________________ ___________ _____________________________ *1106 TOTAL MONTHLY PAYMENTS TO CREDITORS: $ ____ TOTAL MONTHLY EXPENSES: $ ____ ASSETS (OWNERSHIP: IF MARITAL, PUT ONE-HALF OF THE TOTAL VALUE UNDER PETITIONER AND ONE-HALF UNDER RESPONDENT NO MATTER WHOSE NAME THE ITEM IS IN. See Appendix sheet 2 for definition of "marital and nonmarital" assets and obligations.) Description Value Petitioner Respondent Cash on hand ___________ __________ __________ Cash in banks ___________ __________ __________ Stocks/bonds ___________ __________ __________ Notes ___________ __________ __________ Real estate: Home: ___________ __________ __________ _____________________ _____________________ _____________________ ___________ __________ __________ Automobiles: _____________________ ___________ __________ __________ _____________________ ___________ __________ __________ _____________________ ___________ __________ __________ Other personal property: Contents of home ___________ __________ __________ Jewelry ___________ __________ __________ Life ins./cash surrender value ___________ __________ __________ Other assets: _____________________ ___________ __________ __________ _____________________ ___________ __________ __________ _____________________ ___________ __________ __________ TOTAL ASSETS: $ _________ $ ________ $ _______ LIABILITIES Creditor Security Balance Husband Wife ____________ ____________ ___________ ___________ ___________ ____________ ____________ ___________ ___________ ___________ ____________ ____________ ___________ ___________ ___________ ____________ ____________ ___________ ___________ ___________ ____________ ____________ ___________ ___________ ___________ ____________ ____________ ___________ ___________ ___________ TOTAL: $ __________ $ _________ $ _________ $ _________ NET WORTH Total Assets $ ____ Less: Total Liabilities (excluding contingent liabilities)* $ ____ Net Worth $ ____ * If there is a claim for contingent liabilities, it should be set forth in a separate schedule attached. I AM AWARE THAT ANY MATERIALLY FALSE STATEMENT KNOWINGLY MADE WITH THE INTENT TO DEFRAUD OR MISLEAD SHALL SUBJECT ME TO THE PENALTY FOR PERJURY AND MAY BE CONSIDERED A FRAUD UPON THE COURT. *1107 I CERTIFY THAT THE FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM) WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ___________________, 19__. Party or their attorney if represented Other Name _________________________________ Name _______________________ Address ______________________________ Address ____________________ ______________________________________ ____________________________ City State Zip City State Zip Telephone No. ________________________ Telephone No. ______________ Telefax No. __________________________ Telefax No. ________________ DATED: _______________________________ ____________________________________________________ Signature of party signing certificate and affidavit Printed name _______________________________________ Address ____________________________________________ ____________________________________________________ City State Zip ____________________________________________________ Telephone (area code and number) ____________________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} _______________________ Sworn to (or affirmed) and subscribed before me on {date} _______, 19__ by {name} ____________________. _____________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA _____________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced _________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ___________________, a nonlawyer, located at {street} _________________ {city} _______________ {state} _____, {phone} _______, helped {name} _________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ______________________ Division: ______________________ ___________________________________, Petitioner *1108 and ___________________________________, Respondent. _____________________________\ FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM) STATE OF FLORIDA COUNTY OF {name} _______________ BEFORE ME, this date personally appeared {name} _________________________, who being duly sworn, deposes and says that the following information is true and correct according to his/her best knowledge and belief: EMPLOYMENT OCCUPATION: _______________________________________ EMPLOYED BY: _______________________________________ ADDRESS: _______________________________________ _______________________________________ DATE OF BIRTH: _______________________________________ SOCIAL SECURITY NUMBER: _______________________________________ PAY PERIOD: _______________________________________ RATE OF PAY: _______________________________________ If you are employed, but expecting soon to become unemployed or change jobs, describe the change you expect and why and how it will affect your income. If currently unemployed, describe your efforts to find employment, how soon you expect to be employed, and the pay you expect to receive. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ EXCEPT IN PROCEEDINGS FOR ADOPTION, SIMPLIFIED DISSOLUTION OF MARRIAGE, ENFORCEMENT, CONTEMPT, AND INJUNCTIONS FOR DOMESTIC OR REPEAT VIOLENCE, ALL OF THE FOLLOWING MUST BE ATTACHED TO THE COPY OF THIS FINANCIAL AFFIDAVIT SERVED ON THE OPPOSING PARTY. THE ATTACHMENTS SHALL NOT BE FILED WITH THE COURT. Your three most recent pay stubs, your most recent Federal tax return, and the most recent W-2 forms. If last year's Federal income tax return has not yet been filed, attach W-2s, 1099s, K-1s, and any other document to be attached to your tax return. If the attachments are not made to the copy of the financial affidavit served on the opposing party, an explanation is required. See also Florida Family Laws Rule Procedure 12.285. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ [✓ one only] ____ YES OR ____ NO: WE HAVE AGREED TO WAIVE THE REQUIREMENTS OF FLORIDA FAMILY LAW RULE OF PROCEDURE 12.285. LAST YEAR'S INCOME Yours Other Party's (if known) 1. Gross earned income last calendar year (19__) $ __________ $ ___________ *1109 LAST YEAR'S INCOME Yours Other Party's (if known) 2. All other income (same year) ____________ _____________ 3. Total income taxes paid on above income (incl. Fed., FICA) _____________ _____________ 4. Net Income $ ___________ $ ___________ PRESENT INCOME; AVERAGED ON A MONTHLY BASIS: See Appendix 3 for how to figure out money amounts for anything that is NOT paid monthly. Attach more paper, if needed. Items included under "other" should be listed separately with separate dollar amounts. Present gross income from employment $____ Bonuses, commissions, allowances, overtime, tips and similar payments _____ Business income from all other sources such as self-employment, partnerships, close corporations, and/or independent contracts (gross receipts minus ordinary and necessary expenses required to produce income) (Attach sheet itemizing this income and expenses) _____ Disability benefits/SSI _____ Workers' Compensation _____ Unemployment Compensation _____ Pension, retirement, or annuity payments _____ Social Security benefits _____ Spousal Support Received from Previous Marriage _____ Interest and dividends _____ Rental income (gross receipts minus ordinary and necessary expenses required to produce income) (Attach sheet itemizing the income and expense items) _____ Income from royalties, trust or estates _____ Reimbursed expenses and in kind payments to the extent that they reduce personal living expenses _____ Gains derived from dealing in property (not including non-recurring gains) _____ Other: (Itemize any other income on a recurring basis) _____________________________________________________ _____ _____________________________________________________ _____ TOTAL MONTHLY INCOME: $____ LESS DEDUCTIONS ALLOWABLE UNDER SECTION 61.30, FLORIDA STATUTES: Federal income tax, including estimated income tax payments $____ FICA _____ Medicare _____ Mandatory union dues _____ Mandatory retirement _____ Health insurance payments, excluding portion paid for children of the parties _____ Court ordered child support actually paid for children from another relationship _____ *1110 Other: ___________________________ _____ ___________________________ _____ ___________________________ _____ TOTAL DEDUCTIONS: $ ___ AVERAGE NET MONTHLY INCOME: $ ___ LESS COURT ORDERED PAYMENTS Child support for children from another relationship $____ Alimony _____ Attorneys' fees _____ Other: _____ AVERAGE MONTHLY NET INCOME LESS COURT ORDERED PAYMENTS: $ ___ AVERAGE MONTHLY EXPENSES: See instructions for how to figure out money amounts for anything that is NOT paid monthly. Attach more paper, if needed. Items included under "other" should be listed separately with separate dollar amounts. HOUSEHOLD AND FOOD: Mortgage or rent payments $ _______ Property taxes & insurance _________ Condo maintenance fees and homeowner's association fees _________ Electricity _________ Water, garbage & sewer _________ Telephone _________ Fuel oil or natural gas _________ Repairs and maintenance _________ Lawn and pool care _________ Pest control _________ Misc. household _________ Food and household items _________ Meals outside home _________ Cable T.V. _________ Alarm _________ Service contracts on appliances _________ Domestic help _________ FICA _________ Other: __________________________ _________ __________________________ _________ __________________________ _________ $ _______ AUTOMOBILE: Gasoline and oil $ _______ Repairs Auto tag and license _________ Insurance _________ Payments _________ Rental/replacements _________ Alternative transportation (Bus, rail, car pool, etc.) _________ *1111 Tolls and parking _________ Other: _____________________________ _________ _____________________________ _________ _____________________________ _________ $ ________ EXPENSES FOR CHILDREN COMMON TO BOTH PARTIES: Nursery, babysitting, or day care $ _______ School tuition _________ School supplies and books, fees _________ After school activities _________ Lunch money _________ Private lessons/tutoring _________ Allowance _________ Clothing/uniforms _________ Entertainment (movies, birthday parties, etc.) _________ Health insurance _________ Medical, dental, prescription (unreimbursed only) _________ Psychiatric/psychological/ counselor _________ Orthodontic _________ Vitamins _________ Barber/beauty parlor _________ Non-prescription medications _________ Cosmetics/toiletries and sundries _________ Gifts from children to others (other children, relatives, teachers, etc.) _________ Camp or/and other summer activities _________ Clubs (Boy/Girl Scouts, etc.) _________ Visitation expense (for nonresidential parent) _________ Miscellaneous _________ Other: _____________________________ _________ _____________________________ _________ _____________________________ _________ TOTAL $ ________ INSURANCES: Health insurance not previously listed $ _______ Life _________ Other: _____________________________ _________ _____________________________ _________ _____________________________ _________ TOTAL $ _______ OTHER EXPENSES FOR AFFIANT NOT LISTED ABOVE: Dry cleaning & laundry $ _______ Clothing _________ *1112 Medical, dental & prescription (unreimbursed only) _________ Psychiatric, psychological, counselor _________ Non-prescription drugs, cosmetics, toiletries and sundries _________ Grooming (beauty parlor or barber shop) _________ Gifts _________ Pets: Grooming _________ Veterinarian _________ Club dues and membership Social clubs _________ Civic clubs _________ Professional organizations _________ Sports and hobbies _________ Entertainment _________ Newspapers, magazines, and subscriptions _________ Vacations _________ Religious organizations _________ Bank charges/credit card fees _________ Education expenses _________ Postage & stationery _________ Professional expenses (other than this proceeding) _________ Other: (include any usual and customary expenses not otherwise mentioned in the above listed items) ___________________ _________ ___________________ _________ ___________________ _________ TOTAL $ ________ PAYMENTS TO CREDITORS: TO WHOM: BALANCE MONTHLY DUE PAYMENTS: ____________________________ $ ________ $ ___________________________ ____________________________ __________ _____________________________ ____________________________ __________ _____________________________ ____________________________ __________ _____________________________ ____________________________ __________ _____________________________ ____________________________ __________ _____________________________ ____________________________ __________ _____________________________ ____________________________ __________ _____________________________ ____________________________ __________ _____________________________ ____________________________ __________ _____________________________ TOTAL MONTHLY PAYMENTS TO CREDITORS: $ ___ TOTAL MONTHLY EXPENSES: $ ___ SUMMARY Total Monthly Income $ ___ Less: Total Monthly Expenses _____ *1113 Surplus (deficit) $ ___ ASSETS (OWNERSHIP: IF MARITAL, PUT ONE-HALF OF THE TOTAL VALUE UNDER PETITIONER AND ONE-HALF UNDER RESPONDENT NO MATTER WHOSE NAME THE ITEM IS IN. See Appendix 2 for definition of "marital and nonmarital" assets and obligations.) DESCRIPTION Percentage Purchase Lender & amount Present DOLLAR Claim of Of Price & Of debt (mortgage Full fair AMOUNTS Record Date of Encumbrances, Market Petitioner Respondent Marital Nonmarital Title Purchase etc.) value [✓ check correct column] ✓ ✓ ----------------------------------------------------------------------------------------------------------------------------------- Cash on hand Cash in banks Stocks/bonds Notes Money owed to you Real estate: Home Other: Business Interests (set forth on separate sheet names, share, type of business) Automobiles: Boats & other vehicles Retirement Plans (Profit Sharing, Pension, IRA 401K's, etc.) Other Personal Property: Furniture & furnishings Collectibles Jewelry Life Ins./cash surrender value Other assets: TOTAL ASSETS: $_____ $_____ $_____ $_____ _____ _____ _____ _____ If joint ownership, allocate equally. If not joint list which party has record title. Debts: (OWNERSHIP: IF MARITAL, PUT ONE-HALF OF THE TOTAL DEBT UNDER PETITIONER AND ONE-HALF UNDER RESPONDENT NO MATTER WHOSE *1114 NAME THE ITEM IS IN. See Appendix 2 for definition of "marital and nonmarital" assets and debts.) Creditor Security Balance Periodic Dollar amounts Marital Nonmarital payments Average/per Petitioner Respondent [✓ correct column] month ------------------------------------------------------------------------------------------------------- Mortgages on real estate: $ $ $ $ Charge/credit card accts: Other debts: Contingent debts: TOTAL DEBTS $______ $________ $________ ______ ________ ________ If joint debt, allocate equally. If not joint, list which party owes. NET WORTH Total Assets $ ___________________ Less: Total Debts (excluding contingent debts) _____________________ Net Worth $ ___________________ I AM AWARE THAT ANY MATERIALLY FALSE STATEMENT KNOWINGLY MADE WITH THE INTENT TO DEFRAUD OR MISLEAD SHALL SUBJECT ME TO THE PENALTY FOR PERJURY AND MAY BE CONSIDERED A FRAUD UPON THE COURT. I CERTIFY THAT THE FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM) WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or _____ hand delivered to the person(s) listed below on {date} ___________, 19__. Party or their attorney if represented Other Name ____________________________________ Name ____________________________ Address _________________________________ Address _________________________ _________________________________________ _________________________________ City State Zip City State Zip Telephone No. ___________________________ Telephone No. ___________________ Telefax No. _____________________________ Telefax No. _____________________ DATED: __________________________________ _____________________________________________ Signature of party signing certificate and affidavit Printed name ________________________________ Address _____________________________________ _____________________________________________ City State Zip _____________________________________________ Telephone (area code and number) _____________________________________________ Telefax (area code and number) *1115 STATE OF FLORIDA COUNTY OF {name} ___________________. Sworn to (or affirmed) and subscribed before me on {date} ________, 19__ by {name} __________________. ________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________, a nonlawyer, located at {street} __________________ {city} ___________ {state} _____, {phone} _______, helped {name} __________, who is the [✓ one only] ______ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.901(f), UNIFORM CHILD CUSTODY JURISDICTION ACT AFFIDAVIT (UCCJA) You must fill out this form and file it with the court in any lawsuit involving custody of or visitation with a child. For further information, see sections 61.1302-61.1354, Florida Statutes. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR _________ COUNTY, FLORIDA Case No.: _____________________________ Division: _____________________________ __________________________________, Petitioner and __________________________________, Respondent. _______________________________\ UNIFORM CHILD CUSTODY JURISDICTION ACT (UCCJA) AFFIDAVIT 1. The name and present address of each child (under 18) in this case is: 2. The places where the child(ren) has/have lived within the last 5 years are: 3. The name(s) and present address(es) of persons with whom the child(ren) has/have lived within the last 5 years are: 4. I do not know of, and have not participated (as a party, witness, or in any other capacity) in, any other court decision, order, or proceeding (including divorce, separate maintenance, child neglect, dependency, or guardianship) concerning the custody or visitation of *1116 the child(ren) in this state or any other state, except: [specify case name and number and court's name and address]. 5. I do not have information of any pending proceeding (including divorce, separate maintenance, child neglect, dependency, or guardianship) concerning the custody or visitation of the child(ren), in this state or any other state except: [specify case name and number and court's name and address]. Check: That proceeding ______ is continuing _____ has been stayed by the court. ____ Temporary action by this court is necessary to protect the child(ren) because the child(ren) has/have been subjected to or threatened with mistreatment or abuse or is/are otherwise neglected or dependent. Attach explanation. 6. I do not know of any person who is not already a party to this proceeding who has physical custody of, or who claims to have custody or visitation rights with, the child(ren), except: [state name(s) and address(es)]. I acknowledge a continuing duty to advise this court of any custody or visitation proceeding (including dissolution of marriage, separate maintenance, child neglect, or dependency) concerning the child(ren) in this state or any other state about which information is obtained during this proceeding. I CERTIFY THAT THIS UNIFORM CHILD CUSTODY JURISDICTION ACT (UCCJA) AFFIDAVIT WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _________________, 19__. Party or their attorney if represented Other Name _____________________________ Name _______________________________ Address __________________________ Address ____________________________ __________________________________ ____________________________________ City State Zip City State Zip Telephone No. ____________________ Telephone No. ______________________ Telefax No. ______________________ Telefax No. ________________________ DATED: ___________________________ ____________________________________________________ Signature of party signing certificate and affidavit Printed name _______________________________________ Address ____________________________________________ ____________________________________________________ City State Zip ____________________________________________________ Telephone (area code and number) ____________________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ___________________ Sworn to (or affirmed) and subscribed before me on {date} _________, 19__ by {name} ________________. ________________________________________ NOTARY PUBLIC — STATE OF FLORIDA *1117 ________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name} _______________________________, a nonlawyer, located at {street} ___________________ {city} _______________ {state} ______, {phone} ________, helped {name} _________________, who is the [✓ one only] _______ petitioner or _____ respondent, fill out this form. INSTRUCTIONS FAMILY LAW FORM 12.901(g), CHILD SUPPORT GUIDELINES WORKSHEET Child support in Florida is figured out under section 61.30, Florida Statutes and the court cases that have said what that law means and how it fits in different facts. Filling out this worksheet will show you and the court how the facts you have fit into the child support law of Florida. This Worksheet is based on MONTHLY paychecks and bills. Many people are not paid monthly and many bills (like daycare) are not paid monthly. To help you figure out what the MONTHLY payment is for something that is paid weekly or hourly do this: ---------------------------------------------------------------------------- HELPFUL HINTS ×: multiplied by, times ÷ : divided by wages: gross income, the money paid to a person before taxes, benefits or debts are taken out There are 40 hours in the regular fulltime work week. There are 52 weeks in a year. There are 12 months in a year. There are 7 days in a week. ---------------------------------------------------------------------------- Hourly wage × hours per week, × weeks per year, ÷ 12 = monthly wage Daily wage × days per week, × weeks per year, ÷ 12 = monthly wage Weekly wage × weeks per year, ÷ 12 = monthly wage Bi-weekly wage × 26, ÷ 12 = monthly wage Semi-monthly wage × 24, ÷ 12 = monthly wage Bi-monthly wage × 6, ÷ 12 = monthly wage Quarterly wage × 4, ÷ 12 = monthly wage Semi-annual wage × 2, ÷ 12 = monthly wage Annual wage ÷ 12 = monthly wage See Appendix 3 for more information on child support. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must *1118 put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR ___________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ __________________________________, Petitioner and __________________________________, Respondent. _______________________________\ CHILD SUPPORT GUIDELINES WORKSHEET CHILD SUPPORT SUMMARY Number of Children (Section I): _____ FATHER MOTHER Total actual income (Section III) $____ $____ Imputed income _____ _____ Less total deductions (Section IV) _____ _____ Total Net Monthly Income $____ $____ COMBINED NET MONTHLY INCOME ...................... $____ Basic obligation (from chart) $____ $____ Pro rate financial responsibility ____% ____% Pro rate share of basic obligation $____ $____ Additions to basic obligation (Section II) Pro rate share of 75% of child care costs equaling $ ____ $____ $____ Health insurance premiums of $____ $____ $____ Statutory child support obligation $____ $____ Statutory adjustments (Section V) $____ $____ Adjustment for secondary residential parent paying child care expenses $____ $____ Adjustment for secondary residential parent paying child(ren)'s health insurance premiums $____ $____ Total child support responsibility of primary residential parent ............................ $____ Total child support responsibility of secondary residential parent .......................... $____ *1119 SECTION I — CHILDREN NAME DATE OF BIRTH AGE _______________________________ ______________ ______________ _______________________________ ______________ ______________ SECTION II — ADDITIONS TO BASIC OBLIGATION Child(ren)'s health insurance costs $ _______ 75% of allowable child care costs due to job search or education to enhance income or current employment Allowable amount: $ _______ TOTAL ADDITIONS TO BASIC OBLIGATION $____ SECTION III — INCOME FATHER MOTHER AVERAGE GROSS INCOME FROM EMPLOYMENT $____ $____ Bonuses, commissions, allowances, overtime, tips, and similar payments $____ $____ Business income from sources such as self-employment, partnerships, close corporations, or independent contracts (gross receipts minus ordinary and necessary expenses required to produce income) (Attach sheet itemizing this income) $____ $____ Disability benefits/SSI $____ $____ Workers' compensation $____ $____ Unemployment compensation $____ $____ Pension, retirement, or annuity payments $____ $____ Social Security benefits $____ $____ Spousal support received from previous marriage(s) $____ $____ Interest and dividends $____ $____ Rental income (gross receipts minus ordinary and necessary expenses required to produce income) (Attach sheet itemizing the income and expense items) $____ $____ Income from royalties, trusts, or estates $____ $____ Reimbursed expenses or in-kind payments to the extent that they reduce personal living expenses $____ $____ Gains derived from dealing in real property (not including nonrecurring gains) $____ $____ TOTAL GROSS MONTHLY INCOME $____ $____ SECTION IV — DEDUCTIONS Federal income tax, including estimated income tax payments $____ $____ FICA or self-employment taxes $____ $____ Medicare tax $____ $____ Mandatory union dues $____ $____ Mandatory retirement $____ $____ Health insurance and dental payments excluding portion paid for Child(ren) of the parties $____ $____ *1120 Ordered support actually paid for Child(ren) not of this relationship $____ $____ TOTAL DEDUCTIONS $____ $____ SECTION V — ADJUSTMENTS Extraordinary medical, psychological, educational, or dental expenses Independent income of Child(ren) _____ Payment of both child support and spousal support for a parent that regularly has been paid and for which there is a demonstrated need _____ Seasonal variations in a parent's income _____ Age of the child, taking into consideration the greater needs of older children _____ Special needs that have been met traditionally within the family budget even though the fulfilling of those needs will cause support to exceed the guidelines _____ The Child(ren) spend(s) a substantial amount of time with the nonresidential parent, thereby reducing expenses of the residential parent _____ Refusal of the nonresidential parent to become involved in the activities of the Child(ren) _____ Due consideration given to the residential parent's homemaking services _____ Visitation with nonresidential parent for more than 28 consecutive days _____ Total available assets of obligee, obligor, and Child(ren) _____ Impact of IRS dependency exemption and waiver of that exemption _____ Application of the child support guidelines requires the obligor to pay more than 55% of gross income for a single support order _____ Any other adjustment that is needed to achieve an equitable result which may include reasonable and necessary expenses jointly incurred during the marriage _____ Residency of subsequently born or adopted children with the obligor, including consideration of the subsequent spouse's income, only in the case of upward modification proceeding _____ TOTAL ADJUSTMENTS $_____ $_____ SECTION VI — APPLICABLE SECTION OF CHART [Insert applicable section of child support guidelines table] OR Combined income in this case exceeds $10,000 per month. Calculations in this Worksheet are based on the basic obligation of $ ____. This is the minimum amount of support provided by the guidelines, plus ______% multiplied by the amount of income over $10,000 per month (section 61.30(6), Florida Statutes). cc: Petitioner or their attorney (if represented) Respondent Name _____________________________________ Name __________________________ Address __________________________________ Address _______________________ *1121 __________________________________________ _______________________________ City State Zip City State Zip Telephone No. ____________________________ Telephone No. _________________ Telefax No. ______________________________ Telefax No. ___________________ Other Name _____________________________________ Address __________________________________ __________________________________________ City State Zip Telephone No. ____________________________ Telefax No. ______________________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________, a nonlawyer, located at {street} ____________________ {city} ________________ {state} _____, {phone} _______, helped {name} ____________, who is the [✓ one only] ______ petitioner or _____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.901(h), MARITAL SETTLEMENT AGREEMENT FOR DISSOLUTION OF MARRIAGE Use this form in a "Simplified Dissolution Procedure" (a) When: ✓ both parties agree to divorce and ✓ there are no children under 18 years of age and ✓ both parties have previously signed a "Petition/Request by Husband and Wife for Dissolution of Marriage" (No Children of the Marriage Under 18 years of Age and Property Agreement Reached by the Parties) and ✓ there is no request for alimony and ✓ the parties have reached an agreement as to how all their property and bills are to be divided OR (b) When both parties, although not initially agreeing to get a dissolution of marriage, later do agree to a dissolution of marriage, have worked out an agreement to split up property and responsibility for paying bills, there are no children under 18 years of age, and there is no request for alimony. Other legal papers may need to be prepared, signed, witnessed, and recorded in order to give the title of certain belongings or possessions such as land, cars, boats, mobile homes, etc. For example, you may need to prepare a deed to give title of land or a house to the husband/wife, or you may need to sign a certificate of title to give a car to the husband/wife. Some of these papers may need to be prepared and signed in a particular manner. It is suggested that an attorney be consulted. Note that section 61.075(4) says that the final judgment dividing your assets and liabilities has the effect of a duly executed instrument of conveyance, transfer, release, or acquisition which is recorded in the county where the property is located when the judgment or a certified copy of the judgment (available from the clerk of court in the county where you got the final judgment), is recorded in the official records of the county in which the property is located. If additional space is needed, please use additional sheets of paper. Please sign and date any additional sheets of paper used and attach those sheets to this Marital Settlement Agreement for Dissolution of Marriage. See Appendix 1 for more information. *1122 A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ___________________________ Division: ___________________________ __________________________________, Petitioner and __________________________________, Respondent. _______________________________\ MARITAL SETTLEMENT AGREEMENT FOR DISSOLUTION OF MARRIAGE We, _______________, the Husband, and ______________, the Wife, were married on __________, 19__. Because of irreconcilable differences in our marriage (no chance of staying together), we have made this agreement to settle once and for all what we owe to each other and what we can expect from each other. Each of us states that nothing has been held back, that we have honestly included everything we could think of in listing our assets (everything we own and that is owed to us), and our debts (everything we owe); and each of us states that we believe the other one has been open and honest in writing this agreement. Because we have voluntarily made full and fair disclosure to each other of all our assets and debts, we hereby agree to waive the disclosure requirements of Florida Family Law Rule of Procedure 12.285. Each of us agrees to sign and exchange any papers that might be needed to complete this agreement. Each of us gives up any right to spousal support (alimony) that we may have. DIVISION OF ASSETS (EVERYTHING WE OWN) We divide our assets (everything we own) as follows: 1. The Wife shall receive and the Husband waives and releases any claims as to the following belongings and personal property interests. ASSETS Name on title/deed/account [✓ all that apply] Description Value Husband Wife Cash on hand _________ __________ __________ Cash in banks _________ __________ __________ Stocks/bonds _________ __________ __________ Notes _________ __________ __________ Real estate: Homes: _____________ _________ __________ __________ _____________ _________ __________ __________ _____________ _________ __________ __________ Automobiles: _____________ _________ __________ __________ _____________ _________ __________ __________ _____________ _________ __________ __________ *1123 Other personal property: Contents of home __________ __________ __________ Jewelry __________ __________ __________ Life ins./cash surrender value __________ __________ __________ Other assets: ________________________ __________ __________ __________ ________________________ __________ __________ __________ ________________________ __________ __________ __________ TOTAL ASSETS: $ ________ $ ________ $ ________ 2. The Husband shall receive and the Wife waives and releases any claims as to the following belongings and personal property interests. ASSETS Name on title/deed/account [✓ all that apply] Description Value Husband Wife Cash on hand __________ __________ __________ Cash in banks __________ __________ __________ Stocks/bonds __________ __________ __________ Notes __________ __________ __________ Real estate: Homes: ________________________ __________ __________ __________ ________________________ __________ __________ __________ ________________________ __________ __________ __________ Automobiles: ________________________ __________ __________ __________ ________________________ __________ __________ __________ ________________________ __________ __________ __________ Other personal property: Contents of home __________ __________ __________ Jewelry __________ __________ __________ Life ins./cash surrender value __________ __________ __________ Other assets: ________________________ __________ __________ __________ ________________________ __________ __________ __________ ________________________ __________ __________ __________ TOTAL ASSETS: $ ________ $ ________ $ ________ DIVISION OF BILLS AND DEBTS (EVERYTHING WE OWE) 1. The Husband shall pay the following bills and will not at any time ask the Wife to pay these bills: DEBTS Name on title/deed/account To whom/ [✓ all that apply] Description Balance Due Monthly payment Husband Wife House __________ $ __________ $ ____________ ____________ ___________ Car ____________ $ __________ $ ____________ ____________ ___________ Car ____________ $ __________ $ ____________ ____________ ___________ Credit Cards:* No. ____________ $ __________ $ ____________ ____________ ___________ *1124 No. ____________ $ __________ $ ____________ ____________ ___________ No. ____________ $ __________ $ ____________ ____________ ___________ No. ____________ $ __________ $ ____________ ____________ ___________ No. ____________ $ __________ $ ____________ ____________ ___________ No. ____________ $ __________ $ ____________ ____________ ___________ No. ____________ $ __________ $ ____________ ____________ ___________ No. ____________ $ __________ $ ____________ ____________ ___________ ________________ $ __________ $ ____________ ____________ ___________ ________________ $ __________ $ ____________ ____________ ___________ ________________ $ __________ $ ____________ ____________ ___________ ________________ $ __________ $ ____________ ____________ ___________ * give account numbers for all credit cards and loans 2. The Wife shall pay the following bills and will not at any time ask the Husband to pay these bills: DEBTS Name on title/deed/account To whom/ [✓ all that apply] Description Balance Due Monthly payment Husband Wife House _________ $ __________ $ ____________ ____________ ___________ Car ___________ $ __________ $ ____________ ____________ ___________ Car ___________ $ __________ $ ____________ ____________ ___________ Credit Cards:* No. ___________ $ __________ $ ____________ ____________ ___________ No. ___________ $ __________ $ ____________ ____________ ___________ No. ___________ $ __________ $ ____________ ____________ ___________ No. ___________ $ __________ $ ____________ ____________ ___________ No. ___________ $ __________ $ ____________ ____________ ___________ No. ___________ $ __________ $ ____________ ____________ ___________ No. ___________ $ __________ $ ____________ ____________ ___________ No. ___________ $ __________ $ ____________ ____________ ___________ _______________ $ __________ $ ____________ ____________ ___________ _______________ $ __________ $ ____________ ____________ ___________ _______________ $ __________ $ ____________ ____________ ___________ _______________ $ __________ $ ____________ ____________ ___________ * give account numbers for all credit cards and loans HUSBAND DATED: __________________________ _____________________________________ Signature of husband Printed name ________________________ Address _____________________________ _____________________________________ City State Zip _____________________________________ Telephone (area code and number) _____________________________________ Telefax (area code and number) *1125 STATE OF FLORIDA COUNTY OF {name} _______________________ Sworn to (or affirmed) and subscribed before me on {date} _______, 19__ by {name of husband} _________________________. ___________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ______________________________________, a nonlawyer, located at {street} ______________________________ {city} _________________ {state} _______, {phone} ____________, helped {husband} _____________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. WIFE DATED: __________________________ __________________________________________ Signature of wife Printed name _____________________________ Address __________________________________ __________________________________________ City State Zip __________________________________________ Telephone (area code and number) __________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} _____________________________ Sworn to (or affirmed) and subscribed before me on {date} _______, 19__ by {name of wife} _________________________. ___________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} ______________________________ {city} _________________ {state} __________, {phone} ____________, helped {name of wife} ___________, fill out this form. *1126 INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.901(i), CERTIFICATE OF CORROBORATING WITNESS To get a divorce in Florida, either the husband or the wife must have lived in Florida for 6 months before filing the petition. See section 61.021, Florida Statutes. Residence may be proved by a valid Florida driver's license, a Florida voter's registration card, or the testimony or affidavit of a third party (not the other spouse). This form is used to prove residency by affidavit. See section 61.052(2), Florida Statutes. This form must be signed by a person who knows that you have lived in the State of Florida for more than 6 months before the date you signed your Petition/Request for Dissolution of Marriage. The witness must be someone who can truthfully swear to your residence in Florida. This certificate must be signed in the presence of a notary public or the clerk of the circuit court, who must put his or her seal at the proper place on the certificate. You file this document with the court after you file your Petition/Request for Dissolution of Marriage, Florida Family Law Form 12.901(a) if Simplified, or 12.901(b) if Regular. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ___________________________ Division: ___________________________ __________________________________, Petitioner and __________________________________, Respondent. _______________________________\ AFFIDAVIT OF CORROBORATING WITNESS I am a resident of the State of Florida; I have known {name} ___________________ for more than 6 months before the date of filing the petition in this action and know of my own personal knowledge that this person has resided in the State of Florida for at least that period of time. I have attached a copy of my Florida driver's license or Florida identification card to this affidavit. DATED: ___________________________ _______________________________________ Signature of person signing affidavit Printed name __________________________ Address _______________________________ _______________________________________ City State Zip _______________________________________ Telephone (area code and number) _______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF _________________ *1127 Sworn to (or affirmed) and subscribed before me on {date} _______, 19__ by {name} ______________________________. ___________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] _____ Personally known _____ Produced identification Type of identification produced __________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} __________________________ {city} ______________________ {state} ________, {phone} _______________, helped {name} ______________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.902(a), ANSWER/RESPONSE TO AND COUNTERPETITION FOR DISSOLUTION OF MARRIAGE • You must file an answer/response and, if appropriate, a counterpetition with the clerk of the court no later than 20 days after you were properly served with your spouse's request for dissolution of marriage. You must also send a copy to your spouse. You may use this form in response to your spouse's Petition/Request for Dissolution of Marriage. NOTE: Certain items may need to be attached to your response, UNLESS YOU AND YOUR SPOUSE AGREE TO WAIVE THAT RULE. See Florida Family Law Rule of Procedure 12.285. $ If you are requesting child support be paid, see Family Law Form 12.901(g), Child Support Guidelines worksheet, Appendix 3 and section 61.30, Florida Statutes for help. Also, you should decide if you want the support award to be paid through the central depository which keeps a record of all payments and sends notices if the paying parent gets behind in payments and/or by income deduction order which means that the paying parent's (obligor's) boss sends money from the obligor's wages right to you. See Family Law Form 12.991(a), Order of Child Support Paid through the Central Depository and Family Law Form 12.991(b), Income Deduction Order of Child Support. If you do not know your spouse's or your child's other parent's income, you may use Family Law Forms 12.930(a) and (b) and 12.931(a), (b) and (c) to find out about that person's wages, assets and debts. Please read Appendix 2, Regular Dissolution of Marriage, for further information and for the definition of the legal terms used in this form. For further information, see Chapter 61, Florida Statutes. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ___________________________ Division: ___________________________ *1128 __________________________________, Petitioner and __________________________________, Respondent. _______________________________\ ANSWER/RESPONSE TO AND COUNTERPETITION FOR DISSOLUTION OF MARRIAGE ANSWER TO PETITION ______ Respondent admits the claims (allegations) in paragraphs ___________. Respondent denies the claims (allegations) in paragraphs _______. COUNTERPETITION 1. JURISDICTION/RESIDENCE _______ Husband _______ Wife has/have lived in Florida for at least 6 months before, and in this county right before, the filing of this Petition for Dissolution of Marriage and neither party is a member of the military service. The parties lived last as Husband and Wife in {name} ________________, County, Florida. 2. STATISTICAL FACTS Date of marriage: _______________________________ Place of marriage: ______________________________ Date of separation, if applicable: ______________ 3. MARITAL AND NONMARITAL ASSETS AND DEBTS AS PRESENTLY KNOWN [✓ one only] See Appendix 2 for what is marital and what is nonmarital. a. ____ There are no marital assets or debts. b. ____ All marital assets and debts have been divided by written agreement, which is attached. c. ____ All assets and debts are listed in the Financial Affidavit to be completed and filed with this petition (Florida Family Law Form 12.901(d) or 12.901(e)). d. Pension/Retirement plans [✓ all that apply] ____ The husband has pension/retirement benefits that accrued during the marriage ____ The wife has pension/retirement benefits that accrued during the marriage ____ The husband should keep all of his pension/retirement benefits that accrued during the marriage ____ The wife should keep all of her pension/retirement benefits that accrued during the marriage ____ The court divide the parties' pension/retirement benefits by a qualified domestic relations order to be filed separately with this court. 4. SPOUSAL SUPPORT (ALIMONY) ____ spousal support is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is able to pay that support. 5. MINOR (under 18) CHILDREN OF THIS MARRIAGE [✓ one only] a. ____ There are no minor children. b. ____ The wife is pregnant. {due date} ___________ c. ____ The wife is not pregnant. d. ____ The minor children are: *1129 Name Birth Date Age Sex ___________________ _______________ __________ __________ ___________________ _______________ __________ __________ ___________________ _______________ __________ __________ ___________________ _______________ __________ __________ e. A Uniform Child Custody Jurisdiction Act Affidavit is being filed with this petition. IF THERE ARE MINOR CHILDREN (under 18), you must fill out and file with this petition/request a Uniform Child Custody Jurisdiction Affidavit form (Florida Family Law Form 12.901(f)). 6. RESPONDENT/COUNTERPETITIONER REQUESTS THE FOLLOWING RELIEF FROM THE COURT, including injunctive and other orders as may be proper and that: [ fill in all blanks that apply] a. ____ The marriage be dissolved (ended). [✓ one only] ____ Marriage irretrievably broken (cannot be fixed) ____ One of the parties has been adjudged mentally incapacitated for a period of 3 years prior to the filing of this petition. b. ____ Child custody (primary residence) of child(ren) be [✓ one only] with: ____ Husband ____ Wife ____ Other (specify) _____________ This is in the child(ren)'s best interest because: ___________________ ____________________________________________________________________________ ____________________________________________________________________________ c. _____ Parental responsibility [✓ one only] ____ Shared to: ____ Husband ____ Wife ____ Other (e.g., certain decisions with one parent such as education, medical, religious training etc. (specify) _____ Sole to: ____ Husband ____ Wife This is in the child(ren)'s best interest because: ___________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ d. ____ Child visitation: [✓ one only] ____ to be decided by the court. ____ as agreed to by the parties (schedule attached). ____ should be ________________________________________________. This is in the child(ren)'s best interest because: ___________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ e. Child Support (1) Amount [✓ one only] ____ Child support should be set by Florida's child support guidelines (see section 61.30, Florida Statutes). ____ Child support should NOT be set by Florida's child support guidelines (see section 61.30, Florida Statutes). The court should do this because: __________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________________. *1130 (2) Method of Payment: [✓ check all which apply] ____ Directly to the person the court has ordered will be paid the support. ____ Payment will be through the central depository by the attached order (Family Law Form 12.991(a)). ____ Payment will be by income deduction order (Family Law Form 12.991(b)) which is attached. g. ____ Unusual or uninsured medical/dental expenses for the children be provided by: [✓ one only] ____ husband or ____ wife or ____ husband and wife each pay one-half. h. ____ Medical/dental insurance ____ is or ____ is not reasonably available to the [✓ one only] ____ husband or ____ wife for the child(ren) and [✓ one only] ____ husband or ____ wife should be required to provide it. i. ____ Life insurance be provided by: [✓ one only] ____ husband or ____ wife. j. ____ Spousal support be paid to: [✓ one only] ____ husband or ____ wife. The court should do this because: ____________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ k. ____ Equitable distribution of marital assets and debts be decided by the court. ____ Personal property or interests (attach schedule in accordance with paragraph 3) ____ Real property (attach legal descriptions) ____ Debts (attach list) l. ____ Pension/Retirement plan to be awarded or distributed m. ____ Attorneys' fees, suit money, and costs be awarded to: ____ Husband ____ Wife The court should do this because: ____________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ n. ____ Wife's former name restored }(specify): ______________________________________________ o. ____ Other relief. If injunctive relief is sought, state the facts which support irreparable damage or injury. }(specify): ______________________________________________ p. ____ The petitioner needs and the respondent is able to pay all of the money asked for in this petition. I CERTIFY THAT THIS ANSWER/RESPONSE AND COUNTERPETITION FOR DISSOLUTION OF MARRIAGE WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _________, 19__. Party or their attorney (if represented) Other Name _____________________________ Name __________________________ Address __________________________ Address _______________________ __________________________________ _______________________________ City State Zip City State Zip *1131 Telephone No. ____________________ Telephone No. _________________ Telefax No. ______________________ Telefax No. ___________________ DATED: __________________________ _______________________________________________ Signature of party signing certificate and pleading Printed name __________________________________ Address _______________________________________ _______________________________________________ City State Zip _______________________________________________ Telephone (area code and number) _______________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ________________ Sworn to (or affirmed) and subscribed before me on {date} _____, 19 __ by {name} _______________________. ___________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ______________________________________, a nonlawyer, located at {street} ______________________________ {city} _______________ {state} _______, {phone} __________, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.902(b), ANSWER/RESPONSE TO COUNTERPETITION FOR DISSOLUTION OF MARRIAGE • You must file this response with the clerk of the court no later than 20 days after your spouse sends you the Counter Petition for Dissolution of Marriage. You also must send a copy to your spouse. You may use this form in response to your spouse's Counter Petition for Dissolution of Marriage. You must file this response with the clerk of the court no later than 20 days after your spouse sends you the Counter Petition for Dissolution of Marriage. You also must send a copy to your spouse. Please read Appendix 2, Regular Dissolution of Marriage, for further information. See also Chapter 61, Florida Statutes. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. *1132 IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ ________________________________, Petitioner and ________________________________, Respondent. ___________________________\ ANSWER/RESPONSE TO COUNTERPETITION FOR DISSOLUTION OF MARRIAGE _____ Respondent admits the claims (allegations) in paragraphs _____. Respondent denies the claims (allegations) in paragraphs _____. I CERTIFY THAT THE RESPONSE TO COUNTER PETITION FOR DISSOLUTION OF MARRIAGE WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _____, 19__. Party or their attorney if represented Other Name ________________________________ Name ______________________________ Address _____________________________ Address ___________________________ _____________________________________ ___________________________________ City State Zip City State Zip Telephone No. _______________________ Telephone No. _____________________ Telefax No. _________________________ Telefax No. _______________________ DATED: ______________________________ __________________________________________ Signature of party signing certificate and pleading Printed name _____________________________ Address __________________________________ __________________________________________ City State Zip __________________________________________ Telephone (area code and number) __________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} _________________________ Sworn to (or affirmed) and subscribed before me on {date} ______, 19__ by {name} __________________________ ___________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced _____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] *1133 I, {name of nonlawyer} ______________________________________, a nonlawyer, located at {street} ________________________________ {city} ________ {state} _________, {phone} _______, helped {name} _________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.903(a), SUPPLEMENTAL PETITION/REQUEST TO MODIFY/CHANGE VISITATION The court can change a visitation order if the judge finds that there is substantial change in the circumstances of the parties and the proposed change is in the child(ren)'s best interest. You may file this form for the change in the county where you live, in the county where the other parent lives, in the county where the child(ren) live(s), or in the county where the original order providing for visitation was entered. If the order providing for visitation was entered in another state, you should talk to an attorney about where to file your request. To request a change for visitation, you must fill out this form, and Florida Family Law Forms 12.910(a), Summons: Personal Service on Individual and 12.901(f), Uniform Child Custody Jurisdiction Act (UCCJA) and file all these forms with the court. In these forms and other court papers, you are referred to either as the petitioner or the respondent. The petitioner is the person who originally opened the case. The respondent is the other party. For further assistance in identifying yourself as the petitioner or respondent, find your name on the upper left side of the first page of a paper previously filed in your case. Under your name you should see the word petitioner or respondent. $ When you file these forms with the court, you will be charged a filing fee and service fee. If you cannot afford these costs, you must also complete Family Law Form 12.901(c), Affidavit of Insolvency, and file it with the court requesting a waiver of the costs. • After the other parent has been served with a copy of the forms, he or she has 20 days to file a response with the court. If the other parent does not file a response, you are entitled to a default (see Family Law Forms 12.922(a), Request to Enter Default, 12.922(b), Default, and 12.993, Final Judgment of Modification of Parental Responsibility and Visitation). After the other parent has responded to your petition (request) or a default has been entered because he or she has not responded, you must ask for a hearing for the court to consider your request. See Family Law Form 12.921, Order Setting Matter for Uncontested Hearing or Status Conference or Form 12.923, Notice of Hearing (General Form). Even after a default has been entered the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). You should bring a proposed order with you to the hearing (see, for example, Family Law Form 12.993, Final Judgment of Modification of Parental Responsibility and Visitation). If the court rules in your favor, your proposed order usually will be signed at the hearing. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. *1134 IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: _______________________________ Division: _______________________________ ________________________________, Petitioner and ________________________________, Respondent. ___________________________\ SUPPLEMENTAL PETITION/REQUEST TO MODIFY/CHANGE VISITATION The petition of [✓ one only] ____ Petitioner or ____ Respondent shows: 1. The last order on visitation in this case was entered (dated) by the court on {date} ________. A copy of the order is attached. 2. Paragraph(s) _____ of the attached order describe(s) the present visitation. 3. Since the last order on visitation, there has been a substantial change in circumstances as follows: Briefly list below the changes that have taken place since the last order on visitation and the reasons why you feel the visitation in effect at this time should be changed. (if necessary, you may add additional sheets of paper): ___________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 4. This is in the child(ren)'s best interest because: ____________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ WHEREFORE, I ask that the court change the visitation as follows (list the changes you want in the visitation): _______________________________________ ____________________________________________________________________________ ____________________________________________________________________________ I CERTIFY THAT THE SUPPLEMENTAL PETITION/REQUEST TO MODIFY/CHANGE VISITATION WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ____, 19__. Party or their attorney (if represented) Other Name _______________________________________ Name ________________________ Address ____________________________________ Address _____________________ ____________________________________________ _____________________________ City State Zip City State Zip Telephone No. ______________________________ Telephone No. _______________ Telefax No. ________________________________ Telefax No. _________________ DATED: _____________________________________ _______________________________________ Signature of party signing certificate and pleading *1135 Printed name __________________________ Address _______________________________ _______________________________________ City State Zip _______________________________________ Telephone (area code and number) _______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} _______________________________ Sworn to (or affirmed) and subscribed before me on {date} _____, 19__ by {name} ____________________________. ___________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced _____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _____________________________, a nonlawyer, located at {street} ________________ {city} _____________ {state} _______, {phone} ____________, helped {name} ______________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.903(b), PETITION/REQUEST TO MODIFY/CHANGE PRIMARY RESIDENCY/RESPONSIBILITY/CUSTODY OF CHILD(REN) The court can change an order granting primary parental responsibility, including a primary residential responsibility/custody order if the judge finds that there has been a substantial change in the circumstances of the parties and the proposed change is in the child(ren)'s best interest. You may file this request for the change in primary parental responsibility in the circuit court in the county where you live, where the other parent lives, where the children live, or in the county where the original order was entered. If the order was entered in another state or if the child(ren) live(s) in another state, you should speak with an attorney about where to file your request. To request a change in primary parental responsibility, you must fill out this form, and Florida Family Law Forms 12.910(a), Summons: Personal Service on Individual and 12.901(f), Uniform Child Custody Jurisdiction Act (UCCJA) and file all these forms with the court. In these forms and other court papers, you are referred to either as the petitioner or the respondent. The petitioner is the person who originally opened the case. The respondent is the other party. For further assistance in identifying yourself as the petitioner or respondent, find your name on the upper left side of the first page of a paper previously filed in your case. Under your name you should see the word petitioner or respondent. $ When you file these forms with the court, you will be charged a filing fee and service fee. If you cannot afford these costs, you must also complete Family Law Form 12.901(c), Affidavit of Insolvency, and file it with the court requesting a waiver of the costs. If you are requesting child support be paid, see Family Law Form 12.901(g), Child Support Guidelines worksheet, Appendix 3 and section 61.30, Florida Statutes for help. Also, you should decide if you want the support award to be paid through the central depository which keeps a record of all payments and sends notices if the paying parent gets behind in payments and/or by income deduction order which means that the paying parent's (obligor's) boss sends money from the obligor's wages right to you. See Family Law Form 12.991(a), Order of Child Support Paid through the Central Depository and Family Law *1136 Form 12.991(b), Income Deduction Order of Child Support. If you do not know your spouse's or your child's other parent's income, you may use Family Law Forms 12.930(a) and (b) and 12.931(a), (b) and (c) to find out about that person's wages, assets and debts. • After the other parent has been served with a copy of the forms, he or she has 20 days to file a response with the court. If the other parent does not file a response, you are entitled to a default (see Family Law Forms 12.922(a), Request to Enter Default, 12.922(b), Default, and 12.993, Final Judgment of Modification of Parental Responsibility and Visitation). After the other parent has responded to your petition (request) or a default has been entered because he or she has not responded, you must ask for a hearing for the court to consider your request. See Family Law Form 12.921, Order Setting Matter for Uncontested Hearing or Status Conference or Form 12.923, Notice of Hearing (General Form). Even after a default has been entered the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). You should bring a proposed order with you to the hearing (see, for example, Form 12.993, Final Judgment of Modification of Parental Responsibility and Visitation). If the court rules in your favor, your proposed order usually will be signed at the hearing. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ________________________________ Division: ________________________________ ________________________________, Petitioner and ________________________________, Respondent. ___________________________\ PETITION/REQUEST TO MODIFY/CHANGE PRIMARY RESIDENCY/CUSTODY OF CHILDREN This petition of [✓ one only] _____ Petitioner or _____ Respondent shows: 1. [✓ one only] _____ Petitioner or _____ Respondent has primary parental responsibility, including primary residential responsibility (custody). The last order granting primary parental responsibility in this case was entered (dated) by the court on {date} _______, 19__. A copy of the order is attached. 2. My completed Uniform Child Custody Jurisdiction Act Affidavit (Family Law Form 12.901(f)) is also attached. 3. Since the last order granting primary parental responsibility was entered, there has been a substantial change in circumstances as follows (briefly list below the changes that have taken place since the last order granting primary parental responsibility and the reasons why you feel the primary parental responsibility in effect at this time should be changed — if necessary, you may add additional sheets of paper): ___________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ *1137 ____________________________________________________________________________ ____________________________________________________________________________ 4. A change in primary parental responsibility, including primary residential responsibility (custody), is in the best interest of my child(ren) for the following reason(s): ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 5. If I am granted primary parental responsibility, I will need, and [✓ one only] ____ Petitioner or ____ Respondent (the other person in the case) has the ability to pay reasonable child support. WHEREFORE, I am asking that the court enter an order: 1. CUSTODY Granting [✓ one only] ____ Petitioner or ____ Respondent primary parental responsibility, including primary residential responsibility (custody). 2. CHILD SUPPORT Awarding child support to [✓ one only] ____ Petitioner or ____ Respondent (a) Amount [✓ one only] ____ Child support should be set by Florida's child support guidelines (see section 61.30, Florida Statutes). ____ Child support should NOT be set by Florida's child support guidelines (see section 61.30, Florida Statutes). The court should do this because: ________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ (b) Method of Payment: [✓ check all which apply] ____ Directly to the person the court has ordered will be paid the support. ____ Payment will be through the central depository by the attached order (Family Law Form 12.991(a)). ____ Payment will be by income deduction order (Family Law Form 12.991(b)) which is attached. (c) _____ Unusual or uninsured medical/dental expenses for the children be paid by: [✓ one only] _____ Petitioner or _____ Respondent or _____ Petitioner and Respondent each pay one-half. (d) _____ Medical insurance [✓ one only] _____ is or _____ is not reasonably available to the [✓ one only] _____ petitioner or _____ respondent for the child(ren) and [✓ one only] _____ petitioner or _____ respondent should be required to provide it. (e) ____ Dental insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ petitioner or ____ respondent for the child(ren) and [✓ one only] ____ petitioner or ____ respondent should be required to provide it. *1138 (f) ____ Life insurance for the benefit of the children be provided by: [✓ one only] ____ Petitioner ____ Respondent I CERTIFY THAT THE PETITION/REQUEST TO MODIFY/CHANGE PRIMARY RESPONSIBILITY/CUSTODY OF CHILDREN WAS: (✓ check one only) _____ mailed, _____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ___________________________ Sworn to (or affirmed) and subscribed before me on {date} _____, 19__ by {name} _______________________________. _________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced _____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name} _____________________________________, a nonlawyer, located at {street} _________________________ {city} _______________________ {state} ______, {phone} _______, helped {name} __________, who is the [✓ one only] _____ petitioner or _____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.904(a), PETITION/REQUEST FOR SUPPORT UNCONNECTED WITH DISSOLUTION OF MARRIAGE $ If your spouse fails to provide you and your child(ren) with support, you can ask the court to order that person to pay alimony and/or child support without requesting a dissolution of marriage. For further information, see § 61.09, Florida Statutes. To request support unconnected with dissolution of marriage, you must fill out this form, and Florida Family Law Forms 12.910(a), Summons: Personal Service on *1139 Individual and 12.901(f), Uniform Child Custody Jurisdiction Act (UCCJA), and file all these forms with the court. In these forms and other court papers, you are referred to either as the petitioner or the respondent. The petitioner is the person who originally opens the case. $ When you file these forms with the court, you will be charged a filing fee and service fee. If you cannot afford these costs, you must also complete Family Law Form 12.901(c), Affidavit of Insolvency, and file it with the court requesting a waiver of the costs. Because you are requesting child support be paid, you will also need to file Family Law Form 12.901(g), Child Support Guidelines Worksheet, (see Appendix 3 and section 61.30, Florida Statutes for help) and Family Law Form 12.901(d) or 12.901(e), Family Law Financial Affidavits. Finally, you should decide if you want the support award to be paid through the central depository which keeps a record of all payments and sends notices if the paying parent gets behind in payments and/or by income deduction order which means that the paying parent's (obligor's) boss sends money from the obligor's wages right to you. See Family Law Form 12.991(a), Order of Child Support Paid through the Central Depository and Family Law Form 12.991(b), Income Deduction Order of Child Support. If you do not know your spouse's or your child's other parent's income, you may use Family Law Forms 12.930(a) and (b) and 12.931(a), (b) and (c) to find out about that person's wages, assets and debts. • After the other parent has been served with a copy of the forms, he or she has 20 days to file a response with the court. If the other parent does not file a response, you are entitled to a default (see Family Law Forms 12.922(a), Request to Enter Default, 12.922(b), Default, and 12.994(a), Final Judgment of Support Unconnected With Dissolution of Marriage. After the other parent has responded to your petition (request) or a default has been entered because he or she has not responded, you must ask for a hearing for the court to consider your request. See Family Law Form 12.921, Order Setting Matter for Uncontested Hearing or Status Conference or Form 12.923, Notice of Hearing (General Form). Even after a default has been entered the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). You should bring a proposed order with you to the hearing (see, for example, Form 12.994(a), Final Judgment of Support Unconnected with Dissolution). If the court rules in your favor, your proposed order usually will be signed at the hearing. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ *1140 PETITION/REQUEST FOR SUPPORT UNCONNECTED WITH DISSOLUTION OF MARRIAGE The Petitioner files this petition saying: 1. STATISTICAL FACTS. a. Date of marriage: ______________________________________________ b. Place of marriage: _____________________________________________ c. Date of separation, if applicable: _____________________________ d. The other party is employed or otherwise has the ability to support the child(ren) and/or spouse but is not doing so. e. My Financial Affidavit is attached. (Family Law Form 12.901(d) OR 12.901(e).) 2. SPOUSAL SUPPORT ____ spousal support is needed by [✓ one only] the ____ husband or ____ wife, and [✓ one only] the _____ husband or _____ wife is able to pay that support. THE FOLLOWING BILLS ARE NOW DUE OR PAST DUE: Name on title/deed/account To whom/ [✓ all that apply] Description Balance Due Monthly payment Husband Wife House _______ $ _____________ $ _______________ ___________ ____________ Car _________ $ _____________ $ _______________ ___________ ____________ Car _________ $ _____________ $ _______________ ___________ ____________ Credit Cards:* No. _________ $ _____________ $ _______________ ___________ ____________ No. _________ $ _____________ $ _______________ ___________ ____________ No. _________ $ _____________ $ _______________ ___________ ____________ No. _________ $ _____________ $ _______________ ___________ ____________ No. _________ $ _____________ $ _______________ ___________ ____________ No. _________ $ _____________ $ _______________ ___________ ____________ No. _________ $ _____________ $ _______________ ___________ ____________ No. _________ $ _____________ $ _______________ ___________ ____________ _____________ $ _____________ $ _______________ ___________ ____________ _____________ $ _____________ $ _______________ ___________ ____________ _____________ $ _____________ $ _______________ ___________ ____________ * give account numbers for all credit and loans 3. CHILD SUPPORT _____ The minor children are: Name Birth Date Age Sex ________________________ ____________________ _________ ___________ ________________________ ____________________ _________ ___________ ________________________ ____________________ _________ ___________ ________________________ ____________________ _________ ___________ On behalf of my children, I need, and [✓ one only] _____ Petitioner or _____ Respondent (the other person in the case) has the ability to pay reasonable child support. (a) Amount [✓ one only] ____ Child support should be set by Florida's child support guidelines (see section 61.30, Florida Statutes). *1141 ____ Child support should NOT be set by Florida's child support guidelines (see section 61.30, Florida Statutes). The court should do this because: __________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ (b) Health insurance for the child(ren) ____ is or ____ is not reasonably available to the [✓ one only] ____ husband or ____ wife and should be provided by the [✓ one only] ____ husband or ____ wife. WHEREFORE, I am asking this court to order: ____ A. Spousal support in an amount the court deems reasonable. ____ B. Payment of those listed bills that are currently or past due. ____ C. CHILD SUPPORT Awarding child support to [✓ one only] _____ Petitioner or ____ Respondent 1. Amount [✓ one only] ____ Child support should be set by Florida's child support guidelines (see section 61.30, Florida Statutes). ____ Child support should NOT be set by Florida's child support guidelines (see section 61.30, Florida Statutes). The court should do this because: ____________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ 2. ____ Unusual or uninsured medical/dental expenses for the children be paid by: [✓ one only] ____ Petitioner or ____ Respondent or _____ Petitioner and Respondent each pay one-half. 3. ____ Medical insurance [✓ one only] _____ is or _____ is not reasonably available to the [✓ one only] _____ petitioner or _____ respondent for the child(ren) and [✓ one only] _____ petitioner or _____ respondent should be required to provide it. 4. ____ Dental insurance [✓ one only] _____ is or _____ is not reasonably available to the [✓ one only] _____ petitioner or _____ respondent for the child(ren) and [✓ one only] _____ petitioner or _____ respondent should be required to provide it. 5. ____ Life insurance for the benefit of the children be provided by: [✓ one only] _____ Petitioner or _____ Respondent ____ D. All payments for spousal support and child support shall be paid: [✓ check all which apply] ____ Directly to the person the court has ordered will be paid the support. ____ Payment will be through the central depository by the attached order (Family Law Form 12.991(a)). ____ Payment will be by income deduction order (Family Law Form 12.991(b)) which is attached. ____ E. Petitioner is in need of the money requested and Respondent has the ability to pay it. *1142 I CERTIFY THAT THE PETITION/REQUEST FOR SUPPORT UNCONNECTED WITH DISSOLUTION OF MARRIAGE WAS: (✓ check one only) _____ mailed, _____ telefaxed and mailed, or _____ hand delivered to the person(s) listed below on {date} ______________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ________________________ Sworn to (or affirmed) and subscribed before me on {date} _____, 19__ by {name} _________________. ___________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced _____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name} ____________________________, a nonlawyer, located at {street} _____________________ {city} ________________ {state} _____, {phone} _____, helped {name} ______, who is the [✓ one only] _____ petitioner or _____ respondent, fill out this form. INSTRUCTIONS FAMILY LAW FORM 12.904(b) PETITION FOR MODIFICATION OF CHILD SUPPORT AND OTHER RELIEF See Appendix 3 for how to fill out this form. $ When you file these forms with the court, you will be charged a filing fee and service fee. If you cannot afford these costs, you must also complete Family Law Form 12.901(c), Affidavit of Insolvency, and file it with the court requesting a waiver of the costs. Because you are requesting child support be paid, you will also need to file Family Law Form 12.901(g), Child Support Guidelines Worksheet, (see Appendix 3 and section 61.30, Florida Statutes for help) and Family Law Form 12.901(d) or 12.901(e), Family Law Financial Affidavits. Finally, you should decide if you want the support award to be paid through the central depository which keeps a record of all payments and sends notices if the paying *1143 parent gets behind in payments and/or by income deduction order which means that the paying parent's (obligor's) boss sends money from the obligor's wages right to you. See Family Law Form 12.991(a), Order of Child Support Paid through the Central Depository and Family Law Form 12.991(b), Income Deduction Order of Child Support. If you do not know your spouse's or your child's other parent's income, you may use Family Law Forms 12.930(a) and (b) and 12.931(a), (b) and (c) to find out about that person's wages, assets and debts. • After the other parent has been served with a copy of the forms, he or she has 20 days to file a response with the court. If the other parent does not file a response, you are entitled to a default (see Family Law Forms 12.922(a), Request to Enter Default, 12.922(b), Default, and 12.990(d), and Final Judgment Modifying Child Support, 12.994(b)). After the other parent has responded to your petition (request) or a default has been entered because he or she has not responded, you must ask for a hearing for the court to consider your request. See Family Law Form 12.921, Order Setting Matter for Uncontested Hearing or Status Conference or Form 12.923, Notice of Hearing (General Form). Even after a default has been entered the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). You should bring a proposed order with you to the hearing (see, for example, Form 12.994(b), Final Judgment Modification/Change Child Support). If the court rules in your favor, your proposed order usually will be signed at the hearing. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: _____________________________ Division: _____________________________ ________________________________, Petitioner and ________________________________, Respondent. ____________________________\ PETITION/REQUEST FOR MODIFICATION/CHANGE OF CHILD SUPPORT AND OTHER RELIEF [✓ check all which apply, fill in all blanks that apply] The _____ Petitioner/ _____ Respondent, files this Petition for Modification and claims: 1. This is an action for modification of the last order/judgment addressing child support previously entered by this court on the {date} __________. A copy of that order is attached. 2. That order/judgment, required the obligor to pay child support in the amount of $ ___ each pay period: _____ weekly _____ biweekly _____ twice a month _____ monthly 3. That since the entry of the last child support determination there has been a substantial and permanent change of circumstances as follows: *1144 a. Obligor's income has ____ increased or ____ decreased. Please explain: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ b. Obligee's income has ____ increased or ____ decreased. Please explain: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ c. The child's/children's needs have ____ increased or ____ decreased. Please explain: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ d. List any other changes that have taken place since the last child support determination that you feel are reasons why the child support in effect at this time should be changed. _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ e. The child support calculations under the Child Support Guidelines support a change. A guideline worksheet (Family Law Form 12.901(g) is attached). Please explain: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ f. Other: ________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ WHEREFORE, the [✓ one only] ____ Petitioner or ____ Respondent respectfully demands that the child support be modified and such other relief be granted as the court deems appropriate. I CERTIFY THAT THE PETITION/REQUEST FOR MODIFICATION/CHANGE OF CHILD SUPPORT AND OTHER RELIEF WAS: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ________, 19__. Party or their attorney Other (if represented) Name ________________________ Name _________________________________ Address _____________________ Address ______________________________ _____________________________ ______________________________________ City State Zip City State Zip Telephone No. _______________ Telephone No. ________________________ Telefax No. _________________ Telefax No. __________________________ DATED: ______________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) *1145 STATE OF FLORIDA COUNTY OF {name} __________________ Sworn to (or affirmed) and subscribed before me on {date} _____, 19__ by {name} _____________________. _________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name} __________________________________, a nonlawyer, located at {street} _____________________ {city} ________________ {state} _____, {phone} _____, helped {name} __________, who is the [✓ one only] _____ petitioner or _____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.905, PETITION/REQUEST FOR GRANDPARENT VISITATION Great-grandparents and grandparents can be granted reasonable visitation rights with their (great)-grandchild(ren) if the court determines it is in the best interests of the child(ren), and if: ✓ one or both parents are dead; ✓ the marriage of the parents has been dissolved; ✓ a parent of the child has deserted the child; ✓ the minor child was born out of wedlock and not later determined to be a child born within wedlock, as provided in section 742.091, Florida Statutes; or ✓ the minor child lives with both natural parents who have used their parental authority to prohibit a relationship between the child and grandparents. Generally, you would file this request in the county where your (great)-grandchild resides. This form can be used in a dissolution of marriage (divorce) between the child(ren)'s parents, in a paternity or support proceeding, or as a separate action. For more information, see sections 752.01 and 61.13, Florida Statutes. To request grandparent visitation, you must fill out this form, and Florida Family Law Forms 12.910(a), Summons: Personal Service on Individual and 12.901(f), Uniform Child Custody Jurisdiction Act (UCCJA) and file all these forms with the court. • After the objecting parties have been served with a copy of the forms, they have 20 days to file a response with the court. If the other parent does not file a response, you are entitled to a default (see Family Law Forms 12.922(a), Request to Enter Default, and 12.922(b), Default). After the other parent has responded to your petition (request) or a default has been entered because he or she has not responded, you must ask for a hearing for the court to consider your request. See Family Law Form 12.923, Notice of Hearing (General Form). Even after a default has been entered the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). $ When you file these forms with the court, you will be charged a filing fee and service fee. If you cannot afford these costs, you must also complete Family Law Form 12.901(c), Affidavit of Insolvency, and file it with the court requesting a waiver of the costs. *1146 A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ ________________________________, Petitioner and ________________________________, Respondent. ___________________________\ PETITION/REQUEST FOR GRANDPARENT VISITATION 1. This is a request for grandparent(s) visitation. 2. The minor grandchild(ren) have been living in the State of Florida within the jurisdiction of this court since {date} __________, 19__. 3. Attached to this petition/request is my/our declaration under the Uniform Child Custody Jurisdiction Act (Attachment A, Florida Family Law Form 12.901(f)). 4. The grandparent(s) desire to visit with the following minor grandchild(ren). Name Birth Date Age Sex ________________________ _____________________ ____________ __________ ________________________ _____________________ ____________ __________ ________________________ _____________________ ____________ __________ ________________________ _____________________ ____________ __________ 5. The child(ren)'s [✓ one only] ____ father or ____ mother is my [✓ one only] ____ son or ____ daughter. 6. [✓ all that are true]: ____ The mother of the child(ren) has died. ____ The father of the child(ren) has died. ____ The mother and father of the child(ren) are divorced. A copy of the Final Judgment of Dissolution of Marriage/Divorce is attached. (Attachment B). ____ The mother of the child(ren) has deserted the child(ren). ____ The father of child(ren) has deserted the child(ren). ____ The parents were not married when the child(ren) was born and did not marry after the child(ren)'s birth. ____ The child lives with his/her natural parents and the parents have prohibited a relationship between the child and grandparents. 7. It is in the best interest of the child(ren) that the grandparent(s) be allowed reasonable rights of visitation by the grandchild(ren). This is in the child(ren)'s best interest because: ____________________________________________________________________________ *1147 ____________________________________________________________________________ ____________________________________________________________________________ GRANDFATHER DATED: _________________________ __________________________________________ Signature of grandfather Printed name _____________________________ Address __________________________________ __________________________________________ City State Zip __________________________________________ Telephone (area code and number) __________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ___________________ Sworn to (or affirmed) and subscribed before me on {date} ______, 19__ by {name of grandfather} __________________________. ___________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ____________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________ a nonlawyer, located at {street} _____________________ {city} ________________ {state} _____, {phone} _____, helped {grandfather} __________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. GRANDMOTHER DATED: ____________________ _________________________________________ Signature of grandmother Printed name ____________________________ Address _________________________________ _________________________________________ City State Zip _________________________________________ Telephone (area code and number) _________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ___________________ Sworn to (or affirmed) and subscribed before me on {date} ______, 19__ by {name of wife} __________________________. *1148 ___________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________, a nonlawyer, located at {street} _____________________ {city} ________________ {state} _____, {phone} _____, helped {name of grandmother} _________, fill out this form. INSTRUCTIONS FAMILY LAW FORM 12.910(a), SUMMONS: PERSONAL SERVICE ON AN INDIVIDUAL When you begin your lawsuit, you need to fill out this form and Family Law Form 12.910(b) and file your petition/request with the court. Personal service is required for all petitions including modifications. The clerk will sign the form and deliver it for service as instructed by you in your memorandum to the sheriff, Family Law Form 12.910(b). At the time of personal service of process, a copy of the initial petition/request is delivered to the person listed on the summons. The date and hour of service is written on the original summons and on all copies of it by the person making the service. You need to furnish the person delivering the summons with the necessary copies. The person delivering the summons and copies of the petition/request must make proof of service by affidavit promptly. • If delivery of the summons and documents is not made within 120 days after filing the initial request, the lawsuit may be dismissed by the court. If your opposing party fails to respond within 20 days after the delivery of the summons, you are entitled to a default. See Florida Family Law Forms 12.922(a) and 12.992(b). You will need to file Florida Family Law Form 12.912(b), Non-military Affidavit, before the default may be granted. For further information see Florida Rule of Civil Procedure 1.070 and Florida Family Law Rule of Procedure 12.070. If the other party is living outside of this state, you should add the length of time that party lived in Florida, if any, to your original request. If the case involves alimony, child support, or division of property in connection with a dissolution of marriage or an independent action for support of dependents, Florida courts have jurisdiction (can order the person to do or not do things) over a person living outside Florida if that person resided in Florida before the lawsuit was filed (whether they lived with you or not) or maintained a marital home in Florida at the time the lawsuit was filed. See § 48.193, Florida Statutes, for further information. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. *1149 IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ________________________________ Division: ________________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ SUMMONS: PERSONAL SERVICE ON AN INDIVIDUAL TO: _______________________________________________________________________ ___________________________________________________________________________ IMPORTANT A lawsuit has been filed against you. You have 20 calendar days after this summons is served on you to file a written response to the attached complaint/petition with the clerk of this circuit court. A phone call will not protect you. Your written response, including the case number given above and the names of the parties, must be filed if you want the court to hear your side of the case. If you do not file your written response on time, you may lose the case, and your wages, money, and property may thereafter be taken without further warning from the court. There are other legal requirements. You may want to call an attorney right away. If you do not know an attorney, you may call an attorney referral service or a legal aid office (listed in the phone book). If you choose to file a written response yourself, at the same time you file your written response to the court you must also mail or take a copy of your written response to the person named below. WARNING: Rule 12.285, Florida Family Law Rules of Procedure, requires that you provide to the other party in this lawsuit access to or copies of certain documents and information. Failure to do this can result in the court taking action against you, including dismissal (throwing out your case) or striking of pleadings (throwing out part of your case). IMPORTANTE Usted ha sido demandado legalmente. Tiene veinte (20) dias, contados a partir del recibo de esta notificacion, para contestar la demanda adjunta, por escrito, y presentarla ante este tribunal. Una llamada telefonica no lo protegera. Si usted desea que el tribunal considere su defensa, debe presentar su respuesta por escrito, incluyendo el numero del caso y los nombres de las partes interesadas. Si usted no contesta la demanda a tiempo, pudiese perder el caso y podria ser despojado de sus ingresos y propiedades, o privado de sus derechos, sin previo aviso del tribunal. Existen otros requisitos legales. Si lo desea, usted puede consultar a un abogado inmediatamente. Si no conoce a un abogado, puede llamar a una de las oficinas de asistencia legal que aparecen en la guia telefonica. Si desea responder a la demanda por su cuenta, al mismo tiempo en que presente su respuesta ante el tribunal, usted debe enviar por correo o entregar una copia de su respuesta a la persona denominada abajo. AVISO: La regla 12.285, de las reglas de procedimiento del derecho de la familia del estado de la Florida exige que se entreguen ciertos datos y documentos a la parte adversa . . . So Ud. no cumple con estos requisitos, se le podran aplicar sanciones, las cuales pueden dar lugar al rechazo o a la desestimacion de sus escritos. *1150 IMPORTANT Des poursuites judiciaries ont ete entreprises contre vous. Vous avez 20 jours consecutifs a partir de la date de l'assignation de cette citation pour deposer une response ecrite a la plainte ci-jointe aupres de ce tribunal. Un simple coup de telephone est insuffisant pour vous proteger; vous etes obliges de deposer votre reponse ecrite, avec mention du numero de dossier ci-dessus et du nom des parties nommees ici, si vous souhaitez que le tribunal entende votre cause. Si vous ne deposez pas votre reponse ecrite dans le delai requis, vous risquez de perdre la cause ainsi que votre salaire, votreargent, et vos biens peuvent etre saisis par la suite, sans aucun preavis ulterieur du tribunal. Il y a d'autres obligations juridiques et vous pouvez requerir les services immediats d'un avocat. Si vous ne connaissez pas d'avocat, vous pourriez telephoner a un service de reference d'avocats ou a un bureau d'assistance juridique (figurant a l'annuaire de telephones). Si vous choisissez de deposer vous-meme une response ecrite, il vous faudra egalement, en meme temps que cette formalite, faire parvenir ou expedier une copie au carbone ou une photocopie de votre reponse ecrite a a personne nommee ci-dessous. ATTENTION: La regle 12.285 des regles de procedure du droit de la famille de la Floride exige que l'on remette certains renseignements et certains documents a la partie adverse. Tout refus de les fournir pourra donner lieu a des sanctions, y compris le rejet ou la suppression d'un ou de plusieurs actes de procedure. ________________________________ Petitioner ________________________________ Mailing Address ________________________________ City/State/Zip Code THE STATE OF FLORIDA TO EACH SHERIFF OF THE STATE: You are commanded to serve this summons and a copy of the complaint in this lawsuit on the above named defendant. DATED: __________________________ (SEAL) CLERK OF THE CIRCUIT COURT By: __________________________ Deputy Clerk INSTRUCTIONS FAMILY LAW FORM 12.910(b) PROCESS SERVICE MEMORANDUM You should use this form to give the sheriff's department instructions for serving the other person(s) in your case with the summons ( Family Law Form 12.910(a)). On this form, you can tell the sheriff's department the best times to find the other person(s) at work and/or at home. You also can include a map to the other person(s)'s home or work place to help the sheriff find the other person and deliver the summons. PROCESS SERVICE MEMORANDUM TO: Sheriff of ___________________ County, Florida; __________ Division RE: ____________________________________, Petitioner and _______________________________________________, Respondent ____ Circuit Court, County of _____________________________________________ Case No. ______________________________ Please serve the Summons and Petition herein, in the above-styled cause upon: Respondent: _______________________________________________________________ Home Address: _____________________________________________________________ ___________________________________________________________________________ Work Address: _____________________________________________________________ ___________________________________________________________________________ Thank you. *1151 SPECIAL INSTRUCTIONS: _____________________________________ Signature of party _____________________________________ Printed name _____________________________________ Address _____________________________________ City State Zip _____________________________________ Telephone (area code and number) _____________________________________ Telefax (area code and number) INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.911(a), ORDER TO PERFECT SERVICE No instructions. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ________________________ Division: ________________________ _______________________________, Petitioner and ________________________________, Respondent. ___________________________\ ORDER TO PERFECT SERVICE UPON MOTION OF [✓ one only] _____ the Court or _____ Petitioner or _____ Respondent, it appearing that no service has been made within 120 days of the filing and good cause having been shown, it is hereby ORDERED AND ADJUDGED THAT diligent effort shall be made immediately to complete service of process within _____ days from the date of this order. DONE and ORDERED in {name} ____________________ County, Florida, on {date} __________, 19__. ____________________________________ CIRCUIT JUDGE *1152 cc: Petitioner or their attorney Other (if represented) Name ____________________________ Name ______________________________ Address _________________________ Address ___________________________ _________________________________ ___________________________________ City State Zip City State Zip Telephone No. ___________________ Telephone No. _____________________ Telefax No. _____________________ Telefax No. _______________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name} ________________________________, a nonlawyer, located at {street} ______________________________ {city} _______________ {state} _______, {phone} ______, helped {name} ________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.911(b), ORDER OF DISMISSAL FOR FAILURE TO PERFECT SERVICE (120 DAYS) • If you have been unable to obtain proper service on the other party within 120 days after filing your lawsuit, the court will dismiss your lawsuit against the other party unless you can show good cause to the court why service was not made within the 120 days. For further information, see Florida Rule of Civil Procedure 1.070(i). A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: _______________________ Division: _______________________ _______________________________, Petitioner and ________________________________, Respondent. ___________________________\ ORDER OF DISMISSAL FOR FAILURE TO PERFECT SERVICE (120 days) [✓ check all which apply] UPON MOTION OF [✓ one only] _____ the Court or _____ Petitioner or _____ Respondent and this court's review of the file, it is hereby ORDERED AND ADJUDGED that: ____ More than 120 days have passed without service of the summons and initial pleadings. ____ This case is dismissed without prejudice. *1153 DONE and ORDERED in {name} __________________ County, Florida, on {date} __________, 19__. _______________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name _______________________ Name ________________________________ Address ____________________ Address _____________________________ ____________________________ _____________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. _______________________ Telefax No. ________________ Telefax No. _________________________ Other Name _______________________ Address ____________________ ____________________________ City State Zip Telephone No. ______________ Telefax No. ________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name} _________________________________, a nonlawyer, located at {street} __________________________ {city} _______________ {state} _______, {phone} _____, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.912(a), MEMORANDUM FOR CERTIFICATE OF MILITARY SERVICE If you do not know whether the other person in your case is on active duty in the military service, you must fill out this form and mail one copy of it separately to each of the military divisions at the addresses on the form for a response. You may be charged a service fee by the military for their response. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR ___________ COUNTY, FLORIDA Case No.: _________________________ Division: _________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ *1154 MEMORANDUM FOR CERTIFICATE OF MILITARY SERVICE TO: U.S. Coast Guard Commander, GPIM-2, Locators, 2100 2nd St., S.W., Washington, DC 20593 AFMPC/RMIQL, Attn: Air Force Locator, Randolph AFB, TX 78150-6001 Department of Navy, Bureau of Navy Personnel, 2 Navy Annex, Washington, DC XXXXX-XXXX CMC MMSB-10, HQ USMC, Bldg. 2008, Quantico, VA XXXXX-XXXX Surgeon General, U.S. Public Health Service, Div. of Comm., Off. Personnel, 5600 Fishers Lane, Rockville, MD 20857 Army World Wide Locator, U.S. Army Enlisted Records Center, Fort Benjamin Harrison, IN XXXXX-XXXX Commander, U.S. Army Personnel Center, Officer Locator Branch, Attn: Locators, 200 Stovall Street, Alexandria, VA 22332 RE: ______________________________ ________________________________________ [Party] [Soc. Sec. #] This case involves a family matter. It is imperative that a determination be made whether the above named individual, who has an interest in these proceedings, is presently in the military service of the United States, and the date of induction and discharge, if any. This information is necessary to comply with § 581 of the Soldier's and Sailor's Civil Relief Act of 1940, as amended. Please supply a certification of verification as soon as possible. My check is enclosed for your search fees. Self-addressed stamped envelopes are enclosed. DATED: ___________________________ _______________________________________ Signature of party signing certificate Printed name __________________________ Address _______________________________ _______________________________________ City State Zip _______________________________________ Telephone (area code and number) _______________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name} ____________________________________, a nonlawyer, located at {street} ______________________ {city} _____________ {state} _______, {phone} ______, helped {name} _____________________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.912(b), NONMILITARY AFFIDAVIT If you know that the other person in your case is not in the military service, you must fill out this form and file it with your petition/request in order to get a default against the other person if he or she does not respond to your petition/request. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. *1155 IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: _______________________________ Division: _______________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ NONMILITARY AFFIDAVIT STATE OF FLORIDA COUNTY OF ___________________________ ______________________________________, being first duly sworn, states under {Name of person signing below} penalty of perjury: 1. ____ That I know of my own personal knowledge that the respondent is not on active duty in the armed forces of the United States. 2. ____ That I have inquired of the armed forces of the United States and the U.S. Public Health Service to determine whether the respondent is a member of the armed services and am attaching certificates stating that the respondent is not now in the armed forces. I CERTIFY THAT THE NONMILITARY AFFIDAVIT WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} __________, 19__. Party or their attorney Other (if represented) Name _______________________ Name ________________________________ Address ____________________ Address _____________________________ ____________________________ _____________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. _______________________ Telefax No. ________________ Telefax No. _________________________ DATED: _____________________ ____________________________________________________ Signature of party signing certificate and affidavit Printed name _______________________________________ Address ____________________________________________ ____________________________________________________ City State Zip ____________________________________________________ Telephone (area code and number) ____________________________________________________ Telefax (area code and number) *1156 STATE OF FLORIDA COUNTY OF {name} ____________________________ Sworn to (or affirmed) and subscribed before me on {date} ______, 19__ by {name} ___________________. ____________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________, a nonlawyer, located at {street} ______________________________ {city} _________________ {state} _______, {phone} ______, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.913(a), NOTICE OF ACTION OF DISSOLUTION OF MARRIAGE If you do not know where your spouse lives and/or your spouse lives outside Florida and never has lived in Florida, you can use this form to obtain constructive service over your spouse and be able to proceed with your lawsuit. You must fill out this form, inserting your spouse's name and last known address, and file it with the court. You also must complete and file Family Law Form 12.913(b), Affidavit of Service by Publication. • After the Affidavit (Form 12.913(b)) is filed and the clerk of the court signs this form, the notice of action must be given to a qualified local newspaper in order for it to be published for four consecutive weeks. The newspaper will charge you for this service. $ If you cannot afford to pay the cost of publication, you may ask the clerk to post the notice at a place designate. In Dade, Broward, or Duval counties you may ask the clerk to publish your notice without charge. If the clerk determines that you financially cannot afford these costs, the clerk will post the notice of action. You need to fill out Family Law Form 12.901(c), Affidavit of Insolvency, for the clerk to consider your request. • If the opposing party fails to respond to your request within the time limit stated in the notice of action that is published or posted, you are entitled to a default. (See Family Law Forms 12.922(a), Request to Enter Default, 12.922(b), Default, and 12.990(d), Final Default Judgment of Dissolution of Marriage). A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. NOTICE OF ACTION OF DISSOLUTION OF MARRIAGE TO: ________________________ YOU ARE HEREBY NOTIFIED that an action for dissolution of marriage has been filed against you and you are required to serve a copy of your written defenses, if any, to it on *1157 ___________________________________________________________________________ ________________ Petitioner, whose address is _____________________________ ___________________________________________________________________________ ___________________________________________________________________________ [Name of Filing Party] ______________________________ on or before ___________________, and file the original with the clerk of this court before service on Petitioner or immediately thereafter. If you fail to do so, a default will be entered against you for the relief demanded in the petition. WARNING: Rule 12.285, Florida Family Law Rules of Procedure, requires certain automatic disclosure of documents and information. Failure to comply can result in sanctions, including dismissal or striking of pleadings. WITNESS my hand and the seal of this court on ________________________ CLERK OF THE COURT By __________________________________ Deputy Clerk INSTRUCTIONS FOR FAMILY LAW FORM 12.913(b), AFFIDAVIT FOR SERVICE BY PUBLICATION This form is to be used in conjunction with Florida Family Law Form 12.913(a), Notice of Action. If you do not know where the other person in your case is residing and/or the other person is living outside Florida and the other person has never lived in Florida, you need to fill out this form and file it with the court. The "Affiant" is the person filling out and signing the affidavit (Florida Family Law Form 12.913(b)). CHECKLIST FOR AFFIDAVITS OF DUE DILIGENCE (for use in filling out Florida Family Law Form 12.913(b), Affidavit of Service by Publication) The list below can be used as a checklist for filling out affidavits of due diligence. While you do not have to take all of these steps, you must make a very strong effort at getting information and following up on any information you get. ✓ United States Post Office inquiry through Freedom of Information Act for current address or any relocations. ✓ Last known employment of Respondent, including name and address of employer. You should also ask for any addresses to which W-2 Forms were mailed. If a pension or profit sharing plan exists, then to what address is any pension to be mailed. ✓ Unions from which Respondent may have worked or that governed particular trade or craft. ✓ Regulatory agencies, including professional or occupational licensing. ✓ Names and addresses of relatives and contacts with those relatives and inquiry as to Respondent's last known address. You are to follow up any leads of any addresses where Respondent may have moved. Relatives include, but are not limited to: Parents, brothers, sisters, aunts, uncles, cousins, nieces, nephews, grandparents, great-grandparents, former in-laws, stepparents, stepchildren. ✓ Information about the Respondent's possible death and, if dead, the date and location. *1158 ✓ Telephone listings in the last known locations of Respondent's residence. ✓ Law enforcement arrest and/or criminal records at the last known residential area of Respondent. ✓ Highway Patrol records. ✓ Department of Corrections records. ✓ Hospitals in last known area of Respondent. ✓ Utility companies, which include water, sewer, cable TV, electric. ✓ Letters to the Armed Forces of the U.S. and their response as to whether or not there is any information about Respondent. (see Form 12.912(a).) ✓ Tax Assessor's and Tax Collector's Office in the area where Respondent last resided. For further information, see Florida Family Law Rule of Procedure 12.070 and Florida Rules of Civil Procedure 1.070(e) and (f). A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: _______________________ Division: _______________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ AFFIDAVIT FOR SERVICE BY PUBLICATION ____________________, states under penalty of perjury that: 1. I have made diligent search and inquiry to discover the name and residence of Respondent: [Specify details of search] Refer to checklist and list all actions taken (any additional information included such as the date the action was taken and the person with whom you spoke is helpful): _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 2. The age of Respondent is [✓ one only] ____ over or ____ under the age of 18 years or____ is unknown. *1159 3. ____ The residence of Respondent is unknown to Affiant. ____ The residence of Respondent is in some state or country other than Florida, and Respondent's last known address is: __________________. ___________________________________________________________________ [City] [State] [Zip] 4. ____ The Respondent, having residence in Florida, has been absent therefrom for more than 60 days prior to the making of this affidavit, or conceals him(her)self so that process cannot be served personally upon him (her), and that Affiant believes that there is no person in the state upon whom service of process would bind said absent or concealed Respondent. I CERTIFY THAT THE AFFIDAVIT FOR SERVICE BY PUBLICATION WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} __________, 19__. Party or their attorney Other (if represented) Name _______________________ Name ________________________________ Address ____________________ Address _____________________________ ____________________________ _____________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. _______________________ Telefax No. ________________ Telefax No. _________________________ DATED: _____________________ ____________________________________________________ Signature of party signing certificate and affidavit Printed name _______________________________________ Address ____________________________________________ ____________________________________________________ City State Zip ____________________________________________________ Telephone (area code and number) ____________________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} _______________________ Sworn to (or affirmed) and subscribed before me on {date} _____, 19__ by {name} ____________________. ___________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ______________________________________, a nonlawyer, located at {street} ______________________________ {city} ________________ {state} _______, {phone} ______, helped {name} __________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. *1160 INSTRUCTIONS FOR FAMILY LAW FORM 12.914, CERTIFICATE OF SERVICE (GENERAL FORM) After you get proper service over your opposing party (through a summons or publication of notice), you need to send copies of all additional documents or papers you file with the court in your lawsuit to the opposing party. Fill out this form (giving the name of each paper filed) and file this form with the court each time you file an additional document unless the document already has a certificate of service in it. For more information, see Florida Rule of Civil Procedure 1.080 and Florida Family Law Rule of Procedure 12.080. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ________________________ Division: ________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ CERTIFICATE OF SERVICE I CERTIFY THAT THE {name of document(s) served} ____________________ WAS: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ___________, 19__. ______________________________________ Signature of party ______________________________________ Printed name ______________________________________ Address ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ *1161 IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________________, a nonlawyer, located at {street} ___________________________ {city} ________________ {state} ________, {phone} ______________, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.920(a), ORDER OF REFERRAL TO GENERAL MASTER AND 12.920(b), NOTICE OF HEARING BEFORE GENERAL MASTER • The general master is an attorney appointed by a judge to take testimony and recommend decisions on certain matters connected with a divorce. After a hearing, the general master files his or her report and serves copies on all parties. You may serve exceptions to the report within 10 days* from the time the report is served. If no exceptions are served, the court will take appropriate action on the report. If exceptions are served, the judge will hear the exceptions at a date and time scheduled by any party or the court, and then take appropriate action on the report. If the matter is for child support only, the court may enter an order immediately, but you may file exceptions to the order within 10 days after being served. Frequently, the moving party must prepare the order referring the case to a general master. If you are requested to prepare such an order, you will use Family Law Form 12.920(a). Once a general master has been appointed, a hearing will be scheduled. Any party or the general master will send a notice of hearing regarding when and where the hearing before the general master will be held. If you are asked to send the notice of hearing, you will use Family Law Form 12.920(b). Regardless of who prepares the notice of hearing, the moving party is required to have the notice properly served on the other party. * If the report is served by mail, you have an additional 5 days. For further information, see Florida Family Rule of Procedure 12.490. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ___________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner and _______________________________, Respondent. __________________________\ ORDER OF REFERRAL TO GENERAL MASTER THIS CASE IS REFERRED TO THE GENERAL MASTER on the following issues: 1. ________________________________________________________________________ *1162 2. ________________________________________________________________________ 3. ________________________________________________________________________ 4. ________________________________________________________________________ AND ANY OTHER MATTER RELATED THERETO. IT IS FURTHER ORDERED that the above motion(s) and responses are referred to General Master {name}_______________ for further proceedings, pursuant to rule 12.490 of the Florida Family Law Rules of Procedure and current administrative orders of the court. Financial affidavits (Family Law Form 12.901(d) or (e)), shall be filed in accordance with rule 12.285, Florida Family Law Rules of Procedure. The general master is authorized to administer oaths and conduct hearings which may include taking of evidence and shall file a report and recommendations that contain findings of fact, conclusions of law, and the name of the court reporter, if any. The General Master shall assign a time for the proceedings as soon as reasonably possible after this referral is made and give notice to each of the parties either directly or by directing counsel to file and serve a notice of hearing. Counties within the State of Florida may have different rules. Please consult the Clerk of the Court or Pro Se Coordinator relating to this procedure. A REFERRAL TO A GENERAL MASTER REQUIRES THE CONSENT OF ALL PARTIES. YOU ARE ENTITLED TO HAVE THIS MATTER HEARD BY A JUDGE. IF YOU DO NOT WANT TO HAVE THIS MATTER HEARD BY THE GENERAL MASTER, YOU MUST FILE A WRITTEN OBJECTION TO THE REFERRAL WITHIN 10 DAYS OF THE TIME OF SERVICE OF THIS ORDER. IF THE TIME SET FOR THE HEARING IS LESS THAN 10 DAYS AFTER SERVICE OF THIS ORDER, THE OBJECTION MUST BE MADE BEFORE THE HEARING. IF THIS ORDER IS SERVED WITHIN THE FIRST 20 DAYS AFTER SERVICE OF PROCESS, THE TIME TO FILE AN OBJECTION IS EXTENDED TO THE TIME WITHIN WHICH A RESPONSIVE PLEADING IS DUE. FAILURE TO FILE A WRITTEN OBJECTION WITHIN THE APPLICABLE TIME PERIOD IS DEEMED TO BE A CONSENT TO THE REFERRAL. If either party files a timely objection, this matter shall be returned to the undersigned judge with a notice stating the amount of time needed for hearing. REVIEW OF THE REPORT AND RECOMMENDATIONS MADE BY THE GENERAL MASTER SHALL BE BY EXCEPTIONS AS PROVIDED IN RULE 12.490(f), FLORIDA FAMILY LAW RULES OF PROCEDURE. A RECORD, WHICH INCLUDES A TRANSCRIPT, MAY BE REQUIRED TO SUPPORT EXCEPTIONS. YOU ARE ADVISED THAT IN THIS CIRCUIT: ____ electronic recording is provided by the court. A party may provide a court reporter at that party's expense. ____ a court reporter is provided by the court. SHOULD YOU WISH TO SEEK REVIEW OF THE REPORT AND RECOMMENDATION MADE BY THE GENERAL MASTER, YOU MUST FILE EXCEPTIONS IN ACCORDANCE WITH RULE 12.490(f), FLORIDA FAMILY LAW RULES OF PROCEDURE. YOU WILL BE REQUIRED TO PROVIDE THE COURT WITH A RECORD SUFFICIENT TO SUPPORT YOUR EXCEPTIONS OR YOUR EXCEPTIONS WILL BE DENIED. A RECORD ORDINARILY INCLUDES A WRITTEN TRANSCRIPT OF ALL RELEVANT PROCEEDINGS. THE PERSON SEEKING REVIEW MUST HAVE THE TRANSCRIPT PREPARED IF NECESSARY FOR THE COURT'S REVIEW. DONE and ORDERED in {name} ________________________ County, Florida, on {date} _________, 19__. *1163 ______________________________________ CIRCUIT JUDGE This portion to be filled out by the court: In accordance with the Americans with Disabilities Act of 1990, persons needing a special accommodation to participate in this proceeding should contact _________ for proceedings in court or ____________ at ________ for out of court proceedings no later than 7 days before the proceeding. Telephone ___________ or _________ for assistance. If hearing impaired, telephone (TDD) _______ for proceedings in court or Florida Relay Service 1-800-955-8771 for out of court proceedings. cc: Petitioner or their attorney Respondent (if represented) Name _______________________ Name ________________________________ Address ____________________ Address _____________________________ ____________________________ _____________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ General Master Name _______________________ Address ____________________ ____________________________ City State Zip Telephone No. ______________ Telefax No. ________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} __________________________________, a nonlawyer, located at {street} _____________________ {city} ____________ {state} ______, {phone} _______, helped {name} _____, who is the [✓ one only] _____ petitioner or _____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ NOTICE OF HEARING BEFORE GENERAL MASTER [ fill in all blanks] TO: _________________________________ _________________________________ *1164 There will be a hearing before General Master {name of general master} _________________________, on {date} _____________, 19__, at {time} _____________ m., in Room ________ of the _________________ Courthouse, on the following matter: _____________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________. ____ hours/____ minutes have been reserved for this hearing. PLEASE GOVERN YOURSELF ACCORDINGLY. SHOULD YOU WISH TO SEEK REVIEW OF THE REPORT AND RECOMMENDATION MADE BY THE GENERAL MASTER, YOU MUST FILE EXCEPTIONS IN ACCORDANCE WITH RULE 12.490(f), FLORIDA FAMILY LAW RULES OF PROCEDURE. YOU WILL BE REQUIRED TO PROVIDE THE COURT WITH A RECORD SUFFICIENT TO SUPPORT YOUR EXCEPTIONS OR YOUR EXCEPTIONS WILL BE DENIED. A RECORD ORDINARILY INCLUDES A WRITTEN TRANSCRIPT OF ALL RELEVANT PROCEEDINGS. THE PERSON SEEKING REVIEW MUST HAVE THE TRANSCRIPT PREPARED IF NECESSARY FOR THE COURT'S REVIEW. YOU ARE HEREBY ADVISED THAT IN THIS CIRCUIT: ____ electronic recording is provided by the court. A party may bring a court reporter at that party's own expense. ____ a court reporter is provided by the court. If you are represented by an attorney or plan to retain an attorney for this matter you should notify the attorney of this hearing. If this matter is resolved, the moving party shall contact the General Master's Office to cancel this hearing. This part to be filled out by the court: In accordance with the Americans with Disabilities Act of 1990, persons needing a special accommodation to participate in this proceeding should contact __________ for proceedings in court or ______________ at ______ for out of court proceedings no later than 7 days before the proceeding. Telephone __________ or ________ for assistance. If hearing impaired, telephone (TDD) _______ for proceedings in court or Florida Relay Service 1-800-955-8771 for out of court proceedings. I CERTIFY THAT THE NOTICE OF HEARING BEFORE GENERAL MASTER WAS: (✓ check one only) _____ mailed, _____ telefaxed and mailed, or _____ hand delivered to the person(s) listed below on {date} ____________, 19__. Party or their attorney Other (if reprersented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ *1165 City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________________, a nonlawyer, located at {street} _______________________ {city} __________ {state} _____, {phone} __________, helped {name} _________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.921, ORDER SETTING MATTER FOR UNCONTESTED HEARING OR STATUS CONFERENCE No Instructions. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ ORDER SETTING MATTER FOR UNCONTESTED FINAL HEARING OR FOR STATUS CONFERENCE The court having reviewed the file finds that: ____ The time to file an answer has expired, and therefore, IT IS ORDERED that: This case is set for uncontested final hearing before Judge {name of judge} ________________________, on {date} __________, 19__, at {time} ______________ in Room ________ of the ________________ Courthouse. [✓ one only] ____ If no answer has been filed, please bring your default order. You will also need to bring proof of residency, i.e., a residency witness, affidavit of residency, valid Florida driver's license, or valid Florida voter registration card. ____ If an answer has been filed, this hearing will serve as a status conference. The Petitioner, or the attorney for the Petitioner, is required to notify all other parties immediately of this hearing. *1166 FAILURE TO APPEAR MAY RESULT IN A DISMISSAL OF THIS CASE DATED: ________________, 19__. ______________________________________ CIRCUIT JUDGE This part to be filled in by court: In accordance with the Americans with Disabilities Act of 1990, persons needing a special accommodation to participate in this proceeding should contact ________ for proceedings in court or ____________ at _________ for out of court proceedings no later than 7 days before the proceeding. Telephone ________ or _________ for assistance. If hearing impaired, telephone (TDD) ______ for proceedings in court or Florida Relay Service 1-800-955-8771 for out of court proceedings. cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ Other Name _______________________ Address ____________________ ____________________________ City State Zip Telephone No. ______________ Telefax No. ________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________________ a nonlawyer, located at {street} _____________________ {city} ____________ {state} _____, {phone} ________, helped {name} _____, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FAMILY LAW FORM 12.922(a), REQUEST TO ENTER DEFAULT If your spouse has failed to file or serve any documents on you in response to your lawsuit as required, you may ask the clerk of the court to enter a default against your spouse by filling out this form and filing it with the court. • Generally, if your spouse fails to answer your petition/request within 20 days after the date of service, you may ask the clerk to enter a default against your spouse, Family Law Form 12.922(b). Once the default is signed, you can request a trial in your case. After the default has been entered because he or she has not responded, you must ask for a hearing for the court to consider your request. See Family Law Form 12.921, Order Setting Matter for Uncontested Hearing or Status Conference or Form 12.923, Notice of Hearing (General Form). You should bring a proposed order with you to the hearing. You will need to fill in Family Law Form 12.990(d), Final Default Judgment of Dissolution *1167 of Marriage (if the default you are seeking is in another type of matter, see the final judgments at Florida Family Law Forms 12.990-12.994(b) and find the one most appropriate for your type of case). If the court rules in your favor, your proposed order usually will be signed at the hearing. For further information, see Florida Rule of Civil Procedure 1.500 concerning defaults and Rule 1.140 for proper procedure for filing an answer. What to do if a default is entered against you You can request the court to set aside a default entered against you because of a mistake, inadvertence, excusable neglect, newly discovered evidence, or fraud. • You must obtain a hearing date and time for the court to consider your written request. For further information, see Florida Family Law Rule of Procedure 12.540 and Florida Rules of Civil Procedure 1.500(d) and 1.540(b). A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR ___________ COUNTY, FLORIDA Case No.: ______________________________ Division: ______________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ REQUEST TO ENTER DEFAULT TO THE CLERK OF COURT: Please enter a default against the Respondent who has failed to respond to the petition. I CERTIFY THAT THIS REQUEST TO ENTER DEFAULT WAS: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ___________, 19__. Party or their attorney Other (if represented) Name _______________________ Name ________________________________ Address ____________________ Address _____________________________ ____________________________ _____________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ DATED: _____________________ __________________________________________________ Signature of party signing certificate and pleading *1168 Printed name _____________________________________ Address __________________________________________ __________________________________________________ City State Zip __________________________________________________ Telephone (area code and number) __________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} __________________________________, a nonlawyer, located at {street} _______________________ {city} _________ {state} _____, {phone} ______, helped {name} _________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ___________________________ Division: ___________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ DEFAULT A default is entered in this action against the Respondent for failure to serve or file a response or any paper as is required by law. DATED: _____________________ CLERK OF COURT (SEAL) By: __________________________________ Deputy Clerk I CERTIFY THAT THIS DEFAULT WAS: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} __________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ *1169 ______________________________________ Signature of party ______________________________________ Printed name ______________________________________ Address ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________________, a nonlawyer, located at {street} ________________ {city} __________________ {state} _____, {phone} _____, helped {name} _________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.923, NOTICE OF HEARING (GENERAL FORM) Use this form anytime you have set a hearing before a judge and have been instructed to send notice of the hearing to the other party. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ NOTICE OF HEARING (GENERAL FORM) [ fill in all blanks] TO: ________________________ ________________________ There will be a hearing before Judge {name of judge} ____________, on {date} _______, 19__, at {time} _____., in Room ____ of the ______________________________ Courthouse, on the following matter: ___________________________________________________________________________ *1170 ___________________________________________________________________________ ___________________________________________________________________________. ______ hours/_____ minutes have been reserved for this hearing. If you are represented by an attorney or plan to retain an attorney for this matter you should notify the attorney of this hearing. If this matter is resolved, the moving party shall contact the judge's office to cancel this hearing. You will need to get the information from your local courthouse to fill out this part: In accordance with the Americans with Disabilities Act of 1990, persons needing a special accommodation to participate in this proceeding should contact _____ for proceedings in court or ____________ at __________ for out of court proceedings no later than 7 days before the proceeding. Telephone ________ or _____ for assistance. If hearing impaired, telephone (TDD) __________ for proceeding in court or Florida Relay Service 1-800-955-8771 for out of court proceedings. I CERTIFY THAT THE NOTICE OF HEARING ON {name of motion or petition to be heard} ____________________________________________________ WAS: (✓ one only) _____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________________, a nonlawyer, located at {street} _________________ {city} _________________ {state} _____, {phone} __________, helped {name} ______, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.930(a), NOTICE OF SERVICE OF STANDARD FAMILY LAW INTERROGATORIES AND FAMILY LAW FORM 12.930(b), STANDARD FAMILY LAW INTERROGATORIES After filing your lawsuit, you can request the other party to answer various questions relating to your lawsuit in writing by using this form. *1171 +10 Ten interrogatories, including subparts, may be sent to the other party in addition to the interrogatories on Family Law Form 12.930(b). If you wish to send more than 10 additional questions, you must have the court's permission. If the other party fails to answer the questions, you may ask the judge to order the other party to answer the questions. You must fill out this form and mail two copies to the other party. For more information, see Florida Family Law Rules of Procedure 12.280, 12.340, and 12.380 and Florida Rules of Civil Procedure 1.340 and 1.280(b). Instructions to Answering Party • As a general rule, within 30 days after service of these questions, you must answer the questions in writing and mail your answers to the other party. All answers to these questions are made under oath. Each question must be answered separately and as completely as the information available to you permits. You must make a reasonable good faith effort to answer the questions. You may object to a question and state the reason for the objection in the space provided. You may also ask the judge for a protective order granting you permission not to answer certain questions and protecting you from annoyance, embarrassment, apprehension, or undue burden or expense. If you fail either to answer or object to the questions within the required time, you may be subject to court sanctions. For further information, see Florida Family Law Rules of Procedure 12.280, 12.340 and 12.380 and Florida Rules of Civil Procedure 1.380, 1.280, and 1.340. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: __________________________ Division: __________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ NOTICE OF SERVICE OF STANDARD FAMILY LAW INTERROGATORIES You are notified that __________ has on ____ {date} _______, served upon {name of person served} _______________________________________ family law standard interrogatories to be answered under oath within 30 days after service of the interrogatories. *1172 I CERTIFY THAT THESE STANDARD FAMILY LAW INTERROGATORIES WERE: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ___________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________________, a nonlawyer, located at {street} _________________ {city} ________________ {state} ____, {phone} ________, helped {name} _________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ___________________________ Division: ___________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ STANDARD FAMILY LAW INTERROGATORIES 1. BACKGROUND INFORMATION: a. State your full legal name and any other name by which you have been known. b. State your present residence and employment or business addresses and telephone numbers. c. State your Social Security number. *1173 d. State your birthdate. e. List all business, commercial, and professional licenses which you now hold or which you have held in the last 3 years. f. List all of your education after high school, including but not imited to, vocational or specialized training, including the following information: (1) Name and address of each educational institution. (2) Dates of attendance. (3) Degrees or certificates obtained. 2. EMPLOYMENT: a. For each place of your employment or self-employment during the last 3 years state the following information: (1) Name, address, and telephone number of your employer. (2) Dates of employment. (3) Job title and brief description of job duties. (4) Starting and ending salaries. (5) Name of your direct supervisor. (6) All benefits received, including, for example, health, life, and disability insurance, expense account, use of automobile or automobile expense reimbursement, reimbursement for travel, food, or lodging expenses, payment of dues in any clubs or associations, and pension or profit-sharing plans. If you have been unemployed at any time during the last 3 years, show the dates of unemployment. If you have not been employed at any time in the last 3 years, give the requested information for your last period of employment. b. If you have been engaged in or associated with any business, commercial, or professional activity within the last 3 years that was not detailed above, state the following information for each such activity: (1) Name, address, and telephone number of each activity. (2) Dates you were connected with such activity. (3) Position title and brief description of activities. (4) Starting and ending salaries. (5) Name of your direct supervisor. (6) All benefits received, including, for example, health, life, and disability insurance, expense account, use of automobile or automobile expense reimbursement, reimbursement for travel, food, or lodging expenses, payment of dues in any clubs or associations, and pension or profit-sharing plans. If you have not been engaged in any such activities at all in the last 3 years, give the requested information for your last period of such activities. *1174 3. INCOME: a. For each of the last 3 years, state the following information: (1) Each source of your income. (2) The amount of income you received from each source, including earned, passive, and investment income and capital gains. b. For each of your present employment, self-employment, business, commercial, or professional activities, state the following information: (1) How often and on what days you are paid. (2) An itemization of your gross salary, wages, and income, and all deductions from that gross salary, wages, and income. (3) Any additional compensation or expense reimbursement, including, but not limited to, overtime, bonuses, profitsharing, insurance, expense account, automobile or automobile allowance that you have received or anticipate receiving. (For the purpose of these questions, the definition of income shall be that as contained in section 61.30, Florida Statutes.) 4. ASSETS: a. State the street address and legal description of all real property that you own, use, or hold under a deed, lease, or contract. For each property, state the following information: (1) The percentage and type interest you hold. (2) The names and addresses of any other persons or entities holding any interest. (3) The date of your acquisition of your interest. (4) The purchase price, the cost of any improvements made since it was purchased, and the amount of any depreciation taken. (5) The present market value. (6) The market value on the date of your separation from your spouse. *1175 (7) The market value on the date of the filing of the petition for dissolution of marriage. b. List all of the items of tangible personal property, that are owned by you or in which you have had any interest during the last 3 years, including but not limited to, motor vehicles, tools, furniture, boats, jewelry, art objects or other collections, and collectibles. For each item, state the following information: (1) The percentage and type interest you hold. (2) The names and addresses of any other persons or entities holding any interest. (3) The date of your acquisition of your interest. (4) The purchase price. (5) The present market value. (6) The market value on the date of your separation from your spouse. (7) The market value on the date of the filing of the petition for dissolution of marriage. c. Other than the financial accounts listed in the answer to interrogatory 5 below, list all of the items of intangible personal property that are owned by you or in which you have had any ownership interest within the last 3 years, including but not limited to, partnership and business interests, (including good will), stocks, bonds, receivables, choses in action, and debts owed to you by another entity or person. For each item state the following information: (1) The percentage and type interest you hold. (2) The names and addresses of any other persons or entities holding any interest, and the names and addresses of the persons and entities who are indebted to you or against whom you are claiming a chose in action. (3) The date of your acquisition of your interest. (4) The purchase price. (5) The present market value or the amounts you claim are owed as receivables, choses in action, or debts. (6) The market value or the amounts you claim are owed as receivables, choses in action, or debts, on the date of your separation from your spouse. (7) The market value, or the amounts you claim are owed as receivables, choses in action, or debts, on the date of the filing of the petition for dissolution of marriage. d. List all policies of insurance that you hold, own, or in which you have any interest. If the owner of any policy is anyone other than yourself, state the name and address of such person or entity. For each policy, state the following information: (1) The name of the insurance carrier and the name, address, and telephone number of the agent. (2) The policy number. (3) The type of insurance. (4) The face value of any life insurance or annuity policy. (5) The date the policy was acquired. (6) The beneficiary. (7) The cash surrender value. (8) The loan value. (9) The amount and nature of any loans outstanding against the policy. e. If you are the beneficiary of any estate, trust, insurance policy, or annuity state the following information for each one: (1) Identification of the estate, trust, insurance policy, or annuity. (2) The nature and amount of the benefit. *1176 (3) The value of the benefit. (4) Whether the benefit is vested or contingent. f. If you have established any trusts, state the following information: (1) The date the trust was established. (2) The names and addresses of the trustees. (3) The names and addresses of the beneficiaries. (4) The names and addresses of the persons or entities who possess the trust documents. (5) Each asset that is held in each trust, with its present fair market value. g. Other than the financial accounts listed in your answer to interrogatory 5 below, list all other assets that you own, in which you have any interest, or of which you have the use and benefit that has not already been listed. For each asset, state the following: (1) The name of the asset. (2) The date you acquired the asset or the date you first obtained the use or benefit of it. (3) The name and address of the person or entity from whom the asset was acquired or who allows you the use and benefit of it. (4) The fair market value on the date you acquired the asset or the use or benefit of it. (5) The fair market value on the date of your separation from your spouse. (6) The fair market value on the date of the filing of the petition for dissolution of marriage. (7) The present fair market value. 5. FINANCIAL ACCOUNTS: a. Are you an owner, participant, or alternate payee in any pension, profit sharing, deferred compensation, or retirement plan? If so, please state the following: (1) The precise legal name of the plan, and the name and address of the plan administrator or trustee. (2) A description of the type of plan, whether profit sharing, defined benefit, defined contribution, IRA, Keogh, or other. (3) The account balance of any money held for your benefit or to which you are entitled, and your accrued monthly benefit. *1177 (4) The location and last valuation date of said asset, the amount currently vested, and the schedule of vesting. (5) An itemization of any loans that you have made against the plan during the last 5 years, the outstanding balance of the loans, and the amounts of the loans. b. List all accounts, including checking, money market, brokerage, or any other investments that you have had any legal or equitable interest in, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, within the last 3 years. Give the name and address of each institution, the name in which each account is or was maintained, the account numbers, and the names of each person authorized to make withdrawals from the accounts. State the present balance in each account, giving the largest balance during the last 12 months. c. State whether, during the past 3 years, you have prepared any financial statements, loan applications, or lists of your assets and liabilities. If so, for each document state: the date of preparation; the purpose for which the document was prepared; the name and address of the person or firm who prepared the document; and the names and addresses of any persons or financial institutions to whom the statements, applications, or lists were presented. d. State the names, addresses, and telephone numbers of your accountant and any other persons who possess your financial records, and as to each state which records they possess. e. State the location of all safes, vaults, or other similar depositories in which you maintained property at any time during the period commencing 1 year before the initiation of the action pending before this court until the date of furnishing answers to this interrogatory. State the names and addresses of all banks or other depositories where you had a safe deposit box; where you were a signatory or co-signatory on a safe deposit box; where you have access to a safe deposit box; or where you maintained property in a safe deposit box at any time during the period commencing 1 year before the initiation of the action before this court until the date of your answering this interrogatory. Provide the name and address of each other person who has had access to any such depository during the same time period. List any items removed from any depository by you or your agent during that time, together with the present location and fair market value of each item. 6. LIABILITIES: a. List all of your liabilities, debts, and other obligations, indicating for each: the name and address of the creditor; the nature of the security, if any; the payment schedule; the current status of your payments; and the total amount of arrearage, if any. *1178 b. List all charge accounts and credit cards upon which you are a signatory, which you use, or which are issued to you. For each account listed give the account number, the current status of your payments, the balance presently owed, and the minimum monthly payments. 7. LIVING EXPENSES: a. Complete Florida Family Law Form 12.901(d) or 12.901(e) and, if applicable, Florida Family Law Form 12.901(g), child support worksheet. Both of these forms are attached. You do not need to do this if a financial affidavit complying with Family Law Form 12.901(d) or 12.901(e) and/or Florida Family Law Form 12.901(g) has been filed with the court and served on the parties. 8. MISCELLANEOUS: a. List all other assets that you own, have an interest in, or have the use or benefit of, setting forth for each your interest in the asset and its value. For each, set forth the date of your acquisition, receipt, or inheritance, or the date of your first being given use or benefit; the party from whom it was received; the value on the date of your acquisition or use; the value on the date of marriage; the value on the date of the filing of the petition for dissolution of marriage; and the present value. b. If you are claiming a special equity in any assets, list the asset, the amount claimed as special equity, and all facts upon which you rely in your claim. c. If the mental or physical condition of a spouse or child is an issue, identify the person and state the name and address of all health care providers involved in the treatment of that person. I AM AWARE THAT ANY MATERIALLY FALSE STATEMENT KNOWINGLY MADE WITH THE INTENT TO DEFRAUD OR MISLEAD SHALL SUBJECT ME TO THE PENALTY FOR PERJURY AND MAY BE CONSIDERED A FRAUD UPON THE COURT. DATED: _____________________ I CERTIFY THAT THE ANSWERS TO THESE STANDARD FAMILY LAW INTERROGATORIES WERE: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _____________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ *1179 ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________________, a nonlawyer, located at {street} ___________________ {city} ______________ {state} ____, {phone} _______, helped {name} _______, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FAMILY LAW FORMS 12.931(a), NOTICE OF PRODUCTION FROM NON-PARTY AND 12.931(b) SUBPOENA FOR PRODUCTION OF DOCUMENTS If you need copies of documents for your lawsuit from a person who is not a party, you must complete this notice and subpoena, file the notice and subpoena and a copy of the subpoena with the court, and provide a copy of the notice and subpoena to the other person in your case. • After 10 days from the date of mailing your notice and subpoena to the court, you must request the clerk of the court to sign the subpoena and request a deputy sheriff or process server to serve the subpoena on the person listed in the subpoena. The person receiving the subpoena may charge you a reasonable fee for copies of the documents. If the other person objects in writing within 10 days of this notice, you may not use this procedure to obtain documents unless and until the court says you can. These papers must comply with Florida Family Law Rule of Procedure 12.280 and Florida Rules of Civil Procedure 1.280, 1.350, 1.351, and 1.410. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: _____________________________ Division: _____________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ *1180 NOTICE OF PRODUCTION FROM NON-PARTY TO: [all parties] YOU ARE NOTIFIED that after 10 days from the date of service of this notice the undersigned will apply to the clerk of this court for issuance of the attached subpoena directed to {name of person, organization or agency} ____________, who is not a party, to produce the items listed at the time and place specified in the subpoena. Objections to the issuance of this subpoena must be filed with the clerk within 10 days. I CERTIFY THAT THIS NOTICE OF PRODUCTION TO NON-PARTY WAS: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _____________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawer} _________________________________, a nonlawyer, located at {street} _____________ {city} ____________________ {state} ____, {phone} _____, helped {name} _________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: __________________________ Division: __________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ *1181 SUBPOENA FOR PRODUCTION OF DOCUMENTS THE STATE OF FLORIDA TO: ______________ YOU MUST go to {place} ______________________________, on (place) {date} ____, at {time} ____, and bring with you at that time and place the following: ________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ These items will be inspected and may be copied at that time. You will not have to leave the original items. You may obey this subpoena by providing readable copies of the items to be produced to the party or their attorney whose name appears on this subpoena on or before the scheduled date of production. You may condition the preparation of the copies upon payment in advance of the reasonable cost of preparation. You may mail or deliver the copies to the attorney whose name appears on this subpoena and thereby eliminate your appearance at the time and place specified above. If you fail to (1) appear as specified; or (2) furnish the records instead of appearing as provided above; or (3) object to this subpoena, you may be in contempt of court. You are subpoenaed by the person whose name appears on this subpoena and, unless excused by that person or the court, you shall respond as directed. You will need to get the information from your local courthouse to fill in this part: In accordance with the Americans with Disabilities Act of 1990, persons needing a special accommodation to participate in this proceeding should contact _____ for proceedings in court or _______________ at ________ for out of court proceedings no later than 7 days before the proceeding. Telephone ________ or ________ for assistance. If hearing impaired, telephone (TDD) ________ for proceedings in court or Florida Relay Service 1-800-955-8771 for out of court proceedings. Date: ______________________ (Name of Clerk) As Clerk of the Court By: _______________________________ As Deputy Clerk Name _______________________ Address ____________________ *1182 Telephone No. ______________ I HEREBY CERTIFY that I gave notice to every other party to this action of the intent to serve a subpoena upon a person who is not a party to this action directing that person to produce documents or things without deposition. I also certify that no objection under Florida Rule of Civil Procedure 1.351 has been received by the undersigned within 10 days of service of this notice, if service was by hand delivery or appropriate facsimile transmission, and within 15 days if service was by mail. Dated: __________, 19__ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ________________________, a nonlawyer, located at {street} __________________ {city} ________ {state} ____, {phone} ______, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.931(c), REQUEST FOR DOCUMENTS PRODUCED BY SUBPOENA If you need copies of documents or items received by the other party in your case from another person responding to the other party's subpoena for your lawsuit, you must complete this request, file it with the court, and provide a copy of your request to the other party. The other party may charge you a reasonable cost for preparing the copies. For further information, see Florida Rule of Civil Procedure 1.351(d). A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: _____________________________ Division: _____________________________ _______________________________, Petitioner and _______________________________, Respondent. *1183 ___________________________\ REQUEST FOR DOCUMENTS PRODUCED BY SUBPOENA TO: [Name of party or attorney who served subpoena] I request legible copies of the documents produced to you in response to your subpoena without deposition upon: {name of deponent} __________. I will pay the reasonable cost of making these copies. I CERTIFY THAT THIS REQUEST FOR DOCUMENTS PRODUCED BY SUBPOENA WAS: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _____________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ___________________________, a nonlawyer, located at {street} ____________ {city} ________ {state} ______, {phone} _______, helped {name} __________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.940(a), (b) AND (c), MOTION, ORDER AND EMPLOYER'S DECLARATION OF HEALTH INSURANCE COVERAGE You should use form 12.940(a) if the other parent of your children has failed to provide medical insurance for your child(ren) within 30 days after receiving effective notice of a court order requiring that parent to maintain medical insurance coverage. • You first need to serve written notice of your intent to enforce a medical support order by mailing your notice to the other parent's last known address. If he/she fails to provide you with proof of insurance for your child(ren) within 15 days after mailing the notice, you need to fill out this form and file it with the court. You also need to obtain a hearing date before the court to hear your request to order the other parent's employer to enroll and maintain the child(ren) on the health insurance plan. See Family Law Form 12.923, Notice of Hearing (General Form). Once the order is signed by the court, Family Law Form 12.940(b), you need to mail the signed order and Family Law Form 12.940(c) to the other parent's employer. *1184 For further information, see § 61.13(1)(b), Florida Statutes. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ___________________________ Division: ___________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ MOTION FOR HEALTH INSURANCE COVERAGE 1. On {date} __________, this court ordered the child(ren)'s [✓ one only] ____ father or ____ mother to provide health insurance coverage for the following child(ren): Name Date Of Birth Age Soc. Sec. No. _________________ ________________ _________ ____________________ _________________ ________________ _________ ____________________ _________________ ________________ _________ ____________________ _________________ ________________ _________ ____________________ _________________ ________________ _________ ____________________ 2. Notice to [✓ one only] ____ Petitioner or ____ Respondent: [✓ one only] ____ a. On _________, which is at least 15 days before filing this application, I gave written notice of my intent to seek this order to __________ by [✓ one only] _____ certified mail _____ personal service. ____ b. The requirement of written notice has been waived by the other party. 3. I ask the court to order the employer, or other person providing health insurance coverage to enroll or maintain the child(ren) on any health insurance coverage available to father/mother. I CERTIFY THAT THE MOTION FOR HEALTH INSURANCE COVERAGE WAS: (✓ one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ____________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ *1185 DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ____________________ Sworn to (or affirmed) and subscribed before me on {date} ________, 19__ by {name} _____________________________. ___________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ________________________, a nonlawyer, located at {street} __________________ {city} _____________ {state} ______, {phone} ________, helped {name} ______________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ ORDER FOR HEALTH INSURANCE COVERAGE TO: ALL EMPLOYERS (OR FUTURE EMPLOYERS), or any other person providing health insurance coverage for OBLIGOR {name of person who was ordered to provide health insurance} ________________________: *1186 YOU ARE HEREBY ORDERED TO: 1. Begin or maintain health insurance coverage on the child(ren). You may deduct any premium or costs from the wages or earnings of the OBLIGOR {name of person who was ordered to provide health insurance} _________. 2. If the OBLIGOR works for you, or if you have health insurance coverage available to OBLIGOR, you must give him or her a copy of this order within 10 days after you receive it. 3. If no health insurance coverage is available to the OBLIGOR, complete and sign the DECLARATION OF NO HEALTH INSURANCE COVERAGE form and mail the declaration within 20 days to the attorney or person requesting the insurance coverage. DONE and ORDERED in {name} ____________________ County, Florida, on {date} _________________, 19__. __________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ Obligor's employer Name _______________________ Address ____________________ ____________________________ City State Zip Telephone No. ______________ Telefax No. ________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ______________________, a nonlawyer, located at {street} __________________ {city} __________ {state} _____, {phone} _____, helped {name} ____________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ *1187 INSTRUCTIONS TO EMPLOYER OR OTHER PERSON PROVIDING HEALTH INSURANCE 1. If the obligor works for you or health insurance is available through your company, you must give obligor a copy of this order within 10 days after you receive it. 2. Unless you receive a motion to quash the assignment of insurance benefits, you must take steps to begin or maintain health insurance coverage for the specified child(ren) within the shortest possible time consistent with group plan enrollment rules. 3. The obligor's existing health coverage shall be replaced only if the child(ren) are not provided benefits under the existing coverage where they reside. 4. If the obligor is not enrolled in a plan and there is a choice of several plans, you may enroll the child(ren) in any plan that will reasonably provide benefits of coverage where they live, unless the court has ordered coverage by a specific plan. 5. If no coverage is available, complete the declaration of no health insurance coverage on this page, and mail the declaration by first class mail to the attorney or applicant seeking the coverage within 30 days of your receipt of this order. Keep a copy of the form for your records. 6. If coverage is provided, you must supply evidence of coverage to both parents and any person having custody of the child(ren). 7. Upon request of the parents or person having custody of the child(ren), you must provide all forms, identification cards, and other documentation necessary for submitting claims to the insurance carrier to the extent you provide them to other covered individuals. 8. You must notify the applicant of the effective date of the coverage of the child(ren). 9. You will be liable for any amounts incurred for health care services which would have otherwise been covered under the insurance policy, if you willfully fail to comply with the terms of the order attached. You can also be held in contempt of court. Florida law forbids your firing or taking any disciplinary action against any employee because of the health insurance coverage order. EMPLOYEE INFORMATION The attached order tells your employer or other person providing health insurance coverage for you to enroll or maintain the named child(ren) in a health insurance plan available to you and to deduct the appropriate premium amount or costs, if any, from your wages or other compensation. EMPLOYER'S DECLARATION OF NO HEALTH INSURANCE COVERAGE I, (name) ____________________ as (position) _____________ for (company) ____________________ located at ____________________, whose telephone is __________, HEREBY DECLARE THAT NO HEALTH INSURANCE COVERAGE IS AVAILABLE TO OBLIGOR: _________________________________________ because (state reasons) __________________________________________. DATED: _____________________ __________________________________________ Signature of party signing certificate Position _________________________________ Printed name _____________________________ Address __________________________________ __________________________________________ City State Zip __________________________________________ *1188 Telephone (area code and number) __________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF __________________ Sworn to (or affirmed) and subscribed before me on {date} _____________, 19__ by {name} __________________________. ___________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] ____ Personally known ____ Produced identification Type of identification produced ___________ INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.941(a), MOTION FOR TEMPORARY INJUNCTION TO PREVENT REMOVAL OF CHILD(REN) AND DENIAL OF PASSPORT SERVICES You should use this form if you believe there is a real risk of the other parent removing the children from the area. You must be able to give specific reasons why you believe this might occur, for example, the other parent has family and other means of financial support in another state or country and they have made threats that they will take the children there. You must fill out Family Law Form 12.941(b), sign it before a notary public and file it with your request. You will need to set a hearing to bring your motion before the court. See Family Law Form 12.923, Notice of Hearing (General Form). In these forms and other court papers, you are referred to either as the Petitioner or the Respondent. The Petitioner is the person who originally opened the case. The Respondent is the other party. For further assistance in identifying yourself as the Petitioner or Respondent, find your name on the upper left side of the first page of a paper previously filed in your case. Under your name you should see the word Petitioner or Respondent. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner and _______________________________, Respondent. ___________________________\ *1189 MOTION FOR TEMPORARY INJUNCTION TO PREVENT REMOVAL OF CHILD(REN) AND DENIAL OF PASSPORT SERVICES [✓ one only] ____ Petitioner or ____ Respondent requests the court enter a temporary injunction to prevent removal of minor child(ren) from jurisdiction of this court and deny passport services for said minor child(ren) and states [✓ all that apply]: ____ 1. There is/are child(ren) involved in this case. ____ 2. The child(ren) has/have been resident of __________ County, Florida, since __________________________________. 3. [✓ one only] ____ a. I have previously filed a Uniform Child Custody Jurisdiction Act Affidavit (Florida Family Law Form 12.901(f)). Since the time I filed the affidavit, no final order has been entered in this case and I have obtained no information of any custody proceeding concerning the child(ren) in this case or any other state. ____ b. My Uniform Child Custody Jurisdiction Act Affidavit, Family Law Form 12.901(f), is attached. ____ 4. The child(ren) are about to be permanently removed from the jurisdiction of the court. ____ 5. It is in the best interest of the child(ren) that the child(ren) not be removed from the jurisdiction of the court. ____ 6. My Affidavit In Support Of Motion For Temporary Injunction To Prevent Removal Of Child(ren), Florida Family Law Form 12.941(b) is attached. 7. [✓ one only] ____ a. I certify that I have made the following efforts to give notice of this motion to the person against whom I am requesting this injunction (list the efforts you have made) _________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ or, if applicable: ____ b. Notice should not be required for the following reason(s) (list the reason(s)): _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 8. [✓ all that apply] ____ a. In order to prevent the removal of the child(ren) from the jurisdiction of this court, it is necessary for the court to issue an injunction. ____ b. In order to prevent the removal of the child(ren) from the United States of America, it is necessary for the court to order the denial of passport services for the child(ren). ____ 9. In order to prevent the removal of the child(ren) from the United States of America, (fill in the name of the other parent or custodian) __________ should be required to deliver immediately the child(ren)'s passport(s) to: [✓ one only] ____ Petitioner or ____ Respondent or ____ the court or ____ other (specify) ____________________________________________________________________. ____ 10. I have been required to incur expenses for attorney's fees, suit money and costs in the bringing of this motion. I do not have *1190 sufficient funds to pay those fees and costs. _________________ (name of the other parent or custodian) has the ability to pay the fees and costs. The court should require _______________ (name of the other parent or custodian) to pay the attorney's fees and costs. WHEREFORE, I, [✓ one only] ____ Petitioner or ____ Respondent request the court to enter an order: [✓ all that apply] ____ 1. Granting a temporary injunction to prevent removal of the child(ren) from the jurisdiction of the court. ____ 2. Denying passport services for the child(ren). ____ 3. Requiring the delivery of the child(ren)'s passport(s) to __________ (identify the same person as in paragraph 9). ____ 4. Awarding me attorneys' fees, suit money, and costs. ____ 5. Granting other relief the court deems proper under the circumstances. I CERTIFY THAT THE MOTION FOR TEMPORARY INJUNCTION TO PREVENT REMOVAL OF CHILDREN AND DENIAL OF PASSPORT SERVICES WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. ___________________________ DATED: _____________________ ___________________________________________________ Signature of party signing certificate and pleading Printed name ______________________________________ Address ___________________________________________ ___________________________________________________ City State Zip ___________________________________________________ Telephone (area code and number) ___________________________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ______________________, a nonlawyer, located at {street} __________________ {city} ___________ {state} _____, {phone} ________, helped {name} ________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ _______________________________, Petitioner *1191 and ____________________________, Respondent. ________________________\ AFFIDAVIT IN SUPPORT OF MOTION FOR TEMPORARY INJUNCTION AGAINST REMOVAL OF MINOR CHILDREN [name] ____________, states under oath that (check where applicable): ____ 1. This affidavit is filed in support of my motion for temporary injunction to prevent removal of child(ren). ____ 2. There is/are ______ child(ren) involved in this case (write in the name(s) of the child(ren) and the other information requested): Name(s) Age(s) Residing with Residence Address ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ 3. [✓ one only] ____ a. I have previously filed a Uniform Child Custody Jurisdiction Act Affidavit, Florida Family Law Form 12.901(f). Since the time I filed the affidavit, there have been no factual changes in the affidavit. ____ b. My Uniform Child Custody Jurisdiction Act Affidavit, Florida Family Law Form 12.901(f), is attached. ____ 4. I am fearful that ___________ (fill in the name of the other parent or custodian) will permanently remove the child(ren) from this jurisdiction to ____________ (identify the place where you believe the child(ren) will be taken) for the following reasons (list the reasons why you believe the child(ren) is/are about to be removed and will not be returned): ___________________________ ___________________________________________________________________ ___________________________________________________________________ ____ 5. I or the child(ren) will suffer the following irreparable injury, loss or damage if the child(ren) is/are permanently removed from this jurisdiction (list the reasons why you do not want the child(ren) removed): ______________________________________ ___________________________________________________________________ ___________________________________________________________________ ____ 6. I am in need of relief from the court to prevent the removal of the child(ren). I CERTIFY THAT THIS AFFIDAVIT IN SUPPORT OF MOTION FOR TEMPORARY INJUNCTION AGAINST REMOVAL OF MINOR CHILDREN WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} ________________, 19__. Party or their attorney Other (if represented) Name _______________________ Name _________________________________ Address ____________________ Address ______________________________ ____________________________ ______________________________________ City State Zip City State Zip Telephone No. ______________ Telephone No. ________________________ Telefax No. ________________ Telefax No. __________________________ *1192 DATED: _____________________ ____________________________________________________ Signature of party signing certificate and affidavit Printed name _______________________________________ Address ____________________________________________ ____________________________________________________ City State Zip ____________________________________________________ Telephone (area code and number) ____________________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} _____________________ Sworn to (or affirmed) and subscribed before me on {date} _______, 19__ by {name} _____________________________. ___________________________________________________ NOTARY PUBLIC — STATE OF FLORIDA ___________________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ___________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________, a nonlawyer, located at {street} ______________________ {city} _______________ {state} _____, {phone} ________________, helped {name} _______________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.942(a) AND (b), MOTION AND ORDER APPOINTING GUARDIAN AD LITEM In a lawsuit involving divorce or modification of parental responsibility, custody, or visitation, the court may appoint a guardian ad litem to act as next friend, investigator, and/or evaluator in the best interest of the child(ren). In lawsuits involving verified allegations of child abuse or neglect, the court must appoint a guardian ad litem. The guardian ad litem submits his or her report to the court. If you desire that a guardian ad litem be appointed for your child(ren), you can fill out Family Law Form 12.942(a) and file it with the court. You also will need to obtain a hearing date and time with the court for your request to be heard. See Family Law Form 12.923, Notice of Hearing (General Form). You need to complete Family Law Form 12.942(b), except for the name and address of the proposed guardian ad litem, and bring it with you to the hearing. The court determines who will serve as the guardian ad litem and the method of payment of guardian ad litem fees, if applicable. If the court rules in your favor, your proposed order usually will be signed at the hearing. For further information, see §§ 61.401-61.404, Florida Statutes. *1193 A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _______ JUDICIAL CIRCUIT, IN AND FOR _______________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ MOTION FOR APPOINTMENT OF GUARDIAN AD LITEM The [✓ one only] ____ Petitioner or ____ Respondent asks this court to appoint a guardian ad litem and states: 1. Matters before court: — primary residential parent — parental responsibility — visitation 2. Child(ren) Name(s) Date Of Birth Age Sex Presently residing with __________ _____________ ____ ____ _______________________ __________ _____________ ____ ____ _______________________ __________ _____________ ____ ____ _______________________ __________ _____________ ____ ____ _______________________ __________ _____________ ____ ____ _______________________ 3. A guardian ad litem is necessary to protect the best interests of the child(ren). 4. There [✓ one only] ____ is or ____ is not a history of domestic violence between the parties. 5. Other court-ordered social investigations are: ____ Custody investigation unit home study ____ Other {specify} _________________________________________ I CERTIFY THAT THE MOTION FOR APPOINTMENT OF GUARDIAN AD LITEM WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _______, 19__. Party or their attorney (if represented) Other Name _________________________________ Name _______________________ Address ______________________________ Address ____________________ ______________________________________ ____________________________ City State Zip City State Zip Telephone No. ________________________ Telephone No. ______________ Telefax No. __________________________ Telefax No. ________________ DATED: _______________________________ *1194 ______________________________________ Signature of party signing certificate and pleading Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ____________________, a nonlawyer, located at {street} _____________________ {city} ___________ {state} ___________, {phone} ___________________, helped {name} __________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ ORDER APPOINTING GUARDIAN AD LITEM The court hereby appoints the State of Florida Guardian ad Litem Program for the ____ Judicial Circuit to assign a certified Guardian ad Litem in this cause on behalf of the minor child(ren). It is further ORDERED as follows: 1. Powers of Guardian. The guardian ad litem, as party to this cause and a representative of the child(ren) shall have the powers, privileges and responsibilities to the extent necessary to advance the best interest of the child(ren); including, but not limited to, the following: a. Notice Required Prior to Certain Interviews. The guardian ad litem may investigate the allegations of the pleadings affecting the child and, after proper notice to interested parties to the litigation, may interview witnesses, or any other person having information concerning the welfare of the child; provided, however, that no such notice shall be required prior to any interview with the child or the parties as this order shall serve as notice of the guardian ad litem's intent to interview the child and the parties. Receipt of notice does not give the parties or the parties' attorneys any rights to attend or participate in such interviews of non-parties. However, except for scheduling matters, the guardian ad litem shall not have any communication with any of the parties represented by an attorney unless all attorneys participate or consent to non-participation. b. Court Order Required to Inspect Records Other Than Court File and School Records. The guardian ad litem, through counsel, may petition *1195 the court for an order directed to a specified person, agency, or organization, including, but not limited to, hospitals, medical doctors, dentists, psychologists and psychiatrists, which order directs that the guardian ad litem be allowed to inspect and copy any records and documents which relate to the minor child or to the child's parents or other custodial persons or household members with whom the child resides. Such order shall be obtained only after notice to all parties and hearing thereon; provided, however, that upon presentation of this order to the appropriate person or office, the guardian ad litem is authorized, pursuant to section 61.403(2), Florida Statutes, to inspect and copy any school and/or daycare records or medical records relating to the child(ren) without a hearing or consent of the parent(s). c. Court Order Required for Expert Examinations. The guardian ad litem, through counsel, may request the court to order expert examinations of the child, the child's parents, or other interested parties in the action, by medical doctors, dentists, and other providers of health care including psychiatrists, psychologists, or other mental health professions. d. Guardian's Right To Discovery and Other Relief. A guardian ad litem, acting through counsel, may file such pleadings, motions, or petitions for relief as the guardian ad litem deems appropriate or necessary and may request and provide discovery. e. Presence of Guardian At Depositions and Hearings. The guardian ad litem, through counsel, may compel the attendance of witnesses; provided, however, that a guardian ad litem may be present and appear without counsel at such proceedings but may not participate unless permitted by the court. f. Party to Agreement. The guardian ad litem appointed to this cause is a party and must be advised of any agreement or plan entered into in this cause. The guardian ad litem shall submit his/her recommendations to the Court regarding any stipulation or agreement, whether incidental, temporary, or permanent, which affects the interest or welfare of the child(ren), within ten (10) days after the date such stipulation or agreement is served upon the guardian ad litem. 2. Parties to Provide Notice to Guardian ad Litem. The guardian ad litem shall be given reasonable written notice by any party who shall schedule judicial hearings, depositions or judicial conferences, and shall have the right to be present. Written notice to the guardian ad litem shall be mailed or delivered to the Guardian ad Litem Program, Circuit Court of the _____ Judicial Circuit, {city} _____________________, Florida. 3. All parties are ordered to make themselves and their child(ren) available for interview by the guardian ad litem. 4. Reports and Recommendations. The guardian ad litem shall file a written report which may include recommendations and a statement of the wishes of the child. The report must be filed and served on all parties at least 20 days prior to the hearing at which it will be presented unless the court waives such time period. The guardian ad litem shall file and serve such other reports as directed by the Court. 5. Confidentiality. The parties and their counsel shall maintain as confidential the report of the guardian ad litem, and all supporting documents, exhibits, reports and other information. No party or counsel may disclose any information or document, or any part of the guardian's report except with the approval of the Court. DONE and ORDERED in {name} __________________________ County, Florida, on {date} _______, 19__. _______________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ___________________________________ Name __________________________ Address ________________________________ Address _______________________ ________________________________________ _______________________________ City State Zip City State Zip *1196 Telephone No. __________________________ Phone No. _____________________ Telefax No. ____________________________ Fax No. _______________________ Guardian ad Litem Office Name ___________________________________ Address ________________________________ ________________________________________ City State Zip Telephone No. __________________________ Telefax No. ____________________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: I, {name of nonlawyer} ____________________________, a nonlawyer, located at {street} _________________________ {city} ____________ {state} _________, {phone} ________________, helped {name} ________________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.980(a), AFFIDAVIT AND WAIVER OF FEES FOR PETITION FOR INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE See Appendix 4 for instructions and information. A financial affidavit ( Family Law Form 12.901(d) or 12.901(e), Family Law Financial Affidavit) also may be required for a waiver of fees. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR _________________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ AFFIDAVIT AND WAIVER OF FEES FOR PETITION FOR INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE I, {name} ______, being duly sworn, do hereby certify that I do not have enough money to pay filing fees to the clerk of the circuit court or service fees to the Sheriff or other authorized law enforcement agencies and ask that, as allowed by section 741.30(2)(a) or section 784.046(3)(b), Florida Statutes, the fees be waived to process the petition and serve the injunction, subject to a later order of the court about the payment of those fees. _______________________________________ Signature of party _______________________________________ Printed name *1197 _______________________________________ *Address _______________________________________ *City State Zip _______________________________________ *Telephone (area code and number) SWORN TO and signed before me on ___________________, 19__. * (DO NOT ENTER IF ADDRESS OR PHONE NUMBER NEEDS TO BE KEPT CONFIDENTIAL FOR SAFETY, INSTEAD NOTIFY CLERK OF COURT WHEN FILING THIS PAPER) CLERK OF THE CIRCUIT COURT By: ______________________ Deputy Clerk CLERK'S CERTIFICATE AS TO AFFIDAVIT AND REQUEST FOR WAIVER OF FEES I, _______________, as Clerk of the Circuit Court, do here by certify that on the ____ day of ________, 19__, I received and filed an Affidavit and Request for Waiver of Fees pursuant to § 741.30(2)(a) or § 784.04(3)(b), Florida Statutes, of _____, Petitioner, without prepayment of fee to the extent necessary to process the petition and serve the injunction, subject to a subsequent order of the court relative to the payment of such fees. WITNESS my hand and seal in the City of _______ County of ______, State of Florida, this ____ day of _________, 19__. CLERK OF THE CIRCUIT COURT (SEAL) By: ______________________________ Deputy Clerk COPIES PROVIDED TO: Respondent by Sheriff's Service Sheriff of ____________________ County INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.980(b) PETITION FOR INJUNCTION AGAINST DOMESTIC VIOLENCE See Appendix 4 for instructions and for information. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ *1198 _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ PETITION FOR INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE BEFORE ME, the undersigned authority, personally appeared Petitioner, {name} __________________ who has been sworn and says that the following statements are true: 1. Petitioner resides at: _________________________________________________ {City, State and Zip Code} (DO NOT ENTER IF RESIDENCE OR PHONE TO BE KEPT CONFIDENTIAL FOR SAFETY, INSTEAD NOTIFY CLERK OF COURT WHEN FILING THIS PAPER) 2. Respondent resides at: _________________________________________________ {City, State and Zip Code} 3. [✓ one only] a. ____ Petitioner is paying the filing fee and Sheriff's (or other authorized law enforcement agency's) service fees. b. ____ Petitioner does not have enough money to pay filing fees or service fees and files this and a financial affidavit asking that he/she not have to pay the fees necessary to process the Petition and serve the Injunction, as well as any motions or orders needed to enforce the Injunction, subject to later order(s) of the court about the payment of these fees. 4. Respondent's last known place of employment: ___________________________ Working hours _________________________________________________________ 5. Physical description of Respondent: Race: ______________ Sex: ____ M ____ F Date of Birth: ________________ Height: __________ Weight: _______ Eye Color: ______ Hair: ____________ Distinguishing marks/scars: ___________________________________________ Vehicle: (make/model) ______________ Color: __________ Tag: ___________ 6. Aliases of Respondent: ______________ Nickname: ____________ 7. Respondent is (select only one of the following): ____ a. The spouse of the Petitioner. ____ b. The former spouse of the Petitioner. ____ c. Any other person related by blood or marriage to the petitioner, specify relationship __________________________________________ ____ d. Any other person who is or was residing within a single dwelling unit with the Petitioner, as if a family. ____ e. A person with whom Petitioner has a child in common, even if the Petitioner and Respondent never were married or residing together, as if a family. *1199 8. The following describes any other court case, including a dissolution of marriage or paternity action, going on between the Petitioner and Respondent (include case number): ________________________________________________________________________ ________________________________________________________________________ 9. The following describes any previous or pending attempts to get an injunction for protection against domestic violence by Petitioner against Respondent in this or any other court, and what happened in that case (include case number): ____________________ ________________________________________________________________________ 10. Has the Respondent ever gotten or tried to get a domestic violence injunction against Petitioner? ____ Yes ____ No If Yes, case number ___________________________________________________ 11. Petitioner has suffered or has reasonable cause to fear domestic violence at the hands of the Respondent because (briefly describe the latest incident of violence or threat of violence): On {date} ________ _____ ________________, at {location} ______________________________________, the Respondent: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 12. Additional information: a. ____ Other instances of domestic violence as described on attached sheet. b. ____ The Respondent owns, possesses and/or is known to possess weapons. ____ Yes ____ No If yes, what type of weapons: _________________________________ c. ____ The Respondent has a drug and/or alcohol problem: ____ Yes ____ No d. ____ The Respondent has a history of mental health problems: ____ Yes ____ No; has been the subject of a Baker Act proceeding: ____ Yes ____ No; and/or takes medication for mental health problems: ____ Yes ____ No e. ____ Petitioner has known Respondent since {date} ___________________ f. ____ Petitioner's attorney's name, address and telephone number is: _______________ _______________________________________________________________ (If you do not have an attorney, state "none".) g. ____ Respondent's attorney's name, address and telephone number is: _______________ _______________________________________________________________ (If you do not know, state "unknown". If Respondent does not have an attorney, state "none".) 13. The Petitioner claims the following about the home that the Petitioner and Respondent share or that Petitioner left because of domestic violence: a. ____ Petitioner needs the exclusive use and possession of the home that the parties share at the following address: ______________ *1200 b. ____ Petitioner is unable to obtain safe alternative housing because ______________ _______________________________________________________________ _______________________________________________________________ c. ____ The home is owned or leased by the Petitioner and Respondent jointly. ____ The home is solely owned or leased by the Petitioner. ____ The home is solely owned or leased by the Respondent. d. ____ If removed from the home, the Respondent has the money to get other housing or may live without money at {address} ___________ {City, State, Zip Code} ______________________________________ SECTIONS 14-19 MUST BE ANSWERED IF PETITIONER IS SEEKING CUSTODY OF ANY MINOR CHILD 14. ____ Petitioner is the natural parent, adoptive parent, or guardian by court order of the minor child(ren) whose name(s) and age(s) is/are as listed below. The name, place of birth, birthdate and sex of each child, the present address*, periods of residence and places where each child has lived within the past 5 years, and the name, present address and relationship to the child of each person with whom the child has lived during that time are: (if more space is needed, attach a separate sheet) OR ATTACH A UNIFORM CHILD CUSTODY JURISDICTION ACT (UCCJA) AFFIDAVIT, FLORIDA FAMILY LAW FORM 12.901(f). * (DO NOT ENTER IF RESIDENCE IS WITH PETITIONER AND RESIDENCE OR PHONE IS TO BE KEPT CONFIDENTIAL FOR SAFETY, INSTEAD NOTIFY CLERK OF COURT WHEN FILING THIS PAPER) CHILD(REN)'S NAME PLACE OF BIRTH BIRTHDATE SEX ___________________ _________________ ____________ _______ ___________________ _________________ ____________ _______ ___________________ _________________ ____________ _______ ___________________ _________________ ____________ _______ Period of Residence* Person Child Lived With Relationship of Child(ren) (name & address) ___________ to present _______________________ _________________ _______________________ ___________ to _______ _______________________ _________________ _______________________ ___________ to _______ _______________________ _________________ _______________________ ___________ to _______ _______________________ _________________ _______________________ CURRENT SCHOOL OR DAY CARE OF CHILD(REN) __________________________________ Address: __________________________________________________________________ INSTRUCTIONS: PLEASE CHECK ONLY 1 OF THE FOLLOWING: 15. ____ I HAVE NOT been a party, witness, or been involved in any other lawsuit or custody proceeding, in this or any other state, about custody of the child(ren) involved in this court case. OR ____ I HAVE been a party, witness, or involved in another lawsuit or custody proceeding, in this or some other state, about custody of the child(ren) involved in this court case as follows: a. Name of each child: ____________________________________________ *1201 b. Type of proceeding: ____________________________________________ c. Court and State: _______________________________________________ d. Date of Court Order or Judgment (if any): ______________________ ________________________________________________________________ e. Case Number: ___________________________________________________ INSTRUCTIONS: [ ✓ one only] 16. ____ I HAVE NO INFORMATION about any custody proceeding that is going on in a court of this or any other state about the child(ren) involved in this court case, other than what I listed in my answer to 15 above. OR ____ I HAVE THE FOLLOWING INFORMATION about a custody proceeding in a court of this or some other state about the child(ren) involved in this court case, other than what I listed in my answer to question 15 above: a. Name of each child: ____________________________________________ b. Type of proceeding: ____________________________________________ c. Court and State: _______________________________________________ d. Date of Court Order or Judgment (if any): ______________________ _______________________________________________________________ e. Case Number: ___________________________________________________ INSTRUCTIONS: PLEASE CHECK ONLY 1 OF THE FOLLOWING: 17. ____ I DO NOT KNOW OF ANY PERSON not a party to this court case who has physical custody or claims to have custody or visitation rights with any child involved in this court case. OR ____ I KNOW THAT THE FOLLOWING NAMED PERSON(S) not a party to this court case has physical custody or claims to have custody or visitation rights to the child(ren) involved in this court case listed below: Name of Child(ren): _______________________________________________ ___________________________________________________________________ Name of Person(s) who claims custody/visitation rights: ___________ Address: __________________________________________________________ ___________________________________________________________________ [ ✓ all that apply] a. ____ Has Physical Custody b. ____ Claims Custody Rights c. ____ Claims Visitation 18. ____ Petitioner genuinely fears that Respondent will abuse, remove or hide the minor child(ren) from Petitioner because: _______________ __________________________________________________________________ ___________________________________________________________________ 19. ____ Petitioner claims that letting Respondent know that the Petitioner is trying to get an Injunction against Respondent before the Injunction is available to protect Petitioner would put the life, health or well being of the Petitioner and/or the Petitioner's immediate family in great and immediate danger. 20. ____ Petitioner claims that he/she has a need for the money he/she is asking the court to make Respondent pay and the Respondent has the ability to pay that money. *1202 WHEREFORE, the Petitioner asks the court to give an injunction (mark the appropriate sections): NOTE: The Court may consider the following: "Ex-Parte" (without notice and hearing). This relief may be awarded for up to 15 days. a. ____ Immediately keeping the Respondent from doing any acts of domestic violence. b. ____ Giving to the Petitioner the temporary exclusive use and possession of the home that the parties share or keeping the Respondent away from the home of the Petitioner and any future home of Petitioner. c. ____ Keeping the Respondent away from the place of employment of the Petitioner. d. ____ Giving temporary custody of, and/or setting up temporary visitation rights with the minor child(ren) of the parties. e. ____ Doing anything the court decides is needed to protect a victim of domestic violence, including injunctions or directives to law enforcement agencies. NOTE: The court may consider the following only with hearing and notice to the Respondent. These things may be allowed for up to 1 year. f. ____ Continuing for up to 1 year any of the things listed in a — e above. g. ____ Give temporary support for the minor child(ren). (Financial Affidavit, Florida Family Law Form 12.901(d) or (e) must be completed and filed with the court and a copy sent to Respondent before the hearing.) h. ____ Give temporary support for the Petitioner. (Financial Affidavit, Florida Family Law Form 12.901(d) or (e) must be completed and filed with the court and a copy sent to the Respondent before the hearing.) i. ____ Make Respondent go to a batterer's intervention program or other treatment described in section 415.601, Florida Statutes. I understand that as Petitioner I am swearing under oath to the truthfulness of the claims made in this paper and that the punishment for knowingly making a false statement includes fines and/or imprisonment. DATED: ___________________ ______________________________________ Signature of party signing petition Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF _________________________________ Sworn to (or affirmed) and subscribed before me on {date} _________, 19__ by {name} ____________________________. *1203 __________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________ [Print, type, or stamp commissioned name of notary] ____ Personally known ____ Produced identification Type of identification produced ____________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANK BELOW: [ fill in all blanks] I, {name of nonlawyer} __________________________, a nonlawyer, located at {street} _________________________ {city} _____________ {state} _______, {phone} _______________, helped {name} ________________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.980(c), ORDER DENYING PETITION FOR TEMPORARY INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE You should fill out and bring this proposed order with you to the hearing. If the court rules in your favor, your proposed order usually will be signed at the hearing. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ ORDER DENYING PETITION FOR TEMPORARY INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE TO: PETITIONER TO: RESPONDENT _________________________________ _____________________________________ Name Name __________________________________ _____________________________________ Address Address __________________________________ _____________________________________ City State Zip City State Zip The Petition for Injunction for Protection Against Domestic Violence filed under section 741.30, Florida Statutes, or Repeat Violence under section 784.046, Florida Statutes, has been reviewed. This court, based on the claims presented in the petition finds as follows: *1204 ____ The claims in the petition for injunction for protection are not enough under Florida Law (section 741.30 or 784.046, Florida Statutes) to allow the court to issue an ex parte temporary injunction against domestic/repeat violence. ____ It does not appear that there is an immediate and present danger of domestic violence as required under section 741.30, Florida Statutes. ____ Other: _______________________________________________________________ ______________________________________________________________________ DONE and ORDERED in {name} ___________________________ County, Florida, on {date} ______________, 19__. _________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name __________________________ Name ____________________________ Address _______________________ Address _________________________ _______________________________ _________________________________ City State Zip City State Zip Telephone No. _________________ Telephone No. ___________________ Telefax No. ___________________ Telefax No. _____________________ Other Name __________________________ Address _______________________ _______________________________ City State Zip Telephone No. _________________ Telefax No. ___________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ____________________________, a nonlawyer, located at {street} _______________________ {city} ____________ {state} ________, {phone} ____________, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.980(d), TEMPORARY INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE See Appendix 4 for instructions and information. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ *1205 _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ TEMPORARY INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE The petition for Temporary Injunction under section 741.30, Florida Statutes, and other papers filed in this court case have been reviewed. I. NOTICE OF HEARING As this Temporary Injunction for Protection has been issued without notice to the Respondent, the Petitioner and Respondent are hereby told that they must come and testify at a hearing on {day and date} _____________________, at _____ a.m./p.m., when the court will consider whether this Temporary Injunction for Protection shall continue for a longer period not to exceed one year and whether other things should be ordered including who should pay the filing fees and costs. The hearing will be before Circuit Judge {name} __________________________, Room/Courtroom {room name/number} ______ in the {location} _____________ County Courthouse, {address, city} ________________ ______________________________________ Florida. If the Petitioner and Respondent do not appear, the Injunction may be continued in force, extended, dismissed and/or additional orders may be granted. II. FINDINGS The statements under oath by the Petitioner make it appear that section 741.30, Florida Statutes, applies to the parties because it appears that an immediate and present danger of domestic violence exists and that irreparable harm and injury will probably occur in the form of violence to Petitioner or persons lawfully with Petitioner unless this injunction is issued without notice. III. TEMPORARY INJUNCTION CONSIDERED, ORDERED AND ADJUDGED: A. The Respondent shall not harm, molest, stalk, sexually assault, strike, sexually batter, or commit battery upon Petitioner or commit any other criminal offense resulting in physical injury to Petitioner or any of Petitioner's household members who are residing in the same single dwelling unit with Petitioner. B. Respondent is ordered to leave immediately and remain away from the home located at _________________________________________________________________________ * (DO NOT ENTER IF RESIDENCE OR PHONE TO BE KEPT CONFIDENTIAL FOR SAFETY, INSTEAD NOTIFY CLERK OF COURT) Petitioner shall have exclusive use and possession of this home, and the Respondent is ordered to stay away from the following places which the Petitioner goes to often: ___________________________________________________________________________ ___________________________________________________________________________ 1. Respondent, if living there, will leave the home immediately, taking with him/her only his/her clothes, and personal and health hygiene items. *1206 2. Respondent is allowed to return to the home only one time and only if necessary to remove clothes, personal health and hygiene items. The Sheriff and any of his authorized deputies and officers from any municipality with jurisdiction of the home described above can go with Respondent to the home and stand by while he/she takes his/her personal items. 3. If Petitioner asks for the help of a law enforcement agency, the court hereby authorizes an officer to accompany and assist in putting Petitioner in possession of clothes, personal health and hygiene items which may be in the premises formerly shared by the parties. C. Petitioner and Respondent shall not telephone one another at his/her address, unless this injunction specifically allows indirect contact through a third person. D. Respondent is further ordered not to harass, threaten, follow or intimidate Petitioner, Petitioner's minor child(ren), or anyone in said home or in Petitioner's company. E. Respondent is ordered to stay away from Petitioner's place of employment and is further ordered not to harass anyone connected with Petitioner's employment nor telephone Petitioner's place of employment. F. Temporary custody of the minor child(ren) is awarded to Petitioner: ________________________________________________________________________ Respondent shall not take the child(ren) from the custody of Petitioner or any childcare provider or other person entrusted by Petitioner with the care of the child(ren). Neither party shall remove the minor child(ren) from the State of Florida, the jurisdiction of this court, prior to the hearing on this Temporary Injunction. Violation of this custody order may constitute a misdemeanor of the first degree, section 787.03, or a felony of the third degree, section 787.04, Florida Statutes. G. The Sheriffs and all law enforcement officers of the State of Florida shall use any and all reasonable and necessary force to physically deliver the minor child(ren) to the Petitioner. H. Visitation shall be limited to that supervised by a third party as follows: ________ ________________________________________________________________________ I. Visitation shall be as follows: ________________________________________ ________________________________________________________________________ J. Other: _________________________________________________________________ IV. SANCTIONS A. The injunction shall be effective until the hearing set above and in no event for longer than 15 days, unless extended by court order. B. Any violation of this Temporary Injunction for Protection Against Domestic Violence shall be subject to civil or indirect criminal contempt proceedings, including the imposition of a fine or imprisonment. A person may be charged with a crime punishable by a fine, jail, or both, as provided by Florida Statutes. V. DIRECTIONS TO LAW ENFORCEMENT OFFICER IN ENFORCING THIS TEMPORARY INJUNCTION A. The Sheriff of _______ County, or any other law enforcement officer, is ordered to serve this temporary injunction upon the Respondent as soon as possible after its issuance. *1207 B. Violation of this Temporary Injunction should be reported to the appropriate law enforcement agency. If there has not been an arrest, the Petitioner may contact the Clerk of the Circuit Court of the county in which the violation occurred and complete an affidavit in support of the violation. C. Reports concerning arrested and at large violators shall be forwarded to the Domestic Violence Unit of the State Attorney's Office. Upon receiving such a report, the State Attorney is hereby appointed to prosecute such violations by indirect criminal contempt proceedings or the State Attorney may decide to file a criminal charge, if warranted by the evidence. VIOLATION OF THIS INJUNCTION IS PUNISHABLE BY JAIL OR FINE OR BOTH. D. Should any Florida law enforcement officer having jurisdiction have probable cause to believe that Respondent has knowingly violated this injunction, the officer shall arrest Respondent, confine him/her in the county jail without bail, and shall bring him/her before the Initial Appearance Judge on the next regular court day so that Respondent can be dealt with according to law. The arresting agent shall notify the Domestic Violence Unit of the State Attorney's Office immediately after arrest. THIS INJUNCTION IS ENFORCEABLE IN ALL COUNTIES OF FLORIDA AND LAW ENFORCEMENT OFFICERS MAY EFFECT ARRESTS PURSUANT TO SECTION 901.15(6), FLORIDA STATUTES. E. The appropriate Sheriff and any of his authorized deputies and officers from any municipality with jurisdiction of the residence described above are authorized to assist the Petitioner in obtaining exclusive possession of the dwelling described above and, if requested by Petitioner, putting Petitioner in possession of clothes, and personal health and hygiene items that may be in the premises formerly shared by the parties. This proceeding is not a dissolution of marriage. In order for financial matters to be resolved, there must be compliance with the Florida Rules of Civil Procedure, the Florida Family Law Rules of Procedure, and chapter 61, Florida Statutes. The Respondent upon service of this Temporary Injunction upon him/her, shall be deemed to have knowledge of and to be bound by all matters occurring at the hearing on the face of the order, as well as any further injunction that may be entered at that hearing. A copy of any such injunction shall be mailed to the Respondent at the last address known to the Clerk, but failure of the Respondent to receive the mailed copy shall not excuse Respondent from being bound by that injunction. WARNING THE COURT MAY ENFORCE COMPLIANCE WITH THE ABOVE TERMS OF THIS INJUNCTION THROUGH CONTEMPT PROCEEDINGS OR AS PROVIDED BY THE LAWS OF THE STATE OF FLORIDA. VIOLATION OF THIS ORDER MAY SUBJECT THE VIOLATOR TO CRIMINAL PROSECUTION. THIS INJUNCTION IS VALID AND ENFORCEABLE IN ALL COUNTIES OF THE STATE OF FLORIDA. LAW ENFORCEMENT OFFICERS MAY USE THEIR ARREST POWERS FOR VIOLATIONS OF THIS INJUNCTION UNDER WHICH CRIMINAL SANCTIONS MAY BE IMPOSED BY THE LAWS OF THE STATE OF FLORIDA. ANY VIOLATION OF THIS INJUNCTION, WHETHER OR NOT AT THE INVITATION OF THE PETITIONER, MAY SUBJECT YOU TO CRIMINAL PROSECUTION. THE PROVISIONS OF THIS INJUNCTION MAY BE ENDED ONLY BY THE COURT. IT IS A FEDERAL CRIME FOR THE RESPONDENT TO WHOM THIS ORDER IS DIRECTED TO SHIP OR TRANSPORT IN INTERSTATE OR FOREIGN COMMERCE, OR POSSESS IN OR AFFECTING COMMERCE, ANY FIREARM OR AMMUNITION; OR TO RECEIVE ANY FIREARM OR AMMUNITION WHICH HAS *1208 BEEN SHIPPED OR TRANSPORTED IN INTERSTATE OR FOREIGN COMMERCE. 18 U.S.C.A. SEC. 2265 FULL FAITH AND CREDIT: THIS PROTECTION ORDER MEETS THE REQUIREMENTS OF 18 U.S.C.A. SEC. 2265(b) AND THEREFORE SHALL BE ACCORDED FULL FAITH AND CREDIT BY THE COURT OF ANOTHER STATE OR INDIAN TRIBE (THE ENFORCING STATE OR INDIAN TRIBE) AND ENFORCED AS IF IT WERE THE ORDER OF THE ENFORCING STATE OR TRIBE. 18 U.S.C.A. SEC. 2265 DONE AND ORDERED in the City of ___________________________, County of ______________________, Florida, this _____ day of _______, 19__. _____________________________________ CIRCUIT JUDGE I HEREBY CERTIFY that I have furnished a certified copy of this order to the Petitioner(s) and the _____________ County Sheriff's Department or any other designated Law Enforcement Agency for service on Respondent(s) this {date} ______________, 19__. ____________________________________ CLERK OF THE CIRCUIT COURT BY: ________________________________ DEPUTY CLERK To be filled out by the court: In accordance with the Americans with Disabilities Act of 1990, persons needing a special accommodation to participate in this proceeding should contact ________ for proceedings in court or _______________ at _____ for out of court proceedings no later than 7 days before the proceeding. Telephone __________ or __________ for assistance. If hearing impaired, telephone (TDD) __________ for proceedings in court or Florida Relay Service 1-800-955-8771 for out of court proceedings. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.980(e), INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE (AFTER NOTICE) See Appendix 4 for instructions and information. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE (AFTER NOTICE) THIS CAUSE came on to be heard on {date} ____________, upon Petitioner's *1209 application for Injunction for Protection against Domestic Violence pursuant to section 741.30, Florida Statutes, with proper service of the temporary injunction and notice of hearing upon Respondent, this court being fully advised in the premises, and the Petitioner having established to the court's satisfaction that Petitioner has been the victim of an act of domestic violence or has reasonable cause to believe that he/she may become the victim of an act of domestic violence, and is entitled to the issuance of this injunction, IT IS ORDERED AND ADJUDGED as follows: 1. APPEARANCE OF RESPONDENT Respondent [✓ one only] ____ did/____ did not appear. 2. COSTS/FEES [✓ one only] ____ Petitioner and Respondent are indigent and do not have to pay the filing and service fees. ____ Petitioner is not indigent and it is ordered that the filing fee or balance due on it and service fees shall be paid within ____ days. ____ Respondent shall pay the filing fee in the amount of $ ____ to the Clerk on or before {date} ___________ and service fees are to be paid right away. ____ Respondent shall repay petitioner for the filing fee in the amount of $ ____ on or before {date} _______________. The Clerk of the Court fees shall be paid at: Address _________________________________ _________________________________________ City State Zip Telephone No. ___________________________ Telefax No. _____________________________ and the Sheriff's Office (service) fees shall be paid at: Address _________________________________ _________________________________________ City State Zip Telephone No. ___________________________ Telefax No. _____________________________ Both may be paid in person or by mail. 3. Respondent is ordered not to commit any act of violence, abuse, threat, or harassment, at any time or any place whatsoever, including, but not limited to: assault, battery, sexual battery, stalking, aggravated stalking, or any criminal offense resulting in physical injury or death to Petitioner, or any member of Petitioner's immediate family. Respondent is further ordered not to cause any other person to commit any act of violence, threat, or harassment upon the petitioner. 4. Petitioner and Respondent shall have no contact whatsoever directly or indirectly, whether in person, by telephone, in writing or by computer, except as necessary to allow child visitation, if granted. If Respondent is ordered to leave a shared home, Respondent may return to the home, upon reasonable notice to the Petitioner, for the limited purpose of removing strictly personal belongings, if any, on one occasion only if accompanied by law enforcement or as follows: ___________________________________________________________________________ ___________________________________________________________________________ *1210 5. USE OF PARTIES' HOME [✓ one only] ____ a. Petitioner is awarded exclusive use and occupancy of the home which the parties share. Respondent shall leave said home, located at ____________ ___________________ (DO NOT ENTER IF RESIDENCE RESIDENCE OR PHONE TO BE KEPT CONFIDENTIAL FOR SAFETY, INSTEAD NOTIFY CLERK OF COURT) and Respondent is further ordered not to come on or about the premises, except as necessary to allow court-ordered child visitation. ____ b. Respondent shall not go onto the residential premises of petitioner, living separately, located at _________________________________ (DO NOT ENTER IF RESIDENCE RESIDENCE OR PHONE TO BE KEPT CONFIDENTIAL FOR SAFETY, INSTEAD NOTIFY CLERK OF COURT) or wherever petitioner may live in Florida, except to allow court-ordered child visitation. ____ 6. PLACE OF EMPLOYMENT [ fill in all blanks that apply] Respondent shall not go onto Petitioner's place of employment, located at _________________________________________________________, or wherever Petitioner may be employed in Florida. 7. CUSTODY OF CHILDREN [✓ all that apply, fill in all blanks that apply] ____ a. Petitioner is given temporary custody of the parties' minor child(ren), whose names and birthdates are as follows: Name ___________________________ DOB ______________________________ Name ___________________________ DOB ______________________________ Name ___________________________ DOB ______________________________ Name ___________________________ DOB ______________________________ ____ b. Respondent [✓ one only] ____ shall or ____ shall not be allowed to visit with the child(ren). ____ c. Respondent's visitation shall be [✓ one only] ____ supervised or ____ unsupervised. If child visitation is to be supervised, the visitation shall be supervised by a mutually-agreed upon third party. If the parties are unable to agree, a professional agency shall supervise the child visitation. ____ d. Respondent is awarded the following minimum visitation with respect to the child(ren): ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 8. NET INCOME [ fill in all blanks] The net income of Petitioner is $ _____. The net income of Respondent is $ _____. 9. CHILD SUPPORT [✓ all that apply, fill in all blanks that apply] ____ a. Respondent shall pay to Petitioner the sum of $ ____ per child ____ weekly/ ____ bimonthly/ ____ monthly, as temporary support for the parties' minor child(ren), as provided in section 61.13, Florida Statutes. Unless agreed by the parties in writing, such payments shall be made to ____________________________________. [Depository Address] Any fees shall be the responsibility of the Respondent. ____ b. Respondent shall contribute $ ____ per week for child care expenses. ____ c. Respondent [✓ one only] ____ shall or ____ shall not be required to maintain health insurance coverage for the parties' minor child(ren) and for Petitioner. Any uncovered medical costs for the minor child(ren) shall be *1211 assessed as follows: _________________________________________. 10. ALIMONY [✓ all that apply, fill in all blanks that apply] ____ a. Respondent shall pay to Petitioner the sum of $ ____, ____ weekly/ ____ bi-monthly/ _____ monthly, as temporary alimony. Unless agreed by the parties in writing, payment shall be made to _________________________________________. [Depository Address] Any fees shall be the responsibility of Respondent. ____ b. The court finds that Petitioner has the need for the support ordered above and the Respondent has the ability to pay this support. 11. BATTERERS' INTERVENTION PROGRAM [✓ one only] ____ a. Respondent shall contact personnel of the below-named Batterers' Intervention Program within 48 hours of service of this injunction (excluding weekends and holidays) to arrange to enter same at his/her expense, and successfully complete this program. Agency Name: ______________________________________________________ Address: __________________________________________________________ Telephone Number: _________________________________________________ ____ b. The court finds by substantial and competent evidence that it is not necessary for respondent to attend a Batterers' Intervention Program because ___________________________________________________. 12. The following additional order is necessary to protect the petitioner from domestic violence: ___________________________________________________________________________ ___________________________________________________________________________ 13. Upon Petitioner's request, an officer from the appropriate law enforcement agency shall accompany Petitioner and assist in placing Petitioner in possession of the dwelling or residence or other property listed below and in securing and ensuring the placement of the parties' minor child(ren) with Petitioner or otherwise assist in the execution or service of this injunction. The appropriate law enforcement agency shall not be obligated to store and/or otherwise maintain custody and/or control over the personal property, or take custody of the minor child(ren). The Petitioner must accompany the appropriate law enforcement agency to execute this portion of the injunction. 14. Any relief granted by this injunction shall be effective for a period of one year from the date it is issued. The victim may petition the court for an extension of the provisions of this injunction not to exceed one year before the expiration date. Either party may ask the court to change or end the injunction at any time. 15. The Clerk of the Court shall forward a copy of the injunction to the local law enforcement agency with jurisdiction over the residence of Petitioner within 24 hours after its entry. Each appropriate law enforcement agency shall make available to other law enforcement officers, through a system for verification, information as to the existence and status of such injunction. 16. Pursuant to section 901.15(6) and (7), an officer may arrest Respondent without a warrant for violating this injunction when the officer has probable cause to believe Respondent has: (1) knowingly committed an act in violation of this injunction which creates a threat of imminent danger to the Petitioner or household members, over the objection of Petitioner, if necessary; OR (2) committed an act of domestic violence as defined in section 741.28, Florida Statutes, and the officer reasonably believes that there is danger of violence unless the person alleged to have committed the domestic violence is arrested without delay. This paragraph does not limit *1212 or expand the officer's arrest authority conferred by any other provision of law. (See section 901.15, Florida Statutes generally). Respondent shall be taken to the next first appearance if arrested for a crime and thereafter may be admitted to bail in accordance with the provisions of chapter 903, Florida Statutes, and the applicable rules of criminal procedure pending hearing or trial. 17. The Sheriff or municipal law enforcement officer shall serve a copy of any order provided and this injunction at the earliest possible time upon Respondent, who is located at: Residence: ________________________________________________________________ Business: _________________________________________________________________ Copies may be mailed by the clerk to a party who was present at the injunction hearing, otherwise the immediate assistance of the Sheriff is required. There shall be compliance with the Sheriff's service requirements. WARNING THE COURT MAY ENFORCE COMPLIANCE WITH THE ABOVE TERMS OF THIS INJUNCTION THROUGH CONTEMPT PROCEEDINGS OR AS PROVIDED BY THE LAWS OF THE STATE OF FLORIDA. VIOLATION OF THIS ORDER MAY SUBJECT THE VIOLATOR TO CRIMINAL PROSECUTION. THIS INJUNCTION IS VALID AND ENFORCEABLE IN ALL COUNTIES OF THE STATE OF FLORIDA. LAW ENFORCEMENT OFFICERS MAY USE THEIR ARREST POWERS FOR VIOLATIONS OF THIS INJUNCTION UNDER WHICH CRIMINAL SANCTIONS MAY BE IMPOSED BY THE LAWS OF THE STATE OF FLORIDA. ANY VIOLATION OF THIS INJUNCTION, WHETHER OR NOT AT THE INVITATION OF THE PETITIONER, MAY SUBJECT YOU TO CRIMINAL PROSECUTION. THE PROVISIONS OF THIS INJUNCTION MAY BE ENDED ONLY BY THE COURT. IT IS A FEDERAL CRIME FOR THE RESPONDENT TO WHOM THIS ORDER IS DIRECTED TO SHIP OR TRANSPORT IN INTERSTATE OR FOREIGN COMMERCE, OR POSSESS IN OR AFFECTING COMMERCE, ANY FIREARM OR AMMUNITION; OR TO RECEIVE ANY FIREARM OR AMMUNITION WHICH HAS BEEN SHIPPED OR TRANSPORTED IN INTERSTATE OR FOREIGN COMMERCE. 18 USCA SEC. 2265 FULL FAITH AND CREDIT: THIS PROTECTION ORDER MEETS THE REQUIREMENTS OF 18 U.S.C.A. SEC. 2265(b) AND THEREFORE SHALL BE ACCORDED FULL FAITH AND CREDIT BY THE COURT OF ANOTHER STATE OR INDIAN TRIBE (THE ENFORCING STATE OR INDIAN TRIBE) AND ENFORCED AS IF IT WERE THE ORDER OF THE ENFORCING STATE OR TRIBE. 18 U.S.C.A. SEC. 2265 DONE and ORDERED in {name} ____________________ County, Florida, on {date} _________, 19__. __________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ____________________________ Name ___________________________________ Address _________________________ Address ________________________________ _________________________________ ________________________________________ City State Zip City State Zip Telephone No. ___________________ Telephone No. __________________________ Telefax No. _____________________ Telefax No. ____________________________ *1213 Other Name ____________________________ Address _________________________ _________________________________ City State Zip Telephone No. ___________________ Telefax No. _____________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} _____________________________ {city} ___________________ {state} ________, {phone} _______________, helped {name} __________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.980(f), FINAL ORDER OF DISMISSAL OF INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE See Appendix 4 for instructions and for information. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ ORDER OF DISMISSAL OF INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE THIS CAUSE came before the court on this date upon petitioner's action for an Injunction Against Domestic Violence and it appearing to the court as follows: [✓ one only] ____ That petitioner failed to appear and, accordingly, this case is dismissed without prejudice. ____ That petitioner appeared but desires to voluntarily dismiss this action and, accordingly, the case is dismissed without prejudice. ____ The petitioner appeared, but did not sustain his/her burden of proof under section. 741.30 Florida Statutes and, accordingly, the case is dismissed. DONE and ORDERED in {name} ___________________________ County, Florida, on {date} __________, 19__. *1214 _______________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name _______________________________ Name _____________________________ Address ____________________________ Address __________________________ ____________________________________ __________________________________ City State Zip City State Zip Telephone No. ______________________ Telephone No. ____________________ Telefax No. ________________________ Telefax No. ______________________ Other Name _______________________________ Address ____________________________ ____________________________________ City State Zip Telephone No. ______________________ Telefax No. ________________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} ______________________________ {city} _____________ {state} _______, {phone} _______________, helped {name} ____________________ who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.980(g), PETITION FOR INJUNCTION FOR PROTECTION AGAINST REPEAT VIOLENCE No instructions. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ PETITION FOR INJUNCTION FOR PROTECTION AGAINST REPEAT VIOLENCE [ fill in all blanks that apply] The Petitioner, {name} ____________________, files this petition and says: 1. Petitioner resides at address: _______________________________________ City ______________________________ State __________________ Zip __________ *1215 (DO NOT ENTER IF RESIDENCE OR PHONE TO BE KEPT CONFIDENTIAL FOR SAFETY, INSTEAD NOTIFY CLERK OF COURT WHEN FILING THIS PAPER) 2. Respondent resides at address: _______________________________________ City ______________________________ State __________________ Zip __________ 3. [✓ one only] a. ____ Petitioner is paying the filing fee and Sheriff's service fees. OR b. ____ Petitioner does not have enough money to pay filing fees or service fees and files this and a financial affidavit asking that he/she not have to pay the fees necessary to process the Petition and serve the Injunction, as well as any later motions or orders needed to enforce or change the injunction, subject to later order(s) of the court about the payment of fees. 4. Physical description of Respondent: [ fill in all blanks that apply] Race: __________ Sex: _____ M ____ F Date of Birth: ___________________ Height: ________ Weight: ________ Eye Color: ____ Hair: _______________ Distinguishing marks/scars: ___________________________________________ Vehicle: (make/model) _______________ Color: ____ Tag: ________________ 5. Aliases of Respondent: ______________________ Nickname: ______________ 6. The Respondent has directed at least two incidents of "violence" meaning assault, battery, or sexual battery against the Petitioner or a member of the Petitioner's immediate family. One of these two incidents of "violence" has occurred within 6 months of the date of filing of this petition. Most recent incident (including date and location): ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Prior incidents (include dates and location): ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 7. Petitioner has suffered or has reasonable cause to fear more acts of violence because Respondent has: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ *1216 ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 8. Petitioner seeks: An immediate injunction temporarily enjoining Respondent from committing any further acts of violence; an ex parte injunction permanently enjoining Respondent from committing any further acts of violence; an injunction providing any terms the court deems necessary for the protection of the Petitioner and the Petitioner's immediate family, including any injunctions or directives to law enforcement agencies. Questions 9-13 [ fill in all blanks that apply] 9. The Petitioner is asking the Court to restrain the Respondent from entering into the premises of the Petitioner at his/her residence located at: ___________________________________________________________________________ ___________________________________________________________________________ (DO NOT ENTER IF RESIDENCE OR PHONE TO BE KEPT CONFIDENTIAL FOR SAFETY, INSTEAD NOTIFY CLERK OF COURT) The lease is in the name of: __________________________________________ or the property is owned by: ______________________________________________ 10. The Petitioner is also requesting that the Respondent be restrained from entering into the premises of the Petitioner's place of employment located at: _______________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 11. The following describes any previous or pending attempts to get an injunction for protection against repeat violence by Petitioner against Respondent in this court or any other court, and what happened in that case: (include case number) ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 12. The following describes any other court case(s) going on between the Petitioner and the Respondent: (include case number) ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 13. Has Respondent ever gotten or tried to get a repeat violence injunction against Petitioner? [✓ one only] ____ Yes ____ No. If Yes, please give case number: ________ 14. Additional Information: A. The Respondent owns, possesses, and/or is known to possess weapons. [✓ one only] ____ yes or ____ no If yes, what type of weapons: _____________________________________ B. The Respondent has a drug and/or alcohol problem: [✓ one only] ____ yes or ____ no C. Petitioner has known Respondent since: {date} _____________________ D. The Respondent has a history of mental health problems: [✓ one only] ____ yes or ____ no; has been the subject of a Baker Act proceeding: *1217 [✓ one only] ____ yes or ____ no; and/or takes medication for mental health problems: [✓ one only] ____ yes or ____ no. E. Petitioner's attorney's name, address and telephone number is: _____ ____________________________________________________________________ (If you do not have an attorney state "none.") F. Respondent's attorney's name, address and telephone number is: _____ ____________________________________________________________________ (If you do not know, state "unknown." If Respondent does not have an attorney, state "none.") 15. Petitioner claims that letting Respondent know that the Petitioner is trying to get an Injunction against Respondent before the Injunction is available to protect Petitioner would put the life, health, or wellbeing of the Petitioner and/or Petitioner's immediate family in great and immediate danger. WHEREFORE, the Petitioner seeks an injunction [✓ all that apply]: NOTE: The Court may consider the following: "Ex Parte" (without notice and hearing). This relief may be awarded for up to 15 days. a. ____ Immediately restraining the Respondent from committing any acts of violence. b. ____ Restraining the Respondent from entry onto the Petitioner's residential premises or Petitioner's place of employment. c. ____ Providing any terms the court deems necessary for protection of a victim of violence, including injunctions or directives to law enforcement agencies. NOTE: The Court may consider the following only with hearing and notice to the Respondent. This relief may be awarded for up to one year. d. ____ Continuing for up to one year any of the things listed in a-c above. I understand that as Petitioner, I am swearing under oath to the truthfulness of the claims made in this document and that the punishment for knowingly making a false statement includes fines and/or imprisonment. DATED: ________________________________ ______________________________________ Signature of party signing certificate and pleading Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ______________________________ Sworn to (or affirmed) and subscribed before me on {date} _________, 19__ by {name} ________________________. __________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________ [Print, type, or stamp commissioned name of notary] *1218 [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ______________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} _______________________________ {city} _________________ {state} __________, {phone} ______________, helped {name} __________________ who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.981(a), PETITION FOR STEPPARENT ADOPTION The adopting stepparent is the "Petitioner" on this form. All information required must be filled in by the adopting stepparent. After the petition is completed take it to a notary public. You and your spouse must sign the form in the presence of the notary, who must also sign the form and seal it. See Appendix 5 and Chapter 63, Florida Statutes, for further information. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR ____________ COUNTY, FLORIDA In the Matter of the Adoption of CASE NO: __________________ _______________________________________, Adoptee [use name to be given to child(ren)] PETITION FOR ADOPTION BY STEPPARENT [ fill in all blanks] Petitioner, ____________________, Social Security No. ___________________, files this petition for adoption of the above-named minor child(ren), pursuant to Chapter 63, Florida Statutes, and states as grounds for it: 1. This is an action for adoption of a minor child(ren) by [✓ one only] ____ his or ____ her or ____ their stepparent, _______________________. 2. I desire to adopt ____________________________________, who was born on [child's current name] _____________________, at _________________________________________________. [date] [city, county, and state] A copy of the birth certificate is attached. Further, I desire to adopt the minor child in that the child has resided in my care and custody since ________________________ and I now wish to establish legally the [date] parent/child relationship already existing between me and the child. Since that time I have adequately been able to provide for the material needs of the child and am able to continue to do so in the future, as well as to provide for the child's mental and emotional well-being. *1219 3. I am ____ years old and I currently live in ___________________ County, Florida. I have sufficient resources to provide for the child including the following [Employer's name and address or other source of income]: _______________________________. I intend to remain a resident of Florida. 4. The birth _____ father or _____ mother of the child(ren) and I were married on ___________________ in _________________________ County, Florida. [date] 5. The adoptee's name shall be: _________________________________________. 6. A completed Uniform Child Custody Jurisdiction Affidavit, Family Law Form 12.901(f) is attached to this petition. 7. The adoptee's birth parents are: ____________________________________ ________________________________ Father's Name Birthdate ______________________________________________________________________ Address ____________________________________ ________________________________ Mother's Name Birthdate ______________________________________________________________________ Address 8. Consent (mark all that apply): ____ a. _______________________, the birth mother/father of the child consents to this adoption. The consent is attached to and made a part of this petition. ____ b. The consent of the birth father should not be required because: [✓ one only] ____ The minor child is not the birth father's by virtue of a previous adoption. ____ The minor child has not been established by a court proceeding to be his child. ____ To my knowledge, the birth father has not acknowledged in writing, signed in the presence of competent witnesses, that he is the father of the minor child, nor has he filed such an acknowledgment with the Vital Statistics Office of the Department of Health and Rehabilitative Services. ____ The birth father has not provided the child with support in a repetitive and customary manner. ____ c. The consent of the birth parent should be excused for the following reason: [✓ one only] ____ The birth parent has deserted the child without providing a means of identification or has abandoned the child. ____ The birth parent's rights have been terminated by a court order. ____ The birth parent has been declared incapacitated by a court and restoration of capacity is medically improbable. ____ The legal guardian or lawful custodian of the child, other than the birth parent, has failed to respond in writing to a request for consent for a period of 60 days or, after examination of his/her reasons for withholding consent the court has found them to be unreasonable. *1220 ____ The former spouse or birth parent's consent is excused because of prolonged, unexplained absence, unavailability, incapacity, or another circumstance constituting unreasonable withholding of consent. ____ d. The written consent of the minor child, ________________, age ____ (if over 12 years), is attached and made a part of this petition. ____ e. The nonresidential parent is dead. 9. The minor child has property in the approximate value of $ ___________, described as follows: _____________________________________________________. 10. A copy of this petition for adoption has been sent to the local office of the Department of Health and Rehabilitative Services. I am aware that the adoptive stepparent may be liable for child support in the event of a later divorce, and could be liable in litigation for the actions of the adoptee. The adoptee's inheritance may also be affected. WHEREFORE, I request that this court enter a Final Judgment of Adoption of the minor child by the Petitioner Stepparent, and change the name of the adoptee. I CERTIFY THAT THE PETITION FOR STEPPARENT ADOPTION WAS: (✓ check one only) ____ mailed, ____ telefaxed and mailed, or ____ hand delivered to the person(s) listed below on {date} _________________, 19__. Party or their attorney if represented Other Name ___________________________________ Name ____________________________ Address ________________________________ Address _________________________ ________________________________________ _________________________________ City State Zip City State Zip Telephone No. __________________________ Telephone No. ___________________ Telefax No. ____________________________ Telefax No. _____________________ DATED: _________________________________ ______________________________________ Signature of party signing certificate and pleading Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} _____________________________ Sworn to (or affirmed) and subscribed before me on {date} __________, 19__ by {name} ______________________. __________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________ [Print, type, or stamp commissioned name of notary] *1221 [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ______________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} _____________________________ {city} _____________ {state} _______, {phone} ___________, helped {name} _______________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.981(b), STEPPARENT ADOPTION: CONSENT AND WAIVER OF PARENT This form is to be completed and signed by the birth parent to whom the adopting parent is not married. It must be signed in the presence of a notary public, who will also sign and seal it, and two witnesses other than the notary. The form is filed with the petition for adoption. See Appendix 5 and Chapter 63, Florida Statutes, for more information. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR _________, COUNTY, FLORIDA In the Matter of the Adoption of CASE NO: _________________ ___________________________________, STEPPARENT ADOPTION: CONSENT AND WAIVER BY PARENT 1. I, ______________, am the birth [✓ one only] ____ father or ____ mother of the above-named child(ren), who was/were born on _______________________, at ___________________________. I do hereby relinquish all rights to and custody of this/these minor child(ren), _______________, and do consent to the adoption by the Petitioner, _________________, with full knowledge of the legal effect of the stepparent adoption. 2. I understand my legal rights as a parent and I understand that I do not have to sign this consent and release of my parental rights. I acknowledge that this consent is being given knowingly, freely, and voluntarily. I further acknowledge that my consent is not given under fraud or duress. I understand that there is no "grace period" in Florida during which I may revoke my consent. I understand that in signing this consent I am permanently and forever giving up all of my parental rights to and interest in this child/these children. I voluntarily permanently relinquish all my parental rights to this child/these children. 3. I understand that: "After one year from the entry of a judgment of adoption, any irregularity or procedural defect in the proceedings is cured, and the validity of the judgment shall not be subject to direct or collateral attack because of any irregularity or procedural defect. Any defect or irregularity of, or objection to, a consent that could have been cured had it been made during the proceedings shall not be questioned after the time for taking an appeal has expired." 4. I do now, of my own free will, consent and release and give up completely and permanently my parental rights to this child, for the purpose of adoption. 5. I waive any further notice of the adoption proceeding. 6. I [✓ one only] ____ have or ____ have not been interviewed about this adoption pursuant to a preliminary home study. *1222 I am aware that the adoptive stepparent may be liable for child support in the event of a later divorce, and could be liable in litigation for the actions of the adoptee. The adoptee's inheritance may also be affected. DATED: ______________________________ ______________________________________ Signature of party signing consent Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF ________________ Sworn to (or affirmed) and subscribed before me on {date} __________, 19__ by {name} _______________________. __________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________ [Print, type, or stamp commissioned name of notary] ____ Personally known ____ Produced identification Type of identification produced ______________ WITNESS: WITNESS: Signature: __________________________ Signature: __________________________ Print: ______________________________ Print: ______________________________ Home/Business Address: ______________ Home/Business Address: ______________ _____________________________________ _____________________________________ Social Security No.: ________________ Social Security No.: ________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} _____________________________ {city} ___________________ {state} _______, {phone} ______________, helped {name} _____________________ who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.981(c), STEPPARENT ADOPTION: CONSENT OF ADULT ADOPTEE This form must be completed and signed by the person being adopted, the adoptee, if he or she is over 12 years of age. It must be signed in the presence of a notary public, who will sign and seal it, and two witnesses other than the notary. For more information see Appendix 5 and Chapter 63, Florida Statutes. *1223 A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR __________, COUNTY, FLORIDA In the Matter of the Adoption of CASE NO: __________________ ___________________________________, Adoptee STEPPARENT ADOPTION: CONSENT TO ADOPTION BY ADOPTEE 1. I, ________________, being _____ years of age, do hereby consent to my adoption by ________________, to be legal child and heir at law. 2. I hereby consent to being known as _____________, from now on. DATED: ________________________________ ______________________________________ Signature of party signing consent Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF ____________________ Sworn to (or affirmed) and subscribed before me on {date} __________, 19__ by {name} ______________________________. __________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________ [Print, type, or stamp commissioned name of notary] ____ Personally known ____ Produced identification Type of identification produced ______________ WITNESS: WITNESS: Signature: __________________________ Signature: __________________________ Print: ______________________________ Print: ______________________________ Home/Business Address: ______________ Home/Business Address: ______________ Social Security No.: ________________ Social Security No.: ________________ *1224 IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} ________________________________ {city} ________________ {state} _______, {phone} ______________, helped {name} __________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.981(d), STEPPARENT ADOPTION: AFFIDAVIT OF DILIGENT SEARCH This form is to be used if the birth parent who is not married to the stepparent adopting the child could not be located to give consent. It is not to be used if the birth parent was located and refused to agree to the adoption. The birth parent who is married to the adopting stepparent completes this form showing what efforts were made to locate the other birth parent. The form must be signed in the presence of a notary public, who will sign and seal it. ✓ See the checklist with the instructions to Family Law Form 12.913(b), regarding the requirements for conducting a diligent search. For more information see Appendix 5 and Chapter 63, Florida Statutes. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR __________, COUNTY, FLORIDA In the Matter of the Adoption of CASE NO: ___________________ _______________________________________, Adoptee STEPPARENT ADOPTION: AFFIDAVIT OF DILIGENT SEARCH 1. I am married to the child's birth parent. 2. The birth [✓ one only] ____ father's or ____ mother's last known address was Address ______________________________ ______________________________________ City State Zip Telephone No. ________________________ Telefax No. __________________________ as of {date} _________________________ and [✓ one only] ____ his or ____ her last known address of employment was Address ______________________________ ______________________________________ City State Zip Telephone No. ________________________ Telefax No. __________________________ as of {date} _______________. 3. The birth [✓ one only] ____ father or ____ mother is over the age of 18. 4. The birth [✓ one only] ____ father or ____ is not a member of the Armed Forces of the United States or the U.S. Public Health Service, within the meaning of the Soldiers and Sailors Civil Relief Act, as amended. 5. The birth [✓ one only] ____ father or ____ address or location is not known and cannot be determined, although I have made a reasonable effort to locate him/her: (Describe efforts and when made below): ____ Contacted [✓ one only] ____ his or ____ her: ___________________________________________________________________ *1225 __________________________________________________________________ ____ Contacted [✓ one only] ____ his or ____ her employer: ___________________________________________________________________ ___________________________________________________________________ ____ Contacted [✓ one only] ____ his or ____ her friends: ___________________________________________________________________ ___________________________________________________________________ ____ Contacted [✓ one only] ____ his or ____ her last known address: ___________________________________________________________________ ___________________________________________________________________ ____ Sent letters to [✓ one only] ____ his or ____ her last known address: ___________________________________________________________________ ___________________________________________________________________ ____ Sent letters to the Armed Forces on __________ who responded ___________________________________________________________________ ___________________________________________________________________ ____ Other: ___________________________________________________________. DATED: ____________________________________________ ______________________________________ Signature of party signing affidavit Printed name _________________________ Address ______________________________ ______________________________________ City State Zip ______________________________________ Telephone (area code and number) ______________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} _____________________________ Sworn to (or affirmed) and subscribed before me on {date} ________, 19__ by {name} _____________________________. __________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________ [Print, type, or stamp commissioned name of notary [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ______________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ______________________________________, a nonlawyer, located at {street} ________________________________ {city} ________________ {state} ________, {phone} ______________, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. *1226 INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.981(e), FINAL JUDGMENT OF STEPPARENT ADOPTION Before you go to court for the final hearing on the stepparent adoption, you should complete items 1 through 9 on this form. Leave the remainder of the form blank for the judge to complete if the adoption is granted. You should bring this proposed order with you to the hearing. If the court rules in your favor, your proposed order usually will be signed at the hearing. For more information, see Appendix 5 and Chapter 63, Florida Statutes. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ____________ JUDICIAL CIRCUIT, IN AND FOR ___________, COUNTY, FLORIDA In the Matter of the Adoption of CASE NO: _______________ ____________________________________, Adoptee(s) FINAL JUDGMENT OF STEPPARENT ADOPTION This matter was heard for consideration by the court on the Petition for Stepparent Adoption filed in this action, and having heard testimony and considered the evidence, THE COURT FINDS THAT: 1. It has jurisdiction over the subject matter of the petition for adoption. 2. It has jurisdiction over the minor child(ren), __________, the petitioner, _________, and the birth parent, __________, in that they are residents of __________ County, State of Florida. Further, the child and petitioners have significant connections with the State of Florida. 3. There is no pending litigation regarding this child in the State of Florida or any other state, nor is there any other person not a party to these proceedings who has, or claims to have, physical custody or visitation rights to the minor child. 4. The best interests of this child/these children would be served and promoted by this adoption and the petitioner desires the permanent responsibility of a parent in this adoption. 5. Consent of the birth parent is: [✓ one only] ____ Attached ____ Waived because: [✓ all that apply] ____ the parent has deserted the child(ren) without affording a means of identification. ____ the parent has abandoned the child(ren), and has not visited, supported, contacted, or communicated with the child(ren). *1227 ____ the parent has been judicially declared incapacitated and restoration of capacity is medically improbable. ____ the legal guardian or lawful custodian of the adoptee, other than the parent, has failed to respond in writing to a request for consent for 60 days, or the court has examined the written reasons for withholding consent and has found the withholding of consent to be unreasonable. ____ Other: _________________________________________________________ ____ Not required because he/she is deceased. 6. The petitioner stepparent is a fit and proper person to adopt the minor child(ren) and the best interests of the child(ren) will be promoted by this adoption. 7. The minor child(ren) is/are suitable for adoption by the petitioner. NOW, THEREFORE, IT IS ORDERED that: 8. The minor child(ren) presently known as _________ is/are declared to be the legal child(ren) of petitioner, _________, and is/are given the name of ___________________, by which he/she/they shall hereafter be known. 9. The minor child(ren) shall be the child(ren) and legal heir(s) of law of the petitioner, ___________, and shall be entitled to all rights and privileges, and subject to all obligations of children born of petitioner. 10. All legal relations between the adoptee(s) and the birth _____ father or ____ mother and between the adoptee(s) and the relatives of the birth parent are hereby terminated by this adoption, as are all parental rights and responsibilities of the birth parent. 11. This Final Judgment of Adoption creates a relationship between the adoptee and the petitioner and all relatives of petitioner that would have existed if the adoptee were a blood descendant of the petitioner, born within wedlock, entitled to all rights and privileges thereof, and subject to all obligations of a child being born to petitioner. DONE and ORDERED in {name} __________________ County, Florida, on {date} _____________, 19__. _________________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name __________________________________ Name ____________________________ Address _______________________________ Address _________________________ _______________________________________ _________________________________ City State Zip City State Zip Telephone No. _________________________ Telephone No. ___________________ Telefax No. ___________________________ Telefax No. _____________________ _________________________________ Other Name __________________________________ Address _______________________________ _______________________________________ City State Zip Telephone No. _________________________ Telefax No. ___________________________ *1228 IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} ______________________________ {city} __________________ {state} _________, {phone} ______________ helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.981(f), PETITION FOR ADOPTION INFORMATION AND (g), ORDER RELEASING ADOPTION INFORMATION This form is used to request release of information on an adoption. It should be filed with the clerk of the circuit court. For more information, see Appendix 5 and Chapter 63, Florida Statutes. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR ___________, COUNTY, FLORIDA In the Matter of the Adoption of CASE NO: _______________ ____________________________________, Adoptee(s) PETITION FOR ADOPTION INFORMATION 1. I, {name} ______________, am interested in this matter as: [✓ one only] ____ adult adoptee (over 18) ____ adoptive parent ____ adult birth sibling ____ other: __________________________________________________________ 2. The adoptee(s) was/were born on {date} ______________________. 3. I request nonidentifying information as to family medical history and social history of the adoptee as follows: [✓ all that apply] ____ If available, to be furnished to adoptive parents before finalization of the adoption. ____ If available, to be furnished to adoptee upon request after adoptee reaches majority. 4. The reason I am requesting disclosure of this information is __________ ____________________________________________________________________________ ____________________________________________________________________________ DATED: ____________________________________ ________________________________________ Signature of party signing petition *1229 Printed name ___________________________ Address ________________________________ ________________________________________ City State Zip ________________________________________ Telephone (area code and number) ________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF {name} ____________________________ Sworn to (or affirmed) and subscribed before me on {date} _______, 19__ by {name} ___________________________. __________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ______________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} ___________________________ {city} _____________________ {state} ____, {phone} _________, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR ______________, COUNTY, FLORIDA In the Matter of the Adoption of CASE NO: ______________ ___________________________________, Adoptee(s) ORDER RELEASING ADOPTION INFORMATION IT IS ORDERED ____ 1. The petitioner shall receive ____ Nonidentifying information as to: ______________________________ ____ Identifying information as to: _________________________________ ____ All records relating to the adoption proceedings. ____ 2. The petition is denied in whole or part because: _______________ __________________________________________________________________ DONE and ORDERED in {name} _______________ County, Florida, on {date} __________, 19__. *1230 ________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _____________________________ Address ___________________________ Address __________________________ ___________________________________ __________________________________ City State Zip City State Zip Telephone No. _____________________ Telephone No. ____________________ Telefax No. _______________________ Telefax No. ______________________ Other Name ______________________________ Address ___________________________ ___________________________________ City State Zip Telephone No. _____________________ Telefax No. _______________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} ___________________________ {city} _____________________ {state} _______, {phone} _____________, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.982, REQUEST FOR NAME CHANGE Use this form to ask the court to change your name. You must complete the form and file it in the county where you live. Next, you must obtain a hearing date for the court to consider your request. See Family Law Form 12.923, Notice of Hearing (General Form). If you want a name change for yourself or your child because of a dissolution of marriage or an adoption, if final judgment has not been entered yet, the name change can be done as part of that case. NOTE: a husband, wife and minor children can all join in one petition/request if the court agrees. However, if one parent asks for a name change for minor child(ren), process must be served on the other parent ( Family Law Form 12.910(a)) and proof of service on the other parent must be filed with the court. For further information see § 68.07, Florida Statutes. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner *1231 and _______________________________, Respondent. ____________________________\ PETITION/REQUEST FOR NAME CHANGE This is a request for the court to change my name from: {complete present name} _________________________________________________ to {new name requested} ______________________________________________________. 1. I live at: Address _______________________________ _______________________________________ City State Zip Telephone No. _________________________ I am a bonafide resident of the county of {name} _____________________. 2. My date of birth is: _________________________________________________. 3. My place of birth is: {city} __________ {county} ______________________ {state} __________ {country} _________________________________________. 4. My father's name is: _________________________________________________. 5. My mother's maiden name is: ___________________________________________ 6. I have lived in the following place(s) since birth: Address From To _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 7. I [✓ one only] ____ am ____ am not married. If married, fill in your husband's or wife's name: _____________________________________________ 8. The names, ages, and address(es) of each of my children are as follows: Name (write last name first) Age Address ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ *1232 9. I [✓ one only] ____ have ____ have not (circle one) been known or called by any other name. I have been called by the following name(s): _______________________________________________________________________ 10. My name [✓ one only] ____ has ____ has not ever been changed. If you have had a name change in the past [ fill in all blanks] a. My name was previously changed on (date): _________________________ by the following court: ___________________________________________ ___________________________________________________________________ 11. My job is: ______________________________________________________________________ 12. During the last five years, I have had the following jobs: From To Employer Address ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 13. I do/do not (circle one) own and operate a business. (If you do own a business, complete the next part.) a. The name and address of my business is: ___________________________ ___________________________________________________________________ b. My job with the business is: ______________________________________ c. I have been working with the business since (date): _______________ 14. I am/am not (circle one) in a profession. If you are in a profession, which profession? ______________________________________________________________________ 15. I have practiced my profession at the following places: From To Place ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 16. I have graduated from the following schools: School Graduation Date Diploma/Certificate ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 17. I have/have not (circle one) filed for bankruptcy. (If you have filed for bankruptcy, fill out 17a.) a. I was declared bankrupt on (date): ________________________________ in the bankruptcy court in (city and state): ______________________ ___________________________________________________________________ 18. I have/have never (circle one) been convicted of a felony. (If convicted of a felony, fill out 18a.) a. I was convicted on (date) _________________________________________ in (city) _________________________________________________________ (county) __________________________________________________________ (state) ___________________________________________________________ court. *1233 19. The following money judgments have been entered against me by a court: (Attach separate page if necessary.) Judgment Creditor Amount Date Court Paid ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 20. I have no illegal or fraudulent reason for my name change request and this request, if granted, will not invade any property rights of others. DATED: __________________________ ___________________________________________ Signature of party signing petition/request Printed name ______________________________ Address ___________________________________ ___________________________________________ City State Zip ___________________________________________ Telephone (area code and number) ___________________________________________ Telefax (area code and number) STATE OF FLORIDA COUNTY OF __________________ Sworn to (or affirmed) and subscribed before me on {date} _______, 19__ by {name} _______________________. __________________________________________ NOTARY PUBLIC — STATE OF FLORIDA __________________________________________ [Print, type, or stamp commissioned name of notary] [✓ one only] ____ Personally known ____ Produced identification Type of identification produced ______________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM THEY MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} ___________________________ {city} _____________________ {state} _______, {phone} _____________, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FAMILY LAW FORM 12.990(a), FINAL JUDGMENT OF SIMPLIFIED DISSOLUTION OF MARRIAGE See Appendix 1 for information about the use of Family Law Form 12.990(a). You should bring this form filled out as a proposed order with you to the hearing. If the court rules in your favor, your proposed order usually will be signed at the hearing. NOTE: Many of the parts of Family Law Form 12.990(a) are choices and should be used only when they fit the facts of your case. Material portions of any marital settlement agreement, Family Law Form 12.901(h) should also be put in the final judgment. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give a you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must *1234 put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner, and _______________________________, Respondent. ____________________________\ FINAL JUDGMENT OF SIMPLIFIED DISSOLUTION OF MARRIAGE THIS CAUSE was heard by the court on final hearing for simplified (uncontested) dissolution of marriage on {date} ____________. The court, having reviewed the file and heard the testimony, makes these findings of fact and reaches these conclusions of law: a. This court has jurisdiction over the subject matter and the parties. b. At least one party has been a resident of the State of Florida for more than 6 months immediately before filing the Simplified Petition for Dissolution of Marriage. c. The parties have entered into a Marital Settlement Agreement, which is acceptable to both parties. d. The marriage between the parties is irretrievably broken. THEREFORE it is ORDERED AND ADJUDGED: 1. The Marriage between the parties is dissolved and the parties are restored to the status of being single. 2. The Marital Settlement Agreement, which has been filed as an exhibit in this case, is ratified and made a part of this judgment, and the parties are ordered to obey all of its provisions. 3. [✓ one only] ____ yes or ____ no The Wife's former name of ___________________ is restored. 4. The court reserves jurisdiction to enforce the marital settlement agreement. DONE and ORDERED in {name} ______________________ County, Florida, on {date} _______________, 19__. ________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _____________________________ Address ___________________________ Address __________________________ ___________________________________ __________________________________ City State Zip City State Zip Telephone No. _____________________ Telephone No. ____________________ Telefax No. _______________________ Telefax No. ______________________ *1235 Telefax No. _______________________ Telefax No. ______________________ Other Name ______________________________ Address ___________________________ ___________________________________ City State Zip Telephone No. _____________________ Telefax No. _______________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} ___________________________ {city} _____________________ {state} _______, {phone} _____________, helped {name} ___________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FAMILY LAW FORM 12.990(b) FINAL JUDGMENT OF DISSOLUTION OF MARRIAGE See Appendix 2 for information about the use of Family Law Form 12.990(b). You should bring this form filled out as proposed order with you to the hearing. If the court rules in your favor, your proposed order usually will be signed at the hearing. NOTE: Many of the parts of Family Law Form 12.990(b) are choices and should be used only when they fit the facts of your case. Material portions of any marital settlement agreement, Family Law Form 12.901(h) should also be put in the final judgment. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner, and _______________________________, Respondent. ____________________________\ FINAL JUDGMENT OF DISSOLUTION OF MARRIAGE THIS CAUSE was heard by the court on final hearing for dissolution of marriage on {date} ______________. The court, having reviewed the file and heard the testimony, makes these findings of fact and reaches these conclusions of law: *1236 I. FINDINGS OF FACTS [ fill in all blanks that apply] A. JURISDICTION/RESIDENCE 1. This court has jurisdiction over the subject matter and the parties. 2. At least one party has been a resident of the State of Florida for more than 6 months immediately before filing the Petition for Dissolution of Marriage. 3. The marriage between the parties should be dissolved/ended because [✓ one only] ____ The marriage is irretrievably broken (cannot be fixed). ____ One of the parties has been adjudged mentally incapacitated for a period of 3 years prior to the filing of this petition. B. STATISTICAL FACTS [ fill in all blanks that apply] 1. Date of marriage: _____________________________________________________ 2. Place of marriage: ____________________________________________________ 3. Date of separation: ___________________________________________________ C. MARITAL ASSETS AND DEBTS THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT THAT ADDRESS THE FACTORS LISTED IN SECTION 61.075, FLORIDA STATUTES, EXPLAINING WHY THE MARITAL ASSETS AND DEBTS ARE BEING DIVIDED THE WAY THIS ORDER SAYS AND IF THE DIVISION IS NOT EQUAL THE EXACT REASON(S) IT IS NOT. [ fill in all blanks that apply] [✓ all that apply] 1. ____ There are no marital assets or debts. 2. ____ All marital assets and debts have been divided by written agreement, which is attached. 3. ____ All assets and debts are listed in the Financial Affidavit filed in this case. ( Family Law Form 12.901(d) or 12.901(e)). 4. ____ The parties' assets and debts are listed below: (a) These are the parties' marital* assets and debts (what they own and what they owe): [Use more paper if needed] (*marital and nonmarital are explained in Appendix 2). MARITAL ASSETS Name on title/deed/account [✓ all that apply] Description Value Husband Wife Cash on hand ___________ ___________ ___________ Cash in banks ___________ ___________ ___________ Stocks/bonds ___________ ___________ ___________ Notes ___________ ___________ ___________ Real estate: Home: ___________ ___________ ___________ _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ Automobiles: _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ Other personal property: Contents of home ___________ ___________ ___________ Jewelry ___________ ___________ ___________ *1237 Life inc./cash surrender value ___________ ___________ ___________ Other assets: ____________________ ___________ ___________ ___________ ____________________ ___________ ___________ ___________ ____________________ ___________ ___________ ___________ TOTAL ASSETS: $ __________ $ _________ $ _________ MARITAL DEBTS Name on title/deed/account To whom/ [✓ all that apply] Description Balance Due Monthly payment Husband Wife House ___________ $ ______________ $ _______________ _________ _________ Car _____________ $ ______________ $ _______________ _________ _________ Car _____________ $ ______________ $ _______________ _________ _________ *Credit Cards: No. _____________ $ ______________ $ _______________ _________ _________ No. _____________ $ ______________ $ _______________ _________ _________ No. _____________ $ ______________ $ _______________ _________ _________ No. _____________ $ ______________ $ _______________ _________ _________ No. _____________ $ ______________ $ _______________ _________ _________ No. _____________ $ ______________ $ _______________ _________ _________ No. _____________ $ ______________ $ _______________ _________ _________ No. _____________ $ ______________ $ _______________ _________ _________ _________________ $ ______________ $ _______________ _________ _________ _________________ $ ______________ $ _______________ _________ _________ _________________ $ ______________ $ _______________ _________ _________ _________________ $ ______________ $ _______________ _________ _________ * give account number for each credit card (b) These are husband's nonmarital* assets and debts (what he owns and what he owes): [Use more paper if needed] (*marital and nonmarital are explained in Appendix 2). (c) These are wife's nonmarital* assets and debts (what she owns and what she owes): [Use more paper if needed] (*marital and nonmarital are explained in Appendix 2). 5. Pension/Retirement plans [✓ all that apply] ____ The husband has pension/retirement benefits that accrued during the marriage ____ The wife has pension/retirement benefits that accrued during the marriage ____ The husband should keep all of his pension/retirement benefits that accrued during the marriage ____ The wife should keep all of her pension/retirement benefits that accrued during the marriage ____ The court will distribute the parties' pension/retirement benefits by a qualified domestic relations order which is attached. D. SPOUSAL SUPPORT (ALIMONY) THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT THAT ADDRESS THE FACTORS LISTED IN SECTION 61.08, FLORIDA STATUTES, WHEN GRANTING OR DENYING A REQUEST FOR ALIMONY. [ you must fill in 1 or 2 below] *1238 1. ____ The spousal support/alimony request is DENIED. The basis for denying this award pursuant to section 61.08, Florida Statutes is: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 2. ____ The spousal support/alimony request is GRANTED. The basis for granting this award pursuant to section 61.08, Florida Statutes is: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ [✓ all that apply] 3. Permanent periodic spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. 4. Rehabilitative periodic spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. 5. Lump sum spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. 6. ____ Life insurance to secure this support is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay the insurance premiums. E. MINOR (under 18) CHILDREN OF THIS MARRIAGE [ fill in all blanks that apply] 1. Residential Responsibility [✓ one only] ____ There are no minor children. ____ The wife is pregnant. {due date} _________________ ____ The wife is not pregnant. ____ The minor children are: Name Birth Date Age Sex Social Security No. ___________________ ____________ ________ ________ _____________________ ___________________ ____________ ________ ________ _____________________ ___________________ ____________ ________ ________ _____________________ ___________________ ____________ ________ ________ _____________________ [✓ all that apply] ____ a. A Uniform Child Custody Jurisdiction Act Affidavit ( Family Law Form 12.901(f)) is being filed with this court. *1239 ____ b. Florida is the home state of the minor child(ren) and accordingly it is the sole jurisdictional state to determine child custody, visitation, and support under the Uniform Child Custody Jurisdiction Act. ____ c. The parties should share parental responsibility for the minor child(ren). ____ d. Shared parental responsibility would be detrimental to the child(ren). Accordingly, sole parental responsibility should be ordered. The basis for ordering sole parental responsibility is: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 2. Child Support a. Petitioner's net income is: ___________________. OR Petitioner's imputed net income is: _______, based upon the following: ______________________________________________________________________ ______________________________________________________________________ b. Respondent's net income is: _________________. OR Respondent's imputed net income is: _______, based upon the following: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ [✓ all that apply] ____ c. Child support should be set by Florida's child support guidelines (see section 61.30 Florida Statutes). ____ d. The calculations and conclusion included in the child support guidelines worksheet ( Family Law Form 12.901(g)) filed in this case by [✓ one only] ____ Petitioner or ____ Respondent are adopted by this court and incorporated in this order. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS WHY AWARDING THE AMOUNT OF CHILD SUPPORT REQUIRED BY SECTION 61.30, FLORIDA STATUTES, WOULD BE UNJUST OR INAPPROPRIATE IF THE AMOUNT AWARDED IS DIFFERENT FROM THE GUIDELINES AMOUNT BY PLUS OR MINUS FIVE PERCENT (5%). ____ e. Child support should not be set by Florida's child support guidelines (see section 61.30 Florida Statutes). The basis for ordering [✓ one only] ____ more or ____ less than the guidelines amount of child support pursuant to section 61.30, Florida Statutes is: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ *1240 f. ____ Medical insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ husband or ____ wife for the child(ren) and [✓ one only] ____ husband or ____ wife should be required to provide it. g. ____ Dental insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ husband or ____ wife for the child(ren) and [✓ one only] ____ husband or ____ wife should be required to provide it. F. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT EXPLAINING WHY ATTORNEYS' FEES ARE BEING GRANTED AND EXPLAINING THE BASIS OF THE AMOUNT AWARDED. 1. ____ The [✓ one only] ____ husband's or ____ wife's request for fees and costs is DENIED. 2. ____ The [✓ one only] ____ husband's or ____ wife's request for fees and costs is GRANTED. [✓ all that apply] ____ Attorneys' fees, ____ suit money, and/or ____ costs awarded to: [✓ one only] ____ husband or ____ wife. The basis for granting this award and for the determination of the amount is: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ THEREFORE it is ORDERED AND ADJUDGED: II. CONCLUSIONS OF LAW A. JURISDICTION 1. The parties shall be granted a Dissolution of Marriage upon the basis of: [✓ one only] ____ The parties' marriage is irretrievably broken. ____ Mental incapacity of one of the parties. and the parties are restored to the status of being single. 2. [✓ one only] ____ yes or ____ no The Marital Settlement Agreement, which has been filed in this case, is ratified and made a part of this judgment, and the parties are ordered to obey all of its provisions. B. MARITAL AND NONMARITAL ASSETS AND DEBTS AS PRESENTLY KNOWN [ fill in all blanks that apply] 1. The husband will keep as his own the assets found by this court to be his nonmarital assets in paragraph I.C.4.(b) of this final judgment and the wife shall have no further rights or responsibilities regarding that assets. 2. The wife will keep as her own the assets found by this court to be her nonmarital assets in paragraph I.C.4.(c) of this final judgment and the husband shall have no further rights or responsibilities regarding that assets. 3. The husband will keep as his own the following assets found by this court to be marital assets in paragraph I.C.4.(a) of this final judgment and the wife shall have no further rights or responsibilities regarding that assets: [use more pages if needed] *1241 ASSETS Name on title/deed/account [✓ all that apply] Description Value Husband Wife Cash on hand ___________ ___________ ___________ Cash in banks ___________ ___________ ___________ Stocks/bonds ___________ ___________ ___________ Notes ___________ ___________ ___________ Real estate: Home: ___________ ___________ ___________ _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ Automobiles: _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ Other personal property: Contents of home ___________ ___________ ___________ Jewelry ___________ ___________ ___________ Life ins./cash surrender value ___________ ___________ ___________ Other assets: _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ _____________________ ___________ ___________ ___________ TOTAL ASSETS: $ _________ $ _________ $ _________ 4. The wife will keep as her own the assets found by this court to be marital assets in paragraph I.C.4.(a) of this final judgment and the husband shall have no further rights or responsibilities regarding that assets: [use more pages if needed] ASSETS Name on title/deed/account [✓ all that apply] Description Value Husband Wife Cash on hand __________ ___________ ___________ Cash in banks __________ ___________ ___________ Stocks/bonds __________ ___________ ___________ Notes __________ ___________ ___________ Real estate: Home: __________ ___________ ___________ _____________________ __________ ___________ ___________ _____________________ __________ ___________ ___________ _____________________ __________ ___________ ___________ Automobiles: _____________________ __________ ___________ ___________ _____________________ __________ ___________ ___________ _____________________ __________ ___________ ___________ Other personal property: Contents of home __________ ___________ ___________ Jewelry __________ ___________ ___________ Life ins./cash surrender value __________ ___________ ___________ Other assets: _____________________ __________ ___________ ___________ _____________________ __________ ___________ ___________ *1242 _____________________ __________ ___________ ___________ TOTAL ASSETS: $ ________ $ __________ $ _________ 5. The husband will keep as his own the debt(s) found by this court to be his nonmarital debt(s) in paragraph I.C.4.(b) of this final judgment and wife shall have no further responsibility for those debt(s). 6. The wife will keep as her own the property found by this court to be her nonmarital debt(s) in paragraph I.C.4.(c) of this final judgment and husband shall have no further responsibility for that debt. 7. The husband will keep as his own the following debt(s) found by this court to be marital debts in paragraph I.C.4.(a) of this final judgment and wife shall have no further responsibility for that debt: Name on title/deed/account [✓ all that apply] Description Balance Due Monthly payment Husband Wife House ____________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ *Credit Cards: No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ *give account number for each credit card 8. The wife will keep as her own the debt(s) found by this court to be marital debt(s) in paragraph I.C.4.(a) of this final judgment and husband shall have no further responsibility for that debt: Name on title/deed/account To whom/ [✓ all that apply] Description Balance Due Monthly payment Husband Wife House ____________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ *Credit Cards: No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ *give account number for each credit card *1243 9. ____ Pension, retirement, profit-sharing, annuity, deferred compensation, and insurance plans/program benefits are awarded through a separate domestic relations order which is attached. 10. This distribution of assets and debts between the husband and wife is equitable based on the following facts and reasoning: ______________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ C. SPOUSAL SUPPORT (ALIMONY) 1. Permanent periodic spousal support/alimony shall be awarded to the: [✓ one only] ____ husband or ____ wife, in the sum of ___________ dollars per ___________ or ____ in a lump sum amount to be paid on or before {date} _______________ or ____ in payments of $ ________ dollars per ________ plus in a lump sum amount to be paid on or before {date} ______________. 2. Rehabilitative periodic spousal support/alimony shall be awarded to the: [✓ one only] ____ husband or ____ wife, in the sum of __________ dollars per ___________ or ____ in a lump sum amount to be paid on or before {date} ________________ or ____ in payments of $ ___________ dollars per _________ plus in a lump sum amount to be paid on or before {date} _______________. This rehabilitative alimony will end on {date} ____________ [ circle one] and/or upon ___________ {condition} _________________________ ____________________________________________________________________________ 3. Lump sum spousal support/alimony shall be awarded to the: [✓ one only] ____ husband or ____ wife, in a lump sum amount of $ ________ to be paid on or before {date} ________________ or in ____ payments of $ ___________ dollars on {dates} _________________. 4. ____ Life insurance shall be maintained to protect this alimony award with the [✓ one only] ____ husband or ____ wife as owner and beneficiary as follows: [✓ one only] ____ none ordered or ____ by husband with a benefit amount of $ ___________ or ____ by wife with a benefit amount of $ ________. D. MINOR (under 18) CHILDREN OF THIS MARRIAGE [ fill in all blanks that apply] [✓ one only] 1. Parental responsibility over the minor child(ren) of the marriage, if any, shall be as follows: ____ a. There are no minor child(ren) of this marriage. ____ b. Shared by the parties. ____ c. Sole to {specify} ______________________________________________. ____ d. Other (e.g., certain decisions with one parent such as education, medical, religious training etc.). Parental decision making responsibility over the minor child(ren) shall be as follows: [✓ one only] ____ Shared to: [✓ one only] ____ father or ____ mother or ____ Other {Specify other person(s) and issue(s)}: ____________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____ Sole to: [✓ one only] ____ father or ____ mother or ____ Other {Specify other person(s) and ____ issue(s)}: _______________________________ ____________________________________________________________________________ ____________________________________________________________________________ *1244 2. Child visitation rights by the noncustodial parent shall be: [✓ one only] ____ There shall be no visitation by the noncustodial parent pending further orders from the court. ____ Liberal ____ Reasonable ____ Scheduled (schedule attached) ____ Supervised as scheduled (schedule attached) ____ As follows: ____ a. Alternating weekends from ____ p.m. on Fridays until ____ p.m. on Sundays. [✓ all that apply] (1) ____ if there is a school holiday on Friday, visitation will begin at ____ p.m. on Thursday. (2) ____ if there is a school holiday on Monday, visitation will continue until ____ p.m. on Monday. (3) ____ weekend visitation shall not change regardless of Friday or Monday school holidays. (4) ____ if there is a school holiday on Monday or Friday the entire weekend shall be treated as a holiday and alternated in odd and even years under the holiday part of this order. ____ b. One day of contact/visitation during the week in which there is no weekend visitation, for a period of ____ hours on the day of the week of _____________________. ____ c. Alternating legal holiday periods as follows which are also school holiday periods: ____ Spring Break [✓ one only] ____ odd years or ____ even years ____ Thanksgiving Holiday [✓ one only] ____ odd years or ____ even years ____ Winter Holiday period [✓ one only] ____ odd years or ____ even years (odd or even is established by the first day of the holiday) ____ Alternating other legal school holidays or religious holidays: {specify} __________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____ d. A continuous period during the summer for ____ weeks. Contact with the other parent during this summer period will be as follows: ____________________________________________________________________________ ____ e. Alternating the child(ren)'s respective birthdays. ____ f. Spending each parent's respective birthday with that parent. ____ g. Mother's Day and Father's Day with the appropriate parent. ____ h. Unlimited phone communications at reasonable hours. ____ i. Unlimited written communications. 3. ____ Child support of $ __________ to be paid by the [✓ one only] ____ husband or ____ wife [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly. This support shall continue until the first of the parties' minor children reaches the age of 18, or if the child(ren) are between the ages of 18 and 19 and are still in high school performing in good faith with a reasonable expectation of graduation, until the child(ren) reaches the age of 19. At that time the child support will be recomputed under the then-current Child Support Guidelines. 4. ____ Unusual or uninsured medical/dental expenses for the children be provided by: [✓ one only] ____ husband or ____ wife or ____ husband and wife each pay one-half 5. ____ Medical insurance to be provided by [✓ one only] ____ husband or ____ wife for the child(ren). 6. ____ Dental insurance to be provided by [✓ one only] ____ husband or ____ wife for the child(ren). *1245 7. ____ Life insurance shall be maintained for the benefit of the minor child(ren) as beneficiaries or as stated in the {name of trust} ___________ for the benefit of the minor children created {date} _____________ with the [✓ one only] ____ husband or ____ wife or other {specify} __________ as owner as follows: [✓ one only] ____ none ordered or ____ by husband with a benefit amount of $ _____ or ____ by wife with a benefit amount of $ ________. E. METHOD OF PAYMENT All payments of child support and alimony shall be as follows: [✓ check all which apply] ____ Directly to the person the court has ordered will be paid the support. ____ Payment will be through the Central Depository by the attached order Family Law Form 12.991(a). ____ Payment will be by income deduction order, Family Law Form 12.991(b), which is attached. F. ____ Attorneys' fees, suit money, and costs be awarded to: [✓ one only] ____ husband or ____ wife in the amount of $ _______ (fees) $ _______ (costs) $ _______ suit money. The basis for granting or denying this award and for the amount of any fees and costs awarded is given in the findings of fact in this judgment. G. [✓ one only] ____ yes or ____ no The Wife's former name of ______________ is restored. H. This court awards the petitioner the following further relief in this cause: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ I. The court reserves jurisdiction to enforce the terms of this order and all documents incorporated into it (e.g. parties' stipulation/agreement, child support guidelines worksheet, etc.). DONE and ORDERED in {name} ___________________ County, Florida, on {date} __________, 19__. ________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _____________________________ Address ___________________________ Address __________________________ ___________________________________ __________________________________ City State Zip City State Zip Telephone No. _____________________ Telephone No. ____________________ Telefax No. _______________________ Telefax No. ______________________ Other Name ______________________________ Address ___________________________ ___________________________________ City State Zip Telephone No. _____________________ Telefax No. _______________________ *1246 IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} _________________________ {city} ____________________ {state} _______, {phone} _________, helped {name} ____________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FAMILY LAW FORM 12.990(c), ORDER OF DISMISSAL DUE TO RECONCILIATION No instructions. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ ORDER OF DISMISSAL DUE TO RECONCILIATION The Court having been advised that the parties have RECONCILED, it is hereby: ORDERED AND ADJUDGED that the case is dismissed without prejudice. DONE and ORDERED in {name} __________________ County, Florida, on {date} ________________, 19__. ________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _____________________________ Address ___________________________ Address __________________________ ___________________________________ __________________________________ City State Zip City State Zip *1247 Telephone No. _____________________ Telephone No. ____________________ Telefax No. _______________________ Telefax No. ______________________ Other Name ______________________________ Address ___________________________ ___________________________________ City State Zip Telephone No. _____________________ Telefax No. _______________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _______________________________________, a nonlawyer, located at {street} _________________________ {city} ____________________ {state} _______, {phone} _________, helped {name} ____________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FAMILY LAW FORM 12.990(d), FINAL DEFAULT JUDGMENT OF DISSOLUTION OF MARRIAGE This form is to be used with Family Law Forms 12.922(a), Request to Enter Default and 12.922(b), Default, if the other party did not answer your petition. Once the default has been entered using those forms, you must ask for a hearing for the court to consider your request. See Family Law Form 12.923, Notice of Hearing (General Form). Even after a default has been entered the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). See Appendix 2 for information about the use of Family Law Form 12.990(d). You should fill out and bring this proposed order with you to the hearing. If the court rules in your favor, your proposed order usually will be signed at the hearing. NOTE: Many of the parts of Family Law Form 12.990(d) are choices and should be used only when they fit the facts of your case. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ FINAL DEFAULT JUDGMENT OF DISSOLUTION OF MARRIAGE [✓ check all which apply, fill in all blanks that apply] THIS CAUSE was heard on the Petition for Dissolution of Marriage, and the respondent, having failed to file a response to the petition or otherwise serve any paper in this action as required by the Florida Family Law Rules of Procedure; and the Court having reviewed the court file and the default entered against the Respondent, and having heard testimony and being otherwise fully informed and advised in the premises, hereby makes the following findings of fact and conclusions of law: *1248 I. FINDINGS OF FACTS [ fill in all blanks that apply] A. JURISDICTION/RESIDENCE 1. This court has jurisdiction over the subject matter and the parties. 2. At least one party has been a resident of the State of Florida for more than 6 months immediately before filing the Petition for Dissolution of Marriage. 3. The marriage between the parties is irretrievably broken. 4. Respondent was duly served by process of law and a default was properly entered. STATISTICAL FACTS [ fill in all blanks that apply] 1. Date of marriage: ____________________________________________________ 2. Place of marriage: ___________________________________________________ 3. Date of separation: __________________________________________________ C. MARITAL ASSETS AND DEBTS THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT THAT ADDRESS THE FACTORS LISTED IN SECTION 61.075, FLORIDA STATUTES, EXPLAINING WHY THE MARITAL ASSETS AND DEBTS ARE BEING DIVIDED THE WAY THIS ORDER SAYS AND IF THE DIVISION IS NOT EQUAL THE EXACT REASON(S) IT IS NOT. [ fill in all blanks that apply] [✓ all that apply] 1. ____ There are no marital assets or debts. 2. ____ All marital assets and debts have been divided by written agreement, which is attached. 3. ____ All assets and debts are listed in the Financial Affidavit filed in this case. ( Family Law Form 12.901(d) or 12.901(e)). 4. ____ The parties' assets and debts are listed below: (a) These are the parties' marital* assets and debts (what they own and what they owe): [Use more paper if needed] (*marital and nonmarital are explained in Appendix 2). MARITAL ASSETS Name on title/deed/account [✓ all that apply] Description Value Husband Wife Cash on hand __________ __________ __________ Cash in banks __________ __________ __________ Stocks/bonds __________ __________ __________ Notes __________ __________ __________ Real estate: Home: __________ __________ __________ ____________________ __________ __________ __________ ____________________ __________ __________ __________ ____________________ __________ __________ __________ Automobiles: ____________________ __________ __________ __________ ____________________ __________ __________ __________ ____________________ __________ __________ __________ Other personal property: Contents of home __________ __________ ___________ Jewelry __________ __________ ___________ Life ins./cash *1249 surrender value __________ __________ ___________ Other assets: ____________________ __________ __________ ___________ ____________________ __________ __________ ___________ ____________________ __________ __________ ___________ TOTAL ASSETS: $ ________ $ ________ $ _________ MARITAL DEBTS Name on title/deed/account To whom/ [✓ all that apply] Description Balance Due Monthly payment Husband Wife House ____________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ *Credit Cards:* No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ *give account number for each credit card (b) These are husband's nonmarital* assets and debts (what he owns and what he owes): [Use more paper if needed] (*marital and nonmarital are explained in Appendix 2). (c) These are wife's nonmarital* assets and debts (what she owns and what she owes): [Use more paper if needed] (*marital and nonmarital are explained in Appendix 2). 5. Pension/Retirement plans [✓ all that apply] ____ The husband has pension/retirement benefits that accrued during the marriage ____ The wife has pension/retirement benefits that accrued during the marriage ____ The husband should keep all of his pension/retirement benefits that accrued during the marriage ____ The wife should keep all of her pension/retirement benefits that accrued during the marriage ____ The court will distribute the parties' pension/retirement benefits by a qualified domestic relations order which is attached. D. SPOUSAL SUPPORT (ALIMONY) THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT THAT ADDRESS THE FACTORS LISTED IN SECTION *1250 61.08, FLORIDA STATUTES, WHEN GRANTING OR DENYING A REQUEST FOR ALIMONY. [ you must fill in 1 or 2 below] 1. ____ The spousal support/alimony request is DENIED. The basis for denying this award pursuant to section 61.08, Florida Statutes is: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 2. ____ The spousal support/alimony request is GRANTED. The basis for granting this award pursuant to section 61.08, Florida Statutes is: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ [✓ all that apply] 3. Permanent periodic spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. 4. Rehabilitative periodic spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. 5. Lump sum spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. 6. ____ Life insurance to secure this support is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay the insurance premiums. E. MINOR (under 18) CHILDREN OF THIS MARRIAGE [ fill in all blanks that apply] 1. Residential Responsibility [✓ one only] ____ There are no minor children. ____ The wife is pregnant. {due date} ___________________ ____ The wife is not pregnant. ____ The minor children are: Name Birth Date Age Sex Social Security No. ______________________ _____________ _______ _______ ___________________ ______________________ _____________ _______ _______ ___________________ ______________________ _____________ _______ _______ ___________________ ______________________ _____________ _______ _______ ___________________ [✓ all that apply] ____ a. A Uniform Child Custody Jurisdiction Act Affidavit ( Family Law Form 12.901(f)) is being filed with this court. *1251 ____ b. Florida is the home state of the minor child(ren) and accordingly it is the sole jurisdictional state to determine child custody, visitation, and support under the Uniform Child Custody Jurisdiction Act. ____ c. The parties should share parental responsibility for the minor child(ren). ____ d. Shared parental responsibility would be detrimental to the child(ren). Accordingly, sole parental responsibility should be ordered. The basis for ordering sole parental responsibility is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 2. Child Support a. Petitioner's net income is: _________. OR Petitioner's imputed net income is: ______, based upon the following: ____________________________________________________________________ ___________________________________________________________________. b. Respondent's net income is: _________. OR Respondent's imputed net income is: ______, based upon the following: ____________________________________________________________________ ____________________________________________________________________ ___________________________________________________________________. [✓ all that apply] ____ c. Child support should be set by Florida's child support guidelines (see section 61.30 Florida Statutes). ____ d. The calculations and conclusion included in the child support guidelines worksheet ( Family Law Form 12.901(g)) filed in this case by [✓ one only] ____ Petitioner or ____ Respondent are adopted by this court and incorporated in this order. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS WHY AWARDING THE AMOUNT OF CHILD SUPPORT REQUIRED BY SECTION 61.30, FLORIDA STATUTES, WOULD BE UNJUST OR INAPPROPRIATE IF THE AMOUNT AWARDED IS DIFFERENT FROM THE GUIDELINES AMOUNT BY PLUS OR MINUS FIVE PERCENT (5%). ____ e. Child support should not be set by Florida's child support guidelines (see section 61.30 Florida Statutes). The basis for ordering [✓ one only] ____ more or ____ less than the guidelines amount of child support pursuant to section 61.30, Florida Statutes is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________________________________________________________________. *1252 f. ____ Medical insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ husband or ____ wife for the child(ren) and [✓ one only] ____ husband or ____ wife should be required to provide it. g. ____ Dental insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ husband or ____ wife for the child(ren) and [✓ one only] ____ husband or ____ wife should be required to provide it. F. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT EXPLAINING WHY ATTORNEYS' FEES ARE BEING GRANTED AND EXPLAINING THE BASIS OF THE AMOUNT AWARDED. 1. The [✓ one only] ____ husband's or ____ wife's request for fees and costs is DENIED. 2. The [✓ one only] ____ husband's or ____ wife's request for fees and costs is GRANTED. [✓ all that apply] ____ Attorneys' fees, ____ suit money, and/or ____ costs be awarded to: [✓ one only] ____ husband or ____ wife. The basis for granting this award and for the determination of the amount is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ THEREFORE it is ORDERED AND ADJUDGED: II. CONCLUSIONS OF LAW A. JURISDICTION 1. The parties shall be granted a Dissolution of Marriage upon the basis of: [✓ one only] ____ The parties' marriage is irretrievably broken. ____ Mental incapacity of one of the parties and the parties are restored to the status of being single. 2. [✓ one only] ____ yes or ____ no The Marital Settlement Agreement, which has been filed in this case, is ratified and made a part of this judgment, and the parties are ordered to obey all of its provisions. B. MARITAL AND NONMARITAL ASSETS AND DEBTS AS PRESENTLY KNOWN [ fill in all blanks that apply] 1. The husband will keep as his own the assets found by this court to be his nonmarital assets in paragraph I.C.4.(b) of this final judgment and the wife shall have no further rights or responsibilities regarding that assets. 2. The wife will keep as her own the assets found by this court to be her nonmarital assets in paragraph I.C.4.(c) of this final judgment and the husband shall have no further rights or responsibilities regarding that assets. 3. The husband will keep as his own the following assets found by this court to be marital assets in paragraph I.C.4.(a) of this final judgment and the wife shall have no further rights or responsibilities regarding that assets: [use more pages if needed] *1253 ASSETS Name on title/deed/account [✓ all that apply] Description Value Husband Wife Cash on hand ____________ ____________ ____________ Cash in banks ____________ ____________ ____________ Stocks/bonds ____________ ____________ ____________ Notes ____________ ____________ ____________ Real estate: Home: ____________ ____________ ____________ ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ Automobiles: ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ Other personal property: Contents of home ____________ ____________ ____________ Jewelry ____________ ____________ ____________ Life ins./cash surrender value ____________ ____________ ____________ Other assets: ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ TOTAL ASSETS: $ __________ $ __________ $ __________ 4. The wife will keep as her own the assets found by this court to be marital assets in paragraph I.C.4.(a) of this final judgment and the husband shall have no further rights or responsibilities regarding that assets: [use more pages if needed] ASSETS Name on title/deed/account [✓ all that apply] Description Value Husband Wife Cash on hand ____________ ____________ ____________ Cash in banks ____________ ____________ ____________ Stocks/bonds ____________ ____________ ____________ Notes ____________ ____________ ____________ Real estate: Home: ____________ ____________ ____________ ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ Automobiles: ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ ____________________ ____________ ____________ ____________ Other personal property: Contents of home ____________ ____________ ____________ Jewelry ____________ ____________ ____________ Life ins./cash surrender value ____________ ____________ ____________ Other assets: *1254 ___________________ ____________ ____________ ____________ ___________________ ____________ ____________ ____________ ___________________ ____________ ____________ ____________ TOTAL ASSETS: $ __________ $ __________ $ __________ 5. The husband will keep as his own the debt(s) found by this court to be his nonmarital debt(s) in paragraph I.C.4.(b) of this final judgment and wife shall have no further responsibility for those debt(s). 6. The wife will keep as her own the property found by this court to be her nonmarital debt(s) in paragraph I.C.4.(c) of this final judgment and husband shall have no further responsibility for that debt. 7. The husband will keep as his own the following debt(s) found by this court to be marital debts in paragraph I.C.4.(a) of this final judgment and wife shall have no further responsibility for that debt: Name on title/deed/account [✓ all that apply] Description Balance Due Monthly payment Husband Wife House ____________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ *Credit Cards: No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ *give account number for each credit card 8. The wife will keep as her own the debt(s) found by this court to be marital debt(s) in paragraph I.C.4.(a) of this final judgment and husband shall have no further responsibility for that debt: Name on title/deed/account To whom/ [✓ all that apply] Description Balance Due Monthly payment Husband Wife House ____________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ Car ______________ $ _____________ $ _____________ ___________ _________ *Credit Cards: No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ No. ______________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ __________________ $ _____________ $ _____________ ___________ _________ *1255 * give account number for each credit card 9. ____ Pension, retirement, profit-sharing, annuity, deferred compensation, and insurance plans/program benefits are awarded through a separate domestic relations order which is attached. 10. This distribution of assets and debts between the husband and wife is equitable based on the following facts and reasoning: _____________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ C. SPOUSAL SUPPORT (ALIMONY) 1. Permanent periodic spousal support/alimony shall be awarded to the: [✓ one only] ____ husband or ____ wife, in the sum of _______________ dollars per ____________ or ____ in a lump sum amount to be paid on or before {date} ______________ or ____ in payments of $ _____________ dollars per __________ plus in a lump sum amount to be paid on or before {date} _______________. 2. Rehabilitative periodic spousal support/alimony shall be awarded to the: [✓ one only] ____ husband or ____ wife, in the sum of _______________ dollars per ______________ or ____ in a lump sum amount to be paid on or before {date} _______________ or ____ in payments of $ ______________ dollars per _____________ plus in a lump sum amount to be paid on or before {date} ______________. This rehabilitative alimony will end on {date} _______________ [ circle one] and/or upon {condition} ____________________ ___________________________________________________________________________ 3. Lump sum spousal support/alimony shall be awarded to the: [✓ one only] ____ husband or ____ wife, in a lump sum amount of $ ______________ to be paid on or before {date} or in ____ payments of $ _____________ dollars on {dates} _____________. 4. ____ Life insurance shall be maintained to protect this alimony award with the [✓ one only] ____ husband or ____ wife as owner and beneficiary as follows: [✓ one only] ____ none ordered or ____ by (husband with a benefit amount of $ _______________ or ____ by wife with a benefit amount of $ _______________. D. MINOR (under 18) CHILDREN OF THIS MARRIAGE [ fill in all blanks that apply] [✓ one only] 1. Parental responsibility over the minor child(ren) of the marriage, if any, shall be as follows: ____ a. There are no minor child(ren) of this marriage. ____ b. Shared by the parties. ____ c. Sole to {specify} ______________________________________________ ____ d. Other (e.g., certain decisions with one parent such as education, medical, religious training etc.). Parental decision making responsibility over the minor child(ren) shall be as follows: [✓ one only] ____ Shared to: [✓ one only] ____ father or ____ mother or Other {Specify other person(s) and issue(s)}: ____________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ____ Sole to: [✓ one only] ____ father or ____ mother or Other {Specify other person(s) and issue(s)}: ____________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ *1256 2. Child visitation rights by the noncustodial parent shall be: [✓ one only] ____ There shall be no visitation by the noncustodial parent pending further orders from the court. ____ Liberal ____ Reasonable ____ Scheduled (schedule attached) ____ Supervised as scheduled (schedule attached) ____ As follows: ____ a. Alternating weekends from ____ p.m. on Fridays until ____ p.m. on Sundays. [✓ all that apply] (1) ____ if there is a school holiday on Friday, visitation will begin at ____ p.m. on Thursday. (2) ____ if there is a school holiday on Monday, visitation will continue until ____ p.m. on Monday. (3) ____ weekend visitation shall not change regardless of Friday or Monday school holidays. (4) ____ if there is a school holiday on Monday or Friday the entire weekend shall be treated as a holiday and alternated in odd and even years under the holiday part of this order. ____ b. One day of contact/visitation during the week in which there is no weekend visitation, for a period of ____ hours on the day of the week of _________________. ____ c. Alternating legal holiday periods as follows which are also school holiday periods: ____ Spring Break [✓ one only] ____ odd years or ____ even years ____ Thanksgiving Holiday [✓ one only] ____ odd years or ____ even years ____ Winter Holiday period [✓ one only] ____ odd years or ____ even years (odd or even is established by the first day of the holiday) ____ Alternating other legal school holidays or religious holidays: {specify} _________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ____ d. A continuous period during the summer for ____ weeks. Contact with the other parent during this summer period will be as follows: __________________________________________________________________ ___________________________________________________________________________ ____ e. Alternating the child(ren)'s respective birthdays. ____ f. Spending each parent's respective birthday with that parent. ____ g. Mother's Day and Father's Day with the appropriate parent. ____ h. Unlimited phone communications at reasonable hours. ____ i. Unlimited written communications. 3. ____ Child support of $ ________ to be paid by the [✓ one only] ____ husband or ____ wife [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly. This support shall continue until the first of the parties' minor children reaches the age of 18, or if the child(ren) are between the ages of 18 and 19 and are still in high school performing in good faith with a reasonable expectation of graduation, until the child(ren) reaches the age of 19. At that time the child support will be recomputed under the then-current Child Support Guidelines. *1257 4. ____ Unusual or uninsured medical/dental expenses for the children be provided by: [✓ one only] ____ husband or ____ wife or ____ husband and wife each pay one-half. 5. ____ Medical insurance to be provided by [✓ one only] ____ husband or ____ wife for the child(ren). 6. ____ Dental insurance to be provided by [✓ one only] ____ husband or ____ wife for the child(ren). 7. ____ Life insurance shall be maintained for the benefit of the minor child(ren) as beneficiaries or as stated in the $name of trust$ ____________ for the benefit of the minor children created $date$ _____________ with the [✓ one only] ____ husband or ____ wife or other $specified$ _______________ as owner as follows: [✓ one only] ____ none ordered or ____ by husband with a benefit amount of $ _________ or ____ by wife with a benefit amount of $ ______________. E. METHOD OF PAYMENT All payments of child support and alimony shall be as follows: [✓ check all which apply] ____ Directly to the person the court has ordered will be paid the support. ____ Payment will be through the Central Depository by the attached order Family Law Form 12.991(a). ____ Payment will be by income deduction order, Family Law Form 12.991(b), which is attached. F. ____ Attorneys' fees, suit money, and costs be awarded to: [✓ one only] ____ husband or ____ wife in the amount of $ _________ (fees) $ _________ (costs) $ _________ suit money. The basis for granting or denying this award and for the amount of any fees and costs awarded is given in the findings of fact in this judgment. G. [✓ one only] ____ yes or ____ no The Wife's former name of ________________ is restored. H. This court awards the petitioner the following further relief in this cause: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ I. The court reserves jurisdiction to enforce the terms of this order and all documents incorporated into it (e.g. parties' stipulation/agreement, child support guidelines worksheet, etc.). DONE and ORDERED in {name} _______________ County, Florida, on {date} __________, 19__. ________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _________________________________ Address ___________________________ Address ______________________________ ___________________________________ ______________________________________ City State Zip City State Zip Telephone No. _____________________ Telephone No. ________________________ Telefax No. _______________________ Telefax No. __________________________ Other Name ______________________________ Address ___________________________ ___________________________________ *1258 City State Zip Telephone No. _____________________ Telefax No. _______________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer}, ____________________________, a nonlawyer, located at {street} __________________ {city} ____________________ {state} _______, {phone} ___________, helped {name} _____________________, who is the [✓ one only] ____ petitioner or respondent, fill out this form. INSTRUCTIONS FOR FAMILY LAW FORMS 12.991(a), ORDER REQUIRING PAYMENT OF CHILD SUPPORT THROUGH THE CENTRAL DEPOSITORY AND 12.991(b), CHILD SUPPORT INCOME DEDUCTION ORDER 1. PAYEE: the person to whom the court ordered support is paid. 2. OBLIGOR: the person who is ordered by the court, obligated, to pay support to the payee. 3. PAYOR: the person who actually pays the money to the payee. What you may find confusing in Family Law Forms 12.991(a) and (b) and others which says things about child and/or spouse support is that sometimes the obligor and the payor are the same person and sometimes the obligor and the payor are two different people. These examples may help you understand why. Example: The obligor and payor are the same person. If Joe is ordered to pay Sue child support and he pays the money to Sue or to the central depository for Sue than Joe is both the payor (the person who actually pays the money to Sue who is the payee) and Joe is the obligor (The person who is ordered by the court, or obligated, to pay support to Sue the payee). Example: The obligor and the payor are two separate people. If Joe is ordered to pay Sue child support and Joe's boss is ordered to take the money right from Joe's wages and send it to Sue or to the central depository for Sue than Joe's boss is the payor (the person who actually pays the money to Sue who is the payee) and Joe is the obligor (The person who is ordered by the court, or obligated, to pay support to the payee). ORDERS DIRECTING PAYMENT THROUGH THE CENTRAL DEPOSITORY The central depository collects and distributes all alimony and child support paid into it. It keeps proper records of the how much money was paid, the date the money was paid, how much money it sent to the payee, the date the money was sent to the payee, and how much money is past due. The office of the clerk of the court runs the central depository. After the court has decided how much child support and/or alimony will be paid, you should fill out this form order, filling in all the blanks that fit your case and showing how much money should be paid and if it is paid straight to you or to the central depository first and then to you. You must then give this form order to the court for the hearing officer's or judge's signature. You can take the form order with you to court for the support hearing and if the court makes its decision right then, you may be able to fill the form out and have it signed at that time. Be sure you have filled in as many of the blanks as you can before the hearing (like the obligor, payee and payor information). Once the order is signed, the depository keeps track of the payments made and sent out, keeping a written record for any later court hearings. For further information, see section 61.181, Florida Statutes. INCOME DEDUCTION ORDERS Income deduction is when the court ordered support comes straight from the obligor's wages. When the court enters an order is entered beginning, enforcing, or changing a spouse *1259 or child support duty, the court must enter a separate order for income deduction. This order must follow with section 61.1301, Florida Statutes. In this order, the obligor is the person who has been ordered to pay spouse and/or child support. The order makes the obligor's boss (whoever pays the obligor his/her wages) pays the court ordered support from the obligor's wages/earnings. Because the obligor's boss is paying the support duty the obligor's boss is the payor. $ This form orders the person, company, or organization giving wages/earnings to the obligor to keep a certain amount of the money that the obligor should get each time the obligor is paid and send it to the central depository to be paid to you. You must fill out this form order and give it to the judge. After the income deduction order is signed, you should mail a copy of the order to the payor (the person or business paying wages to the obligor), by prepaid certified mail, return receipt requested. You can take the form order with you to court for the support hearing and if the court makes its decision right then, you may be able to fill the form out and have it signed at that time. Be sure you have filled in as many of the blanks as you can before the hearing (like the obligor, payee and payor information). Objecting to an Income Deduction Order • Within 15 days after service of a notice of delinquency, you may ask for a hearing to object to the enforcement of the income deduction order because of mistake of fact regarding the amount of support owed under the court's support order, the amount of arrearages (payments that are past due) of support, or identity of the obligor (the person who must pay the money). See section 61.1301(2), Florida Statutes, for additional information. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR _____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ ORDER REQUIRING PAYMENT THROUGH CENTRAL DEPOSITORY [✓ check all which apply, fill in all blanks that apply] IT IS ORDERED AND ADJUDGED that all payments of child support shall be as follows: ____ Obligor will make the payments ordered — Fill out A & B below, NOT C. ____ Payment will be by income deduction order and payor is not the obligor — Fill out A, B, & C. *1260 A. PAYOR INFORMATION 1. Name: __________________________ DOB: _________________________________ Social Security No: ____________ Phone: _______________________________ Street: ________________________________________________________________ City: __________________________ State: _________________ Zip: ________ 2. Employer: ______________________ Phone: _______________________________ Street: ________________________________________________________________ City: __________________________ State: __________________ Zip: _______ Other sources of income: _______________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ B. PAYEE INFORMATION Name: __________________________ DOB: _________________________________ Social Security No: ____________ Phone: _______________________________ Street: ________________________________________________________________ City: __________________________ State: _________________ Zip: ________ 2. Children for whom support is to be paid: Name Date of Birth Age Sex Social Security No. ____________________ _____________ _____ _______ ______________________ ____________________ _____________ _____ _______ ______________________ ____________________ _____________ _____ _______ ______________________ ____________________ _____________ _____ _______ ______________________ ____________________ _____________ _____ _______ ______________________ C. PAYOR INFORMATION (fill out only if payor is NOT obligor) 1. Name (obligor's employer): _____________________________________________ Named agent for service: _______________________________________________ Street: ________________________________________________________________ City: __________________________ State: _________________ Zip: _________ Telephone: _____________________ Telefax: ______________________________ D. MANNER AND METHOD OF PAYMENT [✓ check all which apply, fill in amount, pay period and number of children] 1. Regular Child Support [✓ one only] ____ The payor shall pay the sum of $ ____ per ____ for ____ children, plus the clerk's processing fee as set forth in paragraph 8 below. ____ The payor shall pay the sum of $ ____ per ____ for ____ children, from which the clerk shall deduct its processing fee. 2. Past Due Child Support/Arrearages. ____ The payor shall pay the sum of $ ____ per ____ for ____ children, and the clerk's processing fee, for past due child support. This payment for past due child support shall last for ___________ months/years, until all past due support, fees to the central depository and interest are paid. Interest on past due child support shall be added to obligor's debt at the rate of _____% per annum until paid. *1261 3. Alimony [✓ one only] ____ The payor shall pay the sum of $ ____ per ____ for alimony, plus the clerk's processing fee as set forth in paragraph 8 below. ____ The payor shall pay the sum of $ ____ per ____ for alimony, from which the clerk shall deduct the processing fee. 4. Past Due Alimony/Arrearages. ____ The payor shall pay the sum of $ ____ per _________, plus the clerk's processing fee for past due alimony. This payment for past due alimony shall last for ____ months until all past due alimony is paid. 5. Payments shall begin on the date of entry of this order and payments shall continue to be made the way this order says they will be paid and in the amount this order says will be paid unless and until this court orders something else. 6. Payments shall be sent to: CLERK OF COURT, CENTRAL DEPOSITORY Address ______________________ ______________________________ City State Zip Telephone No. ________________ Telefax No. __________________ 7. Payment shall be made by cash, check, or money order. For identification and accounting purposes, you must write the court case number on each payment made by check or money order and be attached on a separate sheet of paper with any case payment. If payment is made by check, the clerk may require the payor to fill out a form. 8. Any depository processing fees as allowed in section 61.181, Florida Statutes, shall be paid with each payment. The amount of the service fee is 4% of the total payment, but not less than $1.25 nor more than $5.25. 9. The parties affected by this order must tell the central depository right away if there is any change of name, address, employer, place of employment, or source of income. DONE and ORDERED in {name} _______________ County, Florida, on {date} ___________, 19__. ________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _________________________________ Address ___________________________ Address ______________________________ ___________________________________ ______________________________________ City State Zip City State Zip Telephone No. _____________________ Telephone No. ________________________ Telefax No. _______________________ Telefax No. __________________________ Other Name ______________________________ Address ___________________________ ___________________________________ City State Zip Telephone No. _____________________ Telefax No. _______________________ *1262 IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________, a nonlawyer, located at {street} _________________ {city} __________________ {state} ________, {phone} ___________, helped {name} ___________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR _____________ COUNTY, FLORIDA Case No.: ____________________ Division: ____________________ _______________________________, Petitioner and _______________________________, Respondent. ____________________________\ CHILD SUPPORT INCOME DEDUCTION ORDER [✓ check all which apply, fill in all blanks that apply] THIS COURT entered an order on ______________ establishing support obligations owed by the obligor, {name} _______________, whose social security number is ____________. In compliance with section 61.1301, Florida Statutes, IT IS ADJUDGED: INCOME DEDUCTION: From all income due and payable to obligor __________, the following amounts shall be deducted: A. ONGOING SUPPORT: 1. ____ Child support of $ ________ [✓ one only] each pay period: ____ weekly ____ biweekly ____ twice a month ____ monthly 2. ____ Spousal support of $ _________ [✓ one only] each pay period: ____ weekly ____ biweekly ____ twice a month ____ monthly B. PAST DUE SUPPORT/ARREARAGE: Payments of previously ordered support not paid. 1. ____ Child support of $ _________ [✓ one only] each pay period: ____ weekly ____ biweekly ____ twice a month ____ monthly 2. ____ Spousal support of $ __________ [✓ one only] each pay period: ____ weekly ____ biweekly ____ twice a month ____ monthly 3. TOTAL: $ __________ is past due. 4. INTEREST: of ____% through __________, 19__. Interest continues to accrue at the rate of 12% annually on the unpaid principal, or $ __________ per day. 5. PAYMENT OF PAST DUE CHILD/SPOUSAL SUPPORT: An additional $ __________ shall be withheld each pay period: [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly until full payment is made of this arrearage with interest. C. RETROACTIVE SUPPORT: The court has ordered that the new support amount began on the date the petition asking for it was filed. Retroactive support is the difference between how much support was paid from the date the petition was filed to the date the order was entered *1263 and how much support would have been paid if the new amount had begun when the petition was filed. 1. ____ Child support of $ _________ [✓ one only] each pay period: ____ weekly ____ biweekly ____ twice a month ____ monthly 2. ____ Spousal support of $ _______ [✓ one only] each pay period: ____ weekly ____ biweekly ____ twice a month ____ monthly 3. TOTAL: $ __________ is past due. 4. PAYMENT OF PAST DUE CHILD/SPOUSAL SUPPORT: An additional $ __________ shall be withheld each pay period: [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly until full payment is made of this retroactive support. D. PAST PUBLIC ASSISTANCE: 3. TOTAL: $ __________ past public assistance was awarded in this matter and is due and owing. 4. PAYMENT OF PAST DUE CHILD/SPOUSAL SUPPORT: An additional $ __________ shall be withheld each pay period: [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly until full payment is made of this past public assistance. E. ATTORNEYS' FEES AND COSTS: obligor has been ordered to pay to the payee ____ attorneys' fees in the amount of $ ______ and ____ costs in the amount of $ ______ totalling $ __________. Immediately after support arrearages in subsection (1)(b) are paid in full, an additional $ __________ shall be withheld each pay period: [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly until full payment is made. If there is no support arrearage, this amount shall be withheld immediately. F. SERVICE FEE: Any depository service fees as provided in section 61.181, Florida Statutes shall be paid with each payment. The amount of the service fee is 4% of the total payment, but not less than $1.25 nor more than $5.25. G. AMOUNT OF DEDUCTION: The total amount to be withheld [add (a)-(f) above] each pay period is $ __________, or ____ 55% ____ 65% of the disposable income of the obligor, whichever is lower. H. PLACE OF PAYMENT: The payor (obligor's employer) shall make the total amount in (g) above payable to and send it directly to: CLERK OF COURT, CENTRAL DEPOSITORY Street: _______________________________________________________________ City: _______________________ State: _____________________ Zip: _______ Telephone: __________________ Telefax: _______________________________. I. CONSUMER CREDIT PROTECTION ACT: The maximum amount to be deducted shall not exceed amounts allowed under section 303(b) of the Consumer Credit Protection Act, 15 U.S.C. section 1673(b), as amended. The maximum amount to be deducted shall not exceed 50% of the disposable income where there is a second family, 60% where there is not second family, and an additional 5% of either limit if the arrearage equals or exceeds 12 weeks of support payments. A copy of the Consumer Credit Protection Act is attached to and made a part of this order. J. EFFECTIVE DATE: This income deduction order ____ shall become effective immediately OR ______ shall be effective upon a delinquency in an amount equal to one month's support $ ______. A Notice to Payor and a Statement of Rights, Remedies, and Duties of the Obligor are attached to and made a part of this order. K. DURATION: This income deduction order supersedes any income deduction order that may have been entered earlier in this case. This order shall stay in effect unless and until it is changed by this court or until the support duty ends by operation of law. *1264 L. ATTORNEYS' FEES: This court reserves jurisdiction for an award of attorneys' fees, costs, and suit money incurred by the payee regarding the entry of this order. CONSUMER CREDIT PROTECTION ACT GARNISHMENT RESTRICTIONS (a) Except as provided in subsection (b) of this section, the total disposable earnings of a person for any workweek which can be garnished (kept from the obligor and sent directly to the payee) cannot be more than: (1) 25% of obligor's disposable earnings for that week, or (2) the amount by which obligor's disposable earnings for that week exceed 30 times the Federal minimum hourly wage prescribed by section 206(a) of Title 29 in effect at the time the earnings are payable, whichever is less. In the case of earnings for any pay period other than a week, the Secretary of Labor shall by regulation prescribe a multiple of the federal minimum hourly wage equivalent in effect to that set forth in paragraph (2). EXCEPTIONS (b)(1) The restrictions of subsection (a) of this section do not apply in the case of: (A) any order for the support of any person issued by a court of competent jurisdiction or in accordance with an administrative procedure, which is established by state law, affords substantial due process, and is subject to judicial review. (B) any order of any court of the United States having jurisdiction over cases under Chapter 13 of Title 12. (C) any debt due for a state or federal tax. (2) The total disposable earnings of a person for any workweek which can be garnished (kept from the obligor and sent directly to the payee) cannot be more than: (A) when such individual is supporting a spouse or dependent child (other than a spouse or child with respect to whose support such order is used), 50% of such individual's disposable earnings for that week; and (B) when such individual is not supporting such a spouse or dependent child described in clause (A), 60% of such individual's disposable earnings for that week; except that, with respect to the disposable earnings of any individual for any workweek, the 50% specified in clause (A) shall be deemed to be 55% and the 60% specified in clause (B) shall be deemed to be 65%, if and to the extent that such earnings are subject to garnishment to enforce a support order with respect to a period which is prior to the twelve-week period which ends with the beginning of such workweek. (c) Execution or enforcement of garnishment order or process is prohibited. No court of the United States or any state, and no state (or officer or agency thereof), may make, execute, or enforce any order of process in violation of this section. *1265 NOTICE TO PAYOR [✓ check all which apply, fill in all blanks that apply] RE: Obligor's name: _____________________ SSN: __________________ YOU ARE HEREBY NOTIFIED: 1. Deduction from Obligor's Income. You are required to begin an income deduction in compliance with the income deduction order entered by the court and pay that amount to the payee or the depository, whichever the court order setting support says to make payment to. A copy of that order and any notice of delinquency is enclosed for your payroll records. The amount actually deducted, plus all administrative charges, shall not be in excess of the amount allowed under section 303(b) of the Consumer Credit Protection Act, 15 U.S.C. section 1673(b). If payment is ordered through the court depository, payments shall be made payable to and send it directly to: CLERK OF COURT, CENTRAL DEPOSITORY Address ______________________ ______________________________ City State Zip Telephone No. ________________ Telefax No. __________________ Each payment must have the obligor's name and case number clearly written on it. 2. Effective Date. You must begin the income deduction no later than the first payment date which occurs more than 14 days after the date you get this notice. 3. Forward Payments. You must send to the payee or the court depository (whichever the court order says to send payments to), within 2 days after each payment date, the amount to be kept from the obligor's wages/income and a statement saying if the money sent pays all or part of the payment due as set out in the income deduction order or notice of delinquency, and giving the exact date the money was taken from the obligor's wages/income and sent to the payee directly or through the central depository. 4. Your Liability. If you do not take out the right amount of money from the obligor's wages/income, you are liable for the money you should have kept out, and costs, interest, and reasonable attorneys' fees. 5. Your Costs. You may take out and keep from the obligor's wages/income an additional $5.00 for the first deduction and $2.00 for each deduction after that to cover your administrative costs. 6. Duration. The income deduction order and this [✓ one only] ____ notice to payor OR ____ notice of delinquency are binding upon you until released in writing by the payee, by court order, or until you stop giving wages/income to the obligor. 7. Duty to Report. Penalty if You Do Not. You must tell the ____ payee ____ depository when you are no longer giving wages/income to the obligor. You must also give the obligor's last-known address, and the name and address of the obligor's ____ new payor ____ new employer, if known. You face a civil penalty not to exceed $250.00 for the first violation and $500.00 for any violation after that if you do not give tell the payee/depository obligor's new payor/employer if you know it. Penalties shall be paid to the payee. 8. Duty to Cooperate. Penalty if You Do Not. You may not discharge/fire, refuse to employ, or take disciplinary action against an obligor because of an income deduction order. *1266 You face a civil penalty not to exceed $200.00 for the first violation or $500.00 for any violation after that. Penalties shall be paid to the payee if any support is owing. If no support is owing, the penalty shall be paid to the obligor. 9. Obligor's Rights. The obligor may bring a civil action against you if you refuse to employ the obligor, discharge the obligor, or otherwise discipline the obligor because of an income deduction order. The obligor is entitled to reinstatement and all wages and benefits lost, plus reasonable attorneys' fees and costs. 10. Priority Under Law. The income deduction order has priority over all other legal processes under state law pertaining to the same income. Payment in compliance with the income deduction order is a complete defense by you against any claims of the obligor or obligor's creditors as to the sums paid. 11. Your Convenience. When you get income deduction orders requiring that the income of 2 or more obligors be deducted and sent to the same depository, you may combine the amounts that are to be paid to the depository in a single payment as long as you clearly identify the portion of the payment that is for to each obligor. 12. Conflict. If you receive more than one income deduction order against the same obligor, contact the court for further instructions. STATEMENT OF RIGHTS, REMEDIES, AND DUTIES IN REGARD TO INCOME DEDUCTION ORDER [✓ check all which apply, fill in all blanks that apply] A. Fees of $ ________ shall be imposed. Interest of $ ________ shall be imposed. B. UNTIL the total arrearage, retroactive support, interest, costs and fees are paid in full $ ________ shall be deducted from each pay period: [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly. AFTER all of those amounts are paid in full $ ________ shall be deducted from each pay period: [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly. The amounts deducted may not be in excess of that allowed under section 303(b) of the Consumer Credit Protection Act, 15 U.S.C. section 1673(b), as amended. C. The income deduction order applies to current and subsequent payors and periods of employment. D. A copy of the income deduction order will be served on the obligor's payor or payors. E. Enforcement of the income deduction order may be contested only on the ground of mistake of fact regarding the amount of support owed pursuant to a support order, the arrearage, or the identity of the obligor. F. The obligor is required to notify the payee within 7 days of changes in the obligor's address and payors and the addresses of his payors. DONE and ORDERED in {name} _______________ County, Florida, on {date} ___________, 19__. ________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _________________________________ Address ___________________________ Address ______________________________ ___________________________________ ______________________________________ *1267 City State Zip City State Zip Telephone No. _____________________ Telephone No. ________________________ Telefax No. _______________________ Telefax No. __________________________ Clerk of the Central Depository Payor or their attorney (if represented) Name ______________________________ Name _________________________________ Address ___________________________ Address ______________________________ ___________________________________ ______________________________________ City State Zip City State Zip Telephone No. _____________________ Telephone No. ________________________ Telefax No. _______________________ Telefax No. __________________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ___________________________, a nonlawyer, located at {street} _________________ {city} ________________ {state} ________, {phone} ___________, helped {name} _________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.993, FINAL JUDGMENT OF MODIFICATION OF PARENTAL RESPONSIBILITY AND VISITATION You should fill out and bring this proposed order with you to the hearing. If the court rules in your favor, your proposed order usually will be signed at the hearing. NOTE: Many of the parts of Family Law Form 12.993 are choices and should be used only when they fit the facts of your case. This form can also be used with Family Law Forms 12.922(a), Request to Enter Default and 12.922(b), Default, if the other party did not answer your petition. If the default has been entered using those forms and you must ask for a hearing for the court to consider your request. See Family Law Form 12.923, Notice of Hearing (General Form). Even after a default has been entered, the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). To use Family Law Form 12.993 as a Final Default Judgment of Modification of Parental Responsibility and Visitation just check ✓ WAS in BOTH PLACES (if true) in paragraph 3. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR _____________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ __________________________________, Petitioner and __________________________________, Respondent. ___________________________\ *1268 FINAL JUDGMENT OF MODIFICATION OF PARENTAL RESPONSIBILITY AND VISITATION THIS CAUSE, was heard on {date} _______________ upon the Petition for Modification of Parental Responsibility and/or Visitation. The court, having heard the testimony of the parties and appropriate witnesses, having reviewed the pleadings contained in the court file, and being more fully advised and informed, hereby makes the following findings of fact and conclusions of law: [✓ all that apply] 1. The Court has jurisdiction of the parties and the subject matter of this proceeding. 2. Florida is the home state of the minor child(ren) or there is significant connection with this State and accordingly it has jurisdiction to determine child custody, visitation, and support under the Uniform Child Custody Jurisdiction Act. 3. Respondent [✓ one only] ____ was or ____ was not duly served by process of law and a default, Family Law Form 12.922(b), ____ was or ____ was not properly entered. 4. The last order governing primary parental responsibility or visitation was entered on {date} _______________. A copy of that order is attached. 5. There [✓ one only] ____ has or ____ has not been a substantial change in the circumstances of the parties since the entry of the last order governing primary parental responsibility or visitation, specifically, ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________. 6. It [✓ one only] ____ is or ____ is not in the best interest of the minor child(ren) that the current parenting arrangement be changed because: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 7. Child Support [ fill in all blanks that apply] a. Petitioner's net income is: __________. OR Petitioner's imputed net income is: __________, based upon the following: ________________________________________________________________________ ________________________________________________________________________ b. Respondent's net income is: __________. OR Respondent's imputed net income is: __________, based upon the following ________________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________. [✓ all that apply] ____ c. Child support should be set by Florida's child support guidelines (see section 61.30 Florida Statutes). ____ d. The calculations and conclusion included in the child support guidelines worksheet Family Law Form 12.901(g) filed in this case by [✓ one only] ____ petitioner or ____ respondent are adopted by this court and incorporated in this order. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS WHY AWARDING THE AMOUNT OF CHILD SUPPORT REQUIRED BY SECTION 61.30, FLORIDA STATUTES, WOULD BE UNJUST OR INAPPROPRIATE IF THE AMOUNT AWARDED IS DIFFERENT FROM THE GUIDELINES AMOUNT BY PLUS OR MINUS FIVE PERCENT (5%). *1269 ____ e. Child support should not be set by Florida's child support guidelines (see section 61.30 Florida Statutes). The basis for ordering [✓ one only] ____ more or ____ less than the guidelines amount of child support pursuant to section 61.30, Florida Statutes is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________________________________________________________________. f. ____ Medical insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ petitioner or ____ respondent for the child(ren) and [✓ one only] ____ petitioner or ____ respondent should be required to provide it. g. ____ Dental insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ petitioner or ____ respondent for the child(ren) and [✓ one only] ____ petitioner or ____ respondent should be required to provide it. 8. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT EXPLAINING WHY ATTORNEYS' FEES ARE BEING GRANTED AND EXPLAINING THE BASIS OF THE AMOUNT AWARDED. [✓ all that apply] ____ Attorneys' fees, ____ suit money, and/or ____ costs be awarded to: [✓ one only] ____ petitioner or ____ respondent. The basis for granting this award and for the determination of the amount is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________________________________________________________________. Therefore, upon consideration of the above findings, it is hereby ORDERED AND ADJUDGED that: A. The Petition/Request to Modify/Change Primary Residency/Custody of child(ren) is [✓ one only] ____ GRANTED or ____ DENIED based on the findings of fact regarding changed circumstances and best interests of the child set out previously in this order. B. PRIMARY RESIDENCY/VISITATION [ fill in all blanks that apply] [✓ one only] 1. Parental responsibility over the minor child(ren) shall be changed as follows: ____ a. Primary Residency to {specify} _________________________________ ____ b. Sole to {specify} ______________________________________________ ____ c. Other (e.g., certain decisions with one parent such as education, medical, religious training etc.). Parental decision making responsibility over the minor child(ren) shall be as follows: [✓ one only] ____ Shared to: [✓ one only] ____ father or ____ mother or ____ Other {Specify other person(s) and issue(s)}: ____________________________________ ___________________________________________________________________________ *1270 ____ Sole to: [✓ one only] ____ father or ____ mother or ____ Other {Specify other person(s) and issue(s)}: ____________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 3. Child visitation rights by the noncustodial parent shall be: [✓ one only] ____ There shall be no visitation by the noncustodial parent pending further orders from the court. ____ Liberal ____ Reasonable ____ Scheduled (schedule attached) ____ Supervised as scheduled (schedule attached) ____ As follows: ____ a. Alternating weekends from ____ p.m. on Fridays until ____ p.m. on Sundays. [✓ all that apply] (1) ____ if there is a school holiday on Friday, visitation will begin at ____ p.m. on Thursday. (2) ____ if there is a school holiday on Monday visitation will continue until ____ p.m. on Monday. (3) ____ weekend visitation shall not change regardless of Friday or Monday school holidays. (4) ____ if there is a school holiday on Monday or Friday the entire weekend shall be treated as a holiday an alternated in odd and even years under the holiday part of this order. ____ b. One day of contact/visitation during the week in which there is no weekend visitation, for a period of _______ hours on the day of the week of _________________. ____ c. Alternating legal holiday periods as follows which are also school holiday periods: ____ Spring Break [✓ one only] ____ odd years or ____ even years ____ Thanksgiving Holiday [✓ one only] ____ odd years or ____ even years ____ Winter Holiday period [✓ one only] ____ odd years or ____ even years (odd or even is established by the first day of the holiday) ____ Alternating other legal school holidays or religious holidays: {specify} _________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ____ d. A continuous period during the summer for ____ weeks. Contact with the other parent during this summer period will be as follows: ___________________________________________________________________________ ____ e. Alternating the child(ren)'s respective birthdays. ____ f. Spending each parent's respective birthdays with that parent. ____ g. Mother's Day and Father's Day with the appropriate parent. ____ h. Unlimited phone communications at reasonable hours. ____ i. Unlimited written communications. *1271 C. CHILD SUPPORT 1. ____ Child support of $ ________ to be paid by the [✓ one only] ____ petitioner or ____ respondent [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly. This support shall continue until the first of the parties' minor children reaches the age of 18, or if the child(ren) are between the ages of 18 and 19 and are still in high school performing in good faith with a reasonable expectation of graduation, until the child(ren) reaches the age of 19. At that time the child support will be recomputed under the then-current Child Support Guidelines. 2. ____ Unusual or uninsured medical/dental expenses for the children be provided by: [✓ one only] ____ petitioner or ____ respondent or ____ petitioner and respondent each pay one-half 3. ____ Medical insurance to be provided by [✓ one only] ____ petitioner or ____ respondent for the child(ren). 4. ____ Dental insurance to be provided by [✓ one only] ____ petitioner or ____ respondent for the child(ren). 5. ____ Life insurance shall be maintained for the benefit of the minor child(ren) as beneficiaries or as stated in the {name of trust} _______ __________ for the benefit of the minor children created {date} _______ _________ with the [✓ one only] ____ petitioner or ____ respondent or other {specify} _____________ as owner as follows: [✓ one only] ____ none ordered or ____ by petitioner with a benefit amount of $ _____________ or ____ by respondent with a benefit amount of $ ______________. 6. All payments of child support shall be as follows: [✓ check all which apply] ____ Directly to the person the court has ordered will be paid the support. ____ Payment will be through the Central Depository by the attached order Family Law Form 12.991(a). ____ Payment will be by income deduction order, Family Law Form 12.991(b), which is attached. D. ____ Attorneys' fees, suit money, and costs be awarded to: [✓ one only] ____ petitioner or ____ respondent in the amount of $ __________ (fees) $ __________ (costs) $ __________ suit money. The basis for granting or denying this award and for the amount of any fees and costs awarded is given in the findings of fact in this judgment. E. This court awards the petitioner the following further relief in this cause: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ F. The court reserves jurisdiction to enforce the terms of this order and all documents incorporated into it (e.g., parties' stipulation/agreement, child support guidelines worksheet, etc.). DONE and ORDERED in {name} _______________________ County, Florida, on {date} ___________, 19__. ______________________________________ CIRCUIT JUDGE cc: *1272 Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _________________________________ Address ___________________________ Address ______________________________ ___________________________________ ______________________________________ City State Zip City State Zip Telephone No. _____________________ Telephone No. ________________________ Telefax No. _______________________ Telefax No. __________________________ Other Name ______________________________ Address ___________________________ ___________________________________ City State Zip Telephone No. _____________________ Telefax No. _______________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ______________________________________, a nonlawyer, located at {street} ___________________________ {city} ____________________ {state} ____________, {phone} ______________, helped {name} ______________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FLORIDA FAMILY LAW FORM 12.994(a), FINAL JUDGMENT AWARDING SUPPORT UNCONNECTED WITH DISSOLUTION OF MARRIAGE In Florida, the court can order a person who is living apart from their spouse and child(ren) (whether or not the separation is that person's fault), to pay support for them. When the court orders support unconnected with dissolution, it will establish the child(ren)'s primary residency and the custody and visitation rights of the parents. See section 61.10, Florida Statutes for more information about receiving support unconnected with dissolution of marriage, Appendix 2, for information about child custody and visitation, and Appendix 3, for information about child support. You should fill out and bring this proposed order with you to the hearing. If the court rules in your favor, your proposed order usually will be signed at the hearing. NOTE: Many of the parts of Family Law Form 12.994(a) are choices and should be used only when they fit the facts of your case. This form can also be used with Family Law Forms 12.922(a), Request to Enter Default and 12.922(b), Default, if the other party did not answer your petition. If the default has been entered using those forms and you must ask for a hearing for the court to consider your request. See Family Law Form 12.923, Notice of Hearing (General Form). Even after a default has been entered, the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). To use Family Law Form 12.994(a) as a Final Default Judgment Awarding Support Unconnected with Dissolution of Marriage/Divorce, just check ✓ WAS in BOTH PLACES (if true) in paragraph 3. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. *1273 IN THE CIRCUIT COURT OF THE ______________ JUDICIAL CIRCUIT, IN AND FOR __________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ __________________________________, Petitioner and __________________________________, Respondent. ____________________________\ FINAL JUDGMENT AWARDING SUPPORT UNCONNECTED WITH DISSOLUTION OF MARRIAGE THIS CAUSE, was heard on {date} _________________ upon the Petition/Request for Support Unconnected with Dissolution of Marriage. The court, having heard the testimony of the parties and appropriate witnesses, having reviewed the pleadings contained in the court file, and being more fully advised and informed, makes the following findings of fact and conclusions of law: A. JURISDICTION 1. The Court has jurisdiction of the parties and the subject matter of this proceeding. 2. Florida is the home state of the minor child(ren) or there is significant connection with this State and accordingly it has jurisdiction to determine child custody, visitation, and support under the Uniform Child Custody Jurisdiction Act. A Uniform Child Custody Jurisdiction Act Affidavit (Florida Family Law Form 12.901(f)) has been filed with the court. 3. Respondent [✓ one only] ____ was or ____ was not duly served by process of law and a default, Family Law Form 12.922(b), ____ was or ____ was not properly entered. B. STATISTICAL FACTS [ fill in all blanks that apply] 1. Date of marriage: _________________________ 2. Place of marriage: ________________________ 3. Date of separation: _______________________ 4. Minor (under 18) children of this marriage [ fill in all blanks that apply] [✓ one only] ____ There are no minor children. ____ The wife is pregnant. $due date$ _______________ ____ The wife is not pregnant. ____ The minor children are: Name Birth Date Age Sex Social Security No. ____________________ _____________ _____ _______ ______________________ ____________________ _____________ _____ _______ ______________________ ____________________ _____________ _____ _______ ______________________ ____________________ _____________ _____ _______ ______________________ [✓ all that apply] ____ a. A Uniform Child Custody Jurisdiction Act Affidavit ( Family Law Form 12.901(f)) is being filed with this court. *1274 ____ b. Florida is the home state of the minor child(ren) and accordingly it is the sole jurisdictional state to determine child custody, visitation, and support under the Uniform Child Custody Jurisdiction Act. ____ c. The parties should share parental responsibility for the minor child(ren). ____ d. Shared parental responsibility would be detrimental to the child(ren). Accordingly, sole parental responsibility should be ordered. The basis for ordering sole parental responsibility is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ C. SPOUSAL SUPPORT THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT THAT ADDRESS THE FACTORS LISTED IN SECTION 61.08, FLORIDA STATUTES, WHEN GRANTING OR DENYING A REQUEST FOR ALIMONY. [ you must fill in 1 or 2 below] 1. ____ The spousal support/alimony request is DENIED. The basis for denying this award pursuant to section 61.08, Florida Statute is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 2. ____ The spousal support/alimony request is GRANTED. The basis for granting this award pursuant to section 61.08, Florida Statute is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ [✓ all that apply] 3. Permanent periodic spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. 4. Rehabilitative periodic spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. 5. Lump sum spousal support/alimony is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay that support. *1275 6. ____ Life insurance to secure this support is needed by the [✓ one only] ____ husband or ____ wife and the [✓ one only] ____ husband or ____ wife is financially able to pay the insurance premiums. D. CHILD SUPPORT 1. Petitioner's net income is: ______________. OR Petitioner's imputed net income is: ___________, based upon the following: ______________________________________________________________________ _____________________________________________________________________. 2. Respondent's net income is: __________. OR Respondent's imputed net income is: __________, based upon the following ______________________________________________________________________ ______________________________________________________________________ _____________________________________________________________________. [✓ all that apply] ____ 3. Child support should be set by Florida's child support guidelines (see section 61.30 Florida Statutes). ____ 4. The calculations and conclusion included in the child support guidelines worksheet ( Family Law Form 12.901(g)) filed in this case by [✓ one only] ____ Petitioner or ____ Respondent are adopted by this court and incorporated in this order. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS WHY AWARDING THE AMOUNT OF CHILD SUPPORT REQUIRED BY SECTION 61.30, FLORIDA STATUTES, WOULD BE UNJUST OR INAPPROPRIATE IF THE AMOUNT AWARDED IS DIFFERENT FROM THE GUIDELINES AMOUNT BY PLUS OR MINUS FIVE PERCENT (5%). ____ 5. Child support should not be set by Florida's child support guidelines (see section 61.30 Florida Statutes). The basis for ordering [✓ one only] ____ more or ____ less than the guidelines amount of child support pursuant to section 61.30, Florida Statutes is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________________________________________________________________. 6. ____ Medical insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ husband or ____ wife for the child(ren) and [✓ one only] ____ husband or ____ wife should be required to provide it. 7. ____ Dental insurance [✓ one only] ____ is or ____ is not reasonably available to the [✓ one only] ____ husband or ____ wife for the child(ren) and [one only] ____ husband or ____ wife should be required to provide it. E. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT EXPLAINING WHY ATTORNEYS' FEES ARE BEING GRANTED AND EXPLAINING THE BASIS OF THE AMOUNT AWARDED. [✓ all that apply] ____ Attorneys' fees, ____ suit money, and/or ____ costs be awarded to: [✓ one only] ____ husband or ____ wife. *1276 The basis for granting this award and for the determination of the amount is: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ THEREFORE it is ORDERED AND ADJUDGED: II. CONCLUSIONS OF LAW A. JURISDICTION 1. The court has jurisdiction over the parties and the subject matter of this case. B. SPOUSAL SUPPORT 1. Periodic spousal support/alimony shall be awarded to the: [✓ one only] ____ husband or ____ wife, in the sum of ______________ dollars per ____________ or in a lump sum amount of $ ____________ to be paid on or before {date} __________ or in ____ payments of $ __________ dollars on {dates} ______________________________________________________________ _______________________________________________________________________. 2. ____ Life insurance shall be maintained to protect this alimony award with the [✓ one only] ____ husband or ____ wife as owner and beneficiary as follows: [✓ one only] ____ none ordered or ____ by husband with a benefit amount of $ _____________ or ____ by wife with a benefit amount of $ _______________. C. MINOR (under 18) CHILDREN OF THIS MARRIAGE [ fill in all blanks that apply] [✓ one only] 1. Parental responsibility over the minor child(ren) of the marriage, if any, shall be as follows: ____ a. There are no minor child(ren) of this marriage. ____ b. Shared by the parties. ____ c. Sole to {specify} _____________. ____ d. Other (e.g., certain decisions with one parent such as education, medical, religious training etc.). Parental decision making responsibility over the minor child(ren) shall be as follows: [✓ one only] ____ Shared to: [✓ one only] ____ father or ____ mother or ____ Other {Specify other person(s) and issue(s)}: ___________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ____ Sole to: [✓ one only] ____ father or ____ mother or ____ Other {Specify other person(s) and issue(s)}: ___________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 2. Child visitation rights by the noncustodial parent shall be: [✓ one only] ____ There shall be no visitation by the noncustodial parent pending further orders from the court. ____ Liberal ____ Reasonable ____ Scheduled (schedule attached) ____ Supervised as scheduled (schedule attached) *1277 ____ As follows: ____ a. Alternating weekends from ______ p.m. on Fridays until ______ p.m. on Sundays. [✓ all that apply] (1) ____ if there is a school holiday on Friday, visitation will begin at ____ p.m. on Thursday. (2) ____ if there is a school holiday on Monday, visitation will continue until ____ p.m. on Monday. (3) ____ weekend visitation shall not change regardless of Friday or Monday school holidays. (4) ____ if there is a school holiday on Monday or Friday the entire weekend shall be treated as a holiday and alternated in odd and even years under the holiday part of this order. ____ b. One day of contact/visitation during the week in which there is no weekend visitation, for a period of ________ hours on the day of the week of _______________. ____ c. Alternating legal holiday periods as follows which are also school holiday periods: ____ Spring Break [✓ one only] ____ odd years or ____ even years ____ Thanksgiving Holiday [✓ one only] ____ odd years or ____ even years ____ Winter Holiday period [✓ one only] ____ odd years or ____ even years (odd or even is established by the first day of the holiday) ____ Alternating other legal school holidays or religious holidays: {specify} _________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ____ d. A continuous period during the summer for ____ weeks. Contact with the other parent during this summer period will be as follows: ___________________________________________________________________________. ____ e. Alternating the child(ren)'s respective birthdays. ____ f. Spending each parent's respective birthday with that parent. ____ g. Mother's Day and Father's Day with the appropriate parent. ____ h. Unlimited phone communications at reasonable hours. ____ i. Unlimited written communications. 3. ____ Child support of $ ________ to be paid by the [✓ one only] ____ husband or ____ wife [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly. This support shall continue until the first of the parties' minor children reaches the age of 18, or if the child(ren) are between the ages of 18 and 19 and are still in high school performing in good faith with a reasonable expectation of graduation, until the child(ren) reaches the age of 19. At that time the child support will be recomputed under the then-current Child Support Guidelines. 4. ____ Unusual or uninsured medical/dental expenses for the children be provided by: [✓ one only] ____ husband or ____ wife or ____ husband and wife each pay one-half *1278 5. ____ Medical insurance to be provided by [✓ one only] ____ husband or ____ wife for the child(ren). 6. ____ Dental insurance to be provided by [✓ one only] ____ husband or ____ wife for the child(ren). 7. ____ Life insurance shall be maintained for the benefit of the minor child(ren) as beneficiaries or as stated in the {name of trust} ________________ for the benefit of the minor children created {date} ______________ with the [✓ one only] ____ husband or ____ wife or other {specify} ____________ as owner as follows: [✓ one only] ____ none ordered or ____ by husband with a benefit amount of $ _____________ or ____ by wife with a benefit amount of $ _____________. D. This court awards the petitioner the following further relief in this cause: ___________________________________________________________________________ ___________________________________________________________________________ E. The court reserves jurisdiction to enforce the terms of this order and all documents incorporated into it (e.g., parties' stipulation/agreement, child support guidelines worksheet, etc.). DONE and ORDERED in {name} _________________ County, Florida, on {date} ___________, 19__. ______________________________________ CIRCUIT JUDGE cc: Petitioner or their attorney Respondent or their attorney (if represented) (if represented) Name ______________________________ Name _________________________________ Address ___________________________ Address ______________________________ ___________________________________ ______________________________________ City State Zip City State Zip Telephone No. _____________________ Telephone No. ________________________ Telefax No. _______________________ Telefax No. __________________________ Other Name ______________________________ Address ___________________________ ___________________________________ City State Zip Telephone No. _____________________ Telefax No. _______________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} ___________________________, a nonlawyer, located at {street} _________________________ {city} __________________ {state} _______, {phone} ___________, helped {name} ________________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. INSTRUCTIONS FOR FAMILY LAW FORM 12.994(b), FINAL JUDGMENT MODIFYING CHILD SUPPORT See Appendix 3 for how to fill out this form. You should fill out and bring this proposed order with you to the hearing. If the court rules in your favor, your proposed order usually will be signed at the hearing. NOTE: Many of the parts of Family Law Form 12.994(b) are choices and should be used only when they fit the facts of your case. *1279 This form can also be used with Family Law Forms 12.922(a), Request to Enter Default and 12.922(b), Default, if the other party did not answer your petition. If the default has been entered using those forms and you must ask for a hearing for the court to consider your request. See Family Law Form 12.923, Notice of Hearing (General Form). Even after a default has been entered, the other party must be given notice of the hearing because the court must determine the best interest of the child(ren). To use Family Law Form 12.994(b) as a Final Default Judgment of Modification of Child Support just check ✓ WAS in BOTH PLACES (if true) in paragraph 3. A person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of Family Law Form 12.900, Disclosure from Nonlawyer, before they help you. Anyone helping you fill out these forms also must put their name, address, and telephone number on the bottom of the last page of every form they help you fill out. IN THE CIRCUIT COURT OF THE __________ JUDICIAL CIRCUIT, IN AND FOR _________ COUNTY, FLORIDA Case No.: ____________________________ Division: ____________________________ __________________________________, Petitioner and __________________________________, Respondent. ______________________________\ FINAL JUDGMENT MODIFYING CHILD SUPPORT [✓ check all which apply, fill in all blanks that apply] THIS CAUSE was heard on _______________ upon the ____ Petitioner's ____ Respondent's Petition for Modification of Child Support. Having heard the testimony of the parties, having reviewed the court file in this action and financial affidavits of the parties and being otherwise fully advised, it is: 1. The Court has jurisdiction of the parties and the subject matter of this proceeding. 2. Florida is the home state of the minor child(ren) or there is significant connection with this State and accordingly it has jurisdiction to determine child custody, visitation, and support under the Uniform Child Custody Jurisdiction Act. 3. Respondent [✓ one only] ____ was or ____ was not duly served by process of law and a default, Family Law Form 12.922(b), ____ was or ____ was not properly entered. 4. The last order governing child support was entered on $date] __________. A copy of that order is attached. 5. There [✓ one only] ____ has or ____ has not been a substantial change in the circumstances of the parties since the entry of the last order governing child support, specifically, ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ *1280 6. It [✓ one only] ____ is or ____ is not in the best interest of the minor child(ren) that the current child support order be changed because: ________________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________. 7. Child Support [ fill in all blanks that apply] a. Petitioner's net income is: ______________. OR Petitioner's imputed net income is: __________, based upon the following: ________________________________________________________________________ _______________________________________________________________________. b. Respondent's net income is: ____________. OR Respondent's imputed net income is: ______________, based upon the following ______________________________________________________________ ________________________________________________________________________ _______________________________________________________________________. [✓ all that apply] ____ c. Child support should be set by Florida's child support guidelines (see section 61.30 Florida Statutes). ____ d. The calculations and conclusion included in the child support guidelines worksheet Family Law Form 12.901(g) filed in this case by [✓ one only] ____ petitioner or ____ respondent are adopted by this court and incorporated in this order. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS WHY AWARDING THE AMOUNT OF CHILD SUPPORT REQUIRED BY SECTION 61.30, FLORIDA STATUTES, WOULD BE UNJUST OR INAPPROPRIATE IF THE AMOUNT AWARDED IS DIFFERENT FROM THE GUIDELINES AMOUNT BY PLUS OR MINUS FIVE PERCENT (5%). ____ e. Child support should not be set by Florida's child support guidelines (see section 61.30 Florida Statutes). The basis for ordering [✓ one only] ____ more or ____ less than the guidelines amount of child support pursuant to section 61.30, Florida Statutes is: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ _____________________________________________________________________. f. Past Due Child Support/Arrearages. The [✓ one only] ____ petitioner or ____ respondent has a total child support arrearage of $ ________, this is based upon payments missed on the following dates in the following amounts __________________________________________ ___________________________________________________________________ ___________________________________________________________________ g. ____ Medical insurance [✓ one only] ____ is or is not reasonably available to the [✓ one only] ____ petitioner or ____ respondent for the child(ren) and [✓ one only] ____ petitioner or ____ respondent should be required to provide it. *1281 h. ____ Dental insurance [✓ one only] ____ is or is not reasonably available to the [✓ one only] ____ petitioner or ____ respondent for the child(ren) and [✓ one only] ____ petitioner or ____ respondent should be required to provide it. 8. THE COURT MUST MAKE SPECIFIC, WRITTEN FINDINGS OF FACT EXPLAINING WHY ATTORNEYS' FEES ARE BEING GRANTED AND EXPLAINING THE BASIS OF THE AMOUNT AWARDED. 1. ____ The [✓ one only] ____ husband's or ____ wife's request for fees and costs is DENIED. 2. ____ The [✓ one only] ____ husband's or ____ wife's request for fees and costs is GRANTED. [✓ all that apply] ____ Attorneys' fees, ____ suit money, and/or ____ costs be awarded to: [✓ one only] ____ petitioner or ____ respondent. The basis for granting this award and for the determination of the amount is: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Therefore, upon consideration of the above findings, it is hereby ORDERED AND ADJUDGED that: A. The Petition/Request to Modify Child Support is [✓ one only] ____ GRANTED or ____ DENIED. B. CHILD SUPPORT 1. ____ Child support of $ ____ to be paid by the [✓ one only] ____ petitioner or ____ respondent [✓ one only] ____ weekly ____ biweekly ____ twice a month ____ monthly. This support shall continue until the first of the parties' minor children reaches the age of 18, or if the child(ren) are between the ages of 18 and 19 and are still in high school performing in good faith with a reasonable expectation of graduation, until the child(ren) reaches the age of 19. At that time the child support will be recomputed under the then-current Child Support Guidelines. 2. ____ The [✓ one only] ____ petitioner or ____ respondent shall pay the sum of $ ____ per ____ for ____ children, for past due child support. This payment for past due child support shall last for ____ months/years, until all past due support and interest are paid. Interest on past due child support shall be added to obligor's debt at the rate of ____% per annum until paid. 3. ____ Unusual or uninsured medical/dental expenses for the children be provided by: [✓ one only] ____ petitioner or ____ respondent or ____ petitioner and respondent each pay one-half 4. ____ Medical insurance to be provided by [✓ one only] ____ petitioner or ____ respondent for the child(ren). 5. ____ Dental insurance to be provided by [✓ one only] ____ petitioner or ____ respondent for the child(ren). *1282 6. ____ Life insurance shall be maintained for the benefit of the minor child(ren) as beneficiaries or as stated in the {name trust} ____ for the benefit of the minor children created {date} ____ with the [✓ one only] ____ petitioner or ____ respondent or other {specify} ____ as owner as follows: [✓ one only] ____ none ordered or ____ by petitioner with a benefit amount of $ ____ or ____ by respondent with a benefit amount of $ ____. 8. All payments of child support and alimony shall be as follows: [✓ check all which apply] ____ Directly to the person the court has ordered will be paid the support. ____ Payment will be through the Central Depository by the attached order Family Law Form 12.991(a). ____ Payment will be by income deduction order, Family Law Form 12.991(b), which is attached. C. ____ Attorneys' fees, suit money, and costs be awarded to: [✓ one only] ____ petitioner or ____ respondent in the amount of $ ___ (fees) $ ____ (costs) $ ____ suit money. The basis for granting or denying this award and for the amount of any fees and costs awarded is given in the findings of fact in this judgment. D. This court awards the petitioner the following further relief in this cause: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ F. The court reserves jurisdiction to enforce the terms of this order and all documents incorporated into it (e.g., parties' stipulation/agreement, child support guidelines worksheet, etc.). DONE and ORDERED in {name} ______________________ County, Florida, on {date} _______________, 19__. ______________________________ CIRCUIT JUDGE cc: Petitioner or their attorney (if represented) Respondent or their attorney (if represented) Name _________________________________ Name _________________________ Address ______________________________ Address ______________________ ______________________________________ ______________________________ City State Zip City State Zip Telephone No. ________________________ Telephone No. ________________ Telefax No. __________________________ Telefax No. __________________ Other Name ______________________________________ Address ___________________________________ ___________________________________________ City State Zip Telephone No. _____________________________ Telefax No. _______________________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM TO GIVE TO THE JUDGE TO SIGN, THE NONLAWYER WHO HELPED YOU MUST FILL IN THE BLANKS BELOW: [ fill in all blanks] I, {name of nonlawyer} _________________________, a nonlawyer, located at {street} ___________________ {city} ______________________ {state} ____, {phone} _______, helped {name} ________, who is the [✓ one only] ____ petitioner or ____ respondent, fill out this form. *1283 APPENDIX 1 SIMPLIFIED DISSOLUTION INFORMATION TABLE OF CONTENTS I. INTRODUCTION FOR SIMPLIFIED DISSOLUTION OF MARRIAGE (DIVORCE) II. WHAT IS THIS APPENDIX ABOUT? III. ARE YOU SURE YOUR MARRIAGE CAN'T BE SAVED? IV. SOME TERMS YOU NEED TO KNOW V. DIFFERENCES BETWEEN SIMPLIFIED AND REGULAR DISSOLUTION OF MARRIAGE VI. WHO CAN USE THE SIMPLIFIED DISSOLUTION OF MARRIAGE PROCEDURE? VII. WHAT STEPS DO YOU HAVE TO GO THROUGH TO GET A SIMPLIFIED DISSOLUTION OF MARRIAGE? VIII. WHAT SHOULD BE INCLUDED IN THE FINANCIAL AFFIDAVIT? IX. WHAT SHOULD BE INCLUDED IN THE PROPERTY SETTLEMENT AGREEMENT? X. SHOULD YOU SEE A LAWYER? XI. SOME GENERAL ADVICE XII. SPECIAL INSTRUCTIONS I. INTRODUCTION FOR SIMPLIFIED DISSOLUTION OF MARRIAGE (DIVORCE) It is important that both the husband and the wife read and understand this entire appendix before using the Simplified Dissolution of Marriage (also known as divorce) Procedures. Please carefully follow the instructions. Both the husband and the wife should read and understand this appendix and its instructions before starting this procedure. You should note that the clerk's office can only supply you with this booklet and the necessary forms. A clerk will assist you in the filling out of these forms; however, the clerk is not permitted to advise you of any legal rights you may have or the legal consequences of using this Simplified Dissolution of Marriage Procedure. The judge assigned to your case is also prohibited by law from giving you or your spouse any legal advice or assistance. The judge will not explain any legal consequences of using this simplified dissolution of marriage procedure. Therefore, do not ask the clerk or the judge for any recommendations or legal advice. This procedure is meant to provide a simple, inexpensive dissolution of marriage in very limited circumstances for persons who are eligible to use it. Part VI of this appendix will explain who may use the simplified dissolution of marriage procedure. *1284 You should fill out the forms yourself. If, however, someone helps you fill out the forms, that person should not give you advice on your rights or obligations unless he or she is a licensed Florida attorney. That is to protect you from getting bad advice from someone who is not trained in legal matters. IF THERE IS ANY DOUBT IN YOUR MIND OR YOUR SPOUSE'S CONCERNING A LEGAL QUESTION ABOUT EITHER YOUR RIGHT TO DIVORCE OR ANY PROPERTY RIGHTS OR TAX CONSEQUENCES, IT IS STRONGLY RECOMMENDED THAT THE SERVICES OF AN ATTORNEY BE OBTAINED. IF YOU DO NOT KNOW AN ATTORNEY, YOU SHOULD CONTACT THE LAWYER REFERRAL SERVICE LISTED IN THE YELLOW PAGES OF THE TELEPHONE BOOK. IF YOU ARE FINANCIALLY UNABLE TO AFFORD THE SERVICES OF AN ATTORNEY, YOU SHOULD CONTACT THE LEGAL AID OFFICE IN YOUR AREA OR ASK YOUR LOCAL BAR ASSOCIATION FOR A REFERRAL TO AN APPROPRIATE PERSON OR AGENCY. See Part X for more details about how a lawyer can help you. II. WHAT IS THIS APPENDIX ABOUT? This appendix describes a way to end a marriage through a divorce procedure called Simplified Dissolution of Marriage. The official word for divorce in Florida is dissolution. There are two (2) ways of getting a divorce, or dissolution, in Florida. The usual way is called a regular dissolution of marriage. A shorter and easier way — what this appendix is about — is called a simplified dissolution of marriage. The second method is shorter and easier, but not everybody can use it. Briefly, a simplified dissolution of marriage is possible for couples (when at least one of them has lived in the State of Florida for the 6 months immediately before the filing): (1) Who both agree that their marriage is irretrievably broken and want to end their marriage because of serious permanent differences; and (2) Who must be able to appear before a circuit court clerk to sign the petition for simplified dissolution of marriage and, later, to appear before a judge; and (3) Who have no minor (under 18) or dependent children together, and the wife is not pregnant; and (4) Who have made provisions about how belongings, assets, and property, and their debts are going to be divided once they are no longer married to each other. Both the husband and wife will have to appear in court before a judge who will consider their petition. This dissolution procedure is started by preparing and filing a Petition for Simplified Dissolution of Marriage with the circuit court clerk in your county. This booklet will tell you: (1) Where to turn for help if you want to save your marriage. (2) Who can use the simplified dissolution of marriage procedure. (3) What steps you have to go through to get a simplified dissolution of marriage. (4) When it would help to see a lawyer. (5) What risks you take when you use this simplified procedure rather than the Regular Dissolution of Marriage procedure. *1285 If you wish to use the simplified dissolution of marriage procedure, it is important for you to read this entire appendix very carefully. Save this appendix. If you decide to file for a simplified dissolution of marriage, it will tell you how to complete the procedure. If you fail to complete the procedure the court may dismiss the action to clear its records. III. ARE YOU SURE YOUR MARRIAGE CAN'T BE SAVED? Before you take any legal steps to end your marriage you should make sure that you have thought of all possible ways of saving it. Do you want professional help in working out ways to save your marriage? Many communities and many social and religious organizations offer marriage counseling services. If you believe your marriage can be saved, explore all possible steps for a reconciliation (getting back together) before beginning this simplified dissolution of marriage procedure. You may wish to consult with a marriage counselor, psychologist, psychiatrist, minister, priest, rabbi, or other qualified person. IV. SOME TERMS YOU NEED TO KNOW In the following pages, you will often see the terms marital assets, nonmarital assets, marital obligations, and equitable distribution. Those terms are explained in this section. As a married couple, you are, in the eyes of the law, a single unit. There are certain things which you own together, rather than separately, and there may be debts which you owe together. If one of you buys something on credit, under certain circumstances the other one can be made to pay. If your marriage breaks up, you become two separate individuals again. Before that can happen, you will have to decide what to do with the things that you own as a couple and the debts that you owe as a couple. The laws that cover these questions contain the terms marital assets, marital obligations, nonmarital assets, and nonmarital obligations. To understand what these terms mean, you should have a clear idea of the time you lived together as husband and wife. This is the period of time after you got married and before you separated. It may not be easy to decide exactly when you separated. In most cases, the day of your separation was the day you stopped living together. You might want to choose the day when you definitely decided to get a divorce as your official date of separation. (1) Marital Asset: Everything that a husband and wife acquire during the marriage. In most cases it includes the following: (a) Money that you now have which either of you earned during the time you were living together as husband and wife. (b) Anything either of you bought with money earned during that period. (c) Vested and nonvested benefits, rights, and funds earned during the marriage in a retirement pension, profit sharing, annuity, deferred compensation, and/or insurance plan and program. (d) Increase in value and appreciation of nonmarital assets resulting either from the efforts of either spouse or from the contribution of marital monies or other forms of marital assets. *1286 (e) Interspousal gifts (gifts from one of you to the other) during the marriage. (f) All real property (house, land) held as tenancy by entireties (held as husband and wife), whether obtained before or during the marriage. (2) Nonmarital Asset/Separate Property: Everything that a husband or wife owns separately, including: (a) Anything that you owned before you got married. (b) Anything you earned or received after your separation. (c) Anything that either of you received, as a gift (other than from or to each other) or by inheritance, at any time. (3) Marital Obligation: Debts that a husband and wife took on during the time they were living together as husband and wife. (If you bought furniture on credit while you were married and living together, the unpaid balance is a part of your marital obligations.) (4) Equitable Distribution: The husband's and wife's entitlement to each receive a fair share of the marital property. V. DIFFERENCES BETWEEN SIMPLIFIED AND REGULAR DISSOLUTION OF MARRIAGE With a regular dissolution each spouse has the right to ask questions and obtain documents concerning the other spouse's income, expenses, assets, and liabilities before having a trial or settlement of their case. With a simplified dissolution of marriage you may request financial information but it is not required. With a regular dissolution, if there is no agreement about property or other matters, a judge conducts a trial or hearing. The judge listens to all the evidence concerning the dissolution of marriage and then makes a decision concerning the division of property and other matters. A husband or wife may ask for a new trial or appeal the judge's decision. In a simplified dissolution, there is no trial and no appeal. With a regular dissolution, the judge may order one spouse to pay support (alimony) for the other — either for a period of time or permanently (until death or remarriage). With a simplified dissolution neither husband nor wife can receive alimony (support) from the other spouse regardless of how much income one person has and how much the other person may need support. There are, however, some cases in which divorce agreements under a simplified dissolution can be challenged. Correcting mistakes and unfairness in a simplified dissolution proceeding can be expensive, time consuming, and difficult. It is very important for both spouses to be honest, cooperative, and careful when you or your lawyers do the paperwork for the dissolution. VI. WHO CAN USE THE SIMPLIFIED DISSOLUTION OF MARRIAGE PROCEDURE? A husband and wife can get a divorce through the simplified dissolution of marriage procedure only if ALL of the following statements are true about both spouses at the time they jointly file the petition for simplified dissolution of marriage. Check this list very carefully. If even one of these statements is not true for you, you CANNOT use this way of getting a divorce. ____ 1. We have no minor (under 18) or dependent children. *1287 ____ 2. We have no adopted children under 18 years of age. ____ 3. The wife is not pregnant. ____ 4. At least one of us has lived in Florida for the past six months. ____ 5. We have made provision for the division of our property and the payment of our obligations, and are satisfied with them. ____ 6. We both have signed the joint petition and all other papers needed to carry out this procedure and paid the required fees to the clerk of the circuit court. ____ 7. We both want to end the marriage because it is irretrievably broken (there are serious permanent differences between us which cannot be fixed). ____ 8. We both have agreed to use the simplified dissolution of marriage procedure rather than a regular dissolution. ____ 9. We both are aware of the following facts: (a) That after the dissolution becomes final, neither of us has any right to expect money or support from the other, except for what is included in the property settlement agreement; and (b) That by choosing the simplified dissolution of marriage procedure we give up certain legal rights that we would have if we used the regular dissolution procedure. (These are explained in Part V.) VII. WHAT STEPS DO YOU HAVE TO GO THROUGH TO GET A SIMPLIFIED DISSOLUTION OF MARRIAGE? (1) Both the husband and the wife must go to the office of the clerk of the circuit court in the county where they live. (2) Both the husband and the wife must read and sign before a clerk of the court a joint petition for simplified dissolution of marriage ( Family Law Form 12.901(a)). (3) You must prove that the husband or the wife has lived in Florida for more than 6 months before petitioning for dissolution. Residence can be proved by a valid Florida driver's license or voter registration card presented to the court, by the testimony of another person who comes to court with you, or by affidavit. To prove residence by affidavit use Family Law Form 12.901(i). This form must be signed by a person who knows that either the husband or the wife has lived in Florida for more than six months before the date that you signed the joint petition for simplified dissolution of marriage. This affidavit may be signed in the presence of the clerk of the court or you may take the affidavit with you and have the corroborating witness (the person who knows that either you or your spouse has resided in Florida for more than six months) sign the affidavit in the presence of a notary public who must affix his or her seal at the proper place on the affidavit. (4) Both you and your spouse must file financial affidavits (either Family Law Form 12.901(d) or 12.901(e), depending on your income). (5) You must also fill out the Marital Settlement Agreement for Simplified Dissolution of Marriage ( Family Law Form 12.901(h)). The financial affidavit and property agreement forms should be attached to the joint petition for dissolution of marriage. (6) You must pay the appropriate filing fee and costs to the clerk of the circuit court. If you and your spouse cannot financially afford to pay the filing fees, you may ask the court *1288 to waive the filing fees. You need to fill out Family Law Form 12.901(c) and file it with your joint petition for a dissolution of marriage. (7) You or the clerk will need to complete a civil cover sheet found in Form 1.997 of the Florida Rules of Civil Procedure. The clerk's office can provide this form. (8) You must obtain a date for a court appearance from the clerk. On that date, you and your spouse must both appear before a judge. You should fill in Family Law Form 12.990(a), Final Judgment of Simplified Dissolution of Marriage, and give it to the clerk with the other papers you file ( Family Law Forms 12.901(a), 12.901(d) or (e), 12.901(h), etc.). At that time, if all papers are in order, the judge may grant a final judgment dissolving marriage under simplified dissolution of marriage procedures by signing Family Law Form 12.990(a). VIII. WHAT SHOULD BE INCLUDED IN THE FINANCIAL AFFIDAVIT? A financial affidavit is required in all dissolutions. Completion of the financial affidavit involves one or both spouses figuring out their income, the value of their property, and the amount of their debts. A sample financial affidavit, filled out for an imaginary person, appears at the end of this section. Income Income is the average amount of money you receive from any source, usually calculated on a weekly, monthly, or yearly basis. When filling out the financial affidavit, you must specify on what basis you have calculated your income. The financial affidavit includes a space for your average gross wage, which is the amount of money you would be paid without any deductions for taxes, social security, credit union, or other purposes. After listing all deductions from your gross wages, you then subtract your total deductions to calculate your average net wage. The financial affidavit form also includes spaces for other income that you may receive from sources other than your employment. The total of your average net wage and other income equals your total net income. Assets Cash — Include all cash you have on hand and in all bank accounts (including savings accounts, checking accounts, credit unions, money market funds, etc.) on the day you sign the financial affidavit. Stocks and Bonds — List all stocks and bonds. Call a stockbroker to determine their value or check the newspaper. If you own stock in a small corporation which is not traded, consult an accountant for value. Real Estate — Your real property and buildings are worth what a buyer is willing to pay for them. Consult a realtor or appraiser to determine their value. Automobiles and Other Personal Property — Things you own that have monetary value such as cars, furniture, jewelry, cameras, clothes, boats, etc., are personal property. The value of personal property is the fair market value of the items on the day you sign the financial affidavit. Fair market value means the amount of money you would receive if you sold that item (used or in its present condition) to a stranger. It does not mean the amount the item originally cost or the amount you would have to spend to replace the item. Count the full fair market value of the item even if you are still making payments on it. List the amount of money you still owe on the financial affidavit form under the columns marked "liabilities." *1289 Pension, Profit Sharing, and Retirement Plans — Be sure to list all IRA accounts, Keogh plans, and other retirement plans. Other Assets — Be sure to list all of your assets, even if they do not fit into a category above. Liabilities Liabilities are debts, which means money you owe. These include mortgages, credit card bills, unpaid bills, loans, unpaid taxes, car loans, or anything you are purchasing "on time." The amount of liability is the "pay-off" amount you would have to pay the creditor to cancel the loan — not the total of all your payments. Check your last bill or payment coupon, or call your creditor and ask for a "pay-off" figure. There may be taxes to pay on transfers of property. You may wish to consult an accountant or a lawyer. DOING THE MATH These affidavits are based on MONTHLY paychecks and bills. Many people are not paid monthly and many bills (like daycare) are not paid monthly. To help you figure out what the MONTHLY payment is for something that is paid weekly or hourly do this: Hourly wage × hours per week, × weeks per year, ÷ 12 = monthly wage Daily wage × days per week, × weeks per year, ÷ 12 = monthly wage Weekly wage × weeks per year, ÷ 12 = monthly wage Bi-weekly wage × 26, ÷ 12 = monthly wage Semi-monthly wage × 24, ÷ 12 = monthly wage Bi-monthly wage × 6, ÷ 12 = monthly wage Quarterly wage × 4, ÷ 12 = monthly wage Semi-annual wage × 2, ÷ 12 = monthly wage Annual wage ÷ 12 = monthly wage --------------------------------------------------------------------------- HELPFUL FACTS ×: multiplied by, times ÷: divided by wages: gross income, the money paid to a person before taxes, benefits or debts are taken out There are 40 hours in the regular full time work week. There are 52 weeks in a year. There are 12 months in a year. There are 7 days in a week. --------------------------------------------------------------------------- IX. WHAT SHOULD BE INCLUDED IN THE PROPERTY SETTLEMENT AGREEMENT? A property settlement agreement should contain at least the following: *1290 (a) Preliminary Statement: This part identifies the husband and wife, states that the marriage is being ended, and states that both husband and wife agree on the details of the agreement. (b) Division of Property: This part has two sections. Part One is what the wife receives and Part Two is what the husband receives. (c) Division of Obligations: This part has two sections. Part One is the amount the wife must pay and to whom she must pay it. Part Two is the amount the husband must pay and to whom he must pay it. (d) Date and Signature: Both husband and wife must write in the date and sign the agreement. Remember, you can divide the items any way you want. As long as you both agree, the court will accept it. If you cannot agree about the division of your property and debts, you should file a Regular Dissolution. ======================================================== WARNING In a number of circumstances, neither a written nor an oral property settlement agreement can, by itself, properly transfer ownership of property. Examples of property that require the preparation of additional transfer papers are real estate, automobiles, bank accounts, stocks, bonds, and retirement funds. Contact the retirement fund or program administrator to find out what papers may be needed to divide that asset. You will also need a separate document to change a beneficiary on your life insurance. Contact your insurance agent for further information. ======================================================== It is strongly recommended that you talk to an attorney before you sign an agreement. An attorney can tell you your specific legal rights in your case regarding marital assets, marital obligations, alimony, and other important rights. X. SHOULD YOU SEE A LAWYER? MUST YOU HAVE A LAWYER TO GET A DIVORCE WITH THE SIMPLIFIED DISSOLUTION OF MARRIAGE PROCEDURE? No. You can do the whole thing by yourselves. But it would be wise to see an attorney before you decide to do it yourself. You should not rely on this appendix only. It is not intended to take the place of a lawyer. IF YOU WANT LEGAL ADVICE, DOES THAT MEAN YOU HAVE TO HIRE A LAWYER? No. You may hire a lawyer but you can also just visit a lawyer once or twice (at low cost) for advice on how to carry out the dissolution proceeding. Don't be afraid to ask the lawyer in advance what fee will be charged. It may be surprisingly inexpensive to have a lawyer handle your divorce. DO YOU HAVE TO ACCEPT THE ATTORNEY'S ADVICE? No, you don't. And if you are not pleased with what one attorney advises, you can feel free to go to another one. *1291 HOW CAN AN ATTORNEY HELP YOU WITH THE SIMPLIFIED DISSOLUTION OF MARRIAGE PROCEDURE? First of all, an attorney can advise you, on the basis of your personal situation, whether you ought to use the regular dissolution rather than the simplified procedure. Second, an attorney can check through your property settlement agreement to help you figure out if you've thought of everything you should have. (It is easy to forget things you don't see very often — savings bonds, safe deposit boxes, etc.) Third, there are many situations in which it is not easy to figure out what should count as marital property and what should count as separate property. Suppose one of you had money before the marriage and put it into a joint bank account. If may not be easy to decide how the money that remains should be divided. An attorney can advise you on how to make these decisions. Fourth, there may be special situations in which your property settlement is not covered by the form agreement. An attorney can help you put the agreement in words that are legally precise and cannot be challenged or misinterpreted later on. WHERE CAN YOU FIND AN ATTORNEY? The yellow pages of your telephone directory will list, under "Attorney Referral Service," "Attorneys" or "Information Referral Service," organizations that can help you find a lawyer. In many cases you will be able to find an attorney who will charge only a small fee for your first visit. You can get information about free or low-cost legal services through the local bar association in your city or county. XI. SOME GENERAL ADVICE WHAT ABOUT INCOME TAXES? If you and your spouse have filed a joint tax return, you both will still be responsible for paying any unpaid taxes even after your divorce. If you are receiving a tax refund, you should agree in the property settlement agreement on how it should be divided. The amount of money taken out of your paycheck for income taxes is going to be greater after you are single again, so you should be prepared for a bigger tax bite. It would be a good idea to consult the Internal Revenue Service or a tax expert on how the divorce is going to affect your taxes. You should probably do this before you make your property settlement agreement. WHAT ABOUT BANK ACCOUNTS AND CREDIT CARDS? If you have a joint bank account, it might be a good idea to close it and get two separate bank accounts. That way it will be easier to keep your money separate. If you have credit card accounts that you have both been using, you should destroy the cards and apply for separate credit card accounts. WHAT ABOUT REAL ESTATE? Title to land or buildings cannot be changed by an agreement between the husband and wife alone. You may need to consult with a lawyer, title company, or other expert to help you. *1292 WHAT ABOUT CARS? If both your names are on a title to a car and you agree that one of you is going to own the car, you will need to change the ownership. You should call or visit the Division of Motor Vehicles to find out how to do that. WHAT IF YOUR SPOUSE DOESN'T PAY HIS OR HER DEBTS? If your spouse doesn't pay a debt, the person to whom the money is owed may still be able to collect it from you. However, later a court might order your spouse to pay to you the money you were forced to pay because of your spouse's failure to live up to your agreement. CAN THE WIFE TAKE BACK HER FORMER NAME? The wife in a dissolution has the right to give up her husband's name and get her former name back. You can do this by requesting it in the joint petition form. WHEN YOUR DIVORCE IS FINAL, ALL YOUR RIGHTS AND DUTIES CONNECTED WITH YOUR MARRIAGE HAVE ENDED AND YOU CANNOT APPEAL. IF, HOWEVER, YOU DECIDE LATER THAT YOU WERE CHEATED OR PRESSURED BY YOUR SPOUSE, OR IF YOU BELIEVE THAT A MISTAKE WAS MADE IN THE PAPERWORK CONNECTED WITH THE DISSOLUTION THE COURT MAY BE ABLE TO SET ASIDE THE DIVORCE. XII. SPECIAL INSTRUCTIONS FOR ___________ COUNTY FEES: FILING FEE: ____ + FINAL JUDGMENT FEE: ____ = TOTAL DUE: ____ Both HUSBAND AND WIFE should read and understand the informational booklet before starting the procedure. Both HUSBAND AND WIFE must come into the office of the clerk of the circuit court in order to read and sign the petition for simplified dissolution of marriage before the clerk of the court or a designated deputy clerk(s). Both HUSBAND'S AND WIFE'S home and work telephone numbers must appear on the petition for simplified dissolution of marriage. Both HUSBAND AND WIFE must be present at the final hearing. At the time the petition for simplified dissolution of marriage is filed AND, again at the final hearing, BOTH HUSBAND AND WIFE must produce a(n): a. Valid Florida Driver's License, or b. Official Identification Card — Either will provide the picture identification necessary to file the petition and provide picture identification for the final hearing. To obtain a Florida Driver's License or Official Identification Card contact the Florida Division of Motor Vehicles. Identification Cards may be obtained if: a. A person has never had a license, or b. The license has been suspended You cannot make application if you have a valid Florida Driver's License. Persons applying for Identification Cards must produce: a. Social Security Card — paper, no metal cards *1293 b. Two (2) legal forms of identification. The Division will accept any 2 of the following; however, the identification must be the original or a certified copy. 1. Birth Certificate 2. Voter Registration Card 3. Marriage Certificate 4. Passport 5. Military Identification Card 6. Letter from last school with school seal verifying name and date of birth 7. Life Insurance Policy at least 2 years old containing name and date of birth of insured The following forms should be filled out and filed with the court when using this Simplified Procedure: 1. Family Law Form 12.901(a), Petition/Request for Simplified Dissolution of Marriage (Divorce) 2. Family Law Form 12.901(d) or (e), Financial Affidavit 3. Family Law Form 12.901(h) Marital Settlement Agreement 4. Family Law Form 12.901(i), Affidavit of Corroborating Witness 5. Family Law Form 12.901(c), Affidavit of Insolvency (should be completed and filed if you are requesting a waiver of filing fees because of financial reasons) 6. Civil Cover Sheet — available from the clerk of court's office. 7. Family Law Form 12.990(a), Final Judgment of Simplified Dissolution of Marriage APPENDIX 2 REGULAR DISSOLUTION OF MARRIAGE (DIVORCE) This appendix describes a way to end a marriage through a divorce proceeding called a regular dissolution of marriage. The official word for divorce in Florida is "dissolution." There are two ways of getting a divorce or dissolution in Florida. The usual way is called a regular dissolution of marriage. A shorter way is called a simplified dissolution of marriage which is described in Appendix 1. Regular Dissolution of Marriage: With a regular dissolution of marriage, each spouse has the right to ask questions and get documents concerning the spouse's income, expenses, assets, debts, and other matters before having a trial or settlement (agreement) of your case. With a regular dissolution of marriage, if there is no agreement about property and other matters, a judge conducts a trial or hearing. The judge listens to all the evidence concerning the dissolution of marriage and then makes decisions concerning the division of property, alimony, child support, custody of children, visitation, possession of property (usually of the home when there are minor children), and other matters. Either spouse can ask for a reconsideration of certain matters or appeal the judge's decision, when appropriate. Who can use a Regular Dissolution of Marriage Procedure? Before you can request the court to grant a regular dissolution of marriage, the following must be true: ✓ You or your spouse must have continuously resided in the state of Florida for 6 months preceding the day you filed your request for dissolution of marriage. ✓ Your marriage must be irretrievably broken (you want to end your marriage because of serious permanent differences) or one of you must be mentally incapacitated (see section 61.052(1)(b), Florida Statutes). ✓ If the parties lived in the State of Florida, the place of filing is the last county where the parties lived as husband and wife. *1294 WORDS YOU NEED TO KNOW: Before you use the Florida Family Law Forms and request a regular dissolution of marriage (divorce) you should be familiar with the following legal terms: Shared Parental Responsibility: Both parents have full parental rights and responsibilities for their child(ren) and the parents make major decisions affecting the welfare of the child(ren) jointly. 1 Sole Parental Responsibility: The responsibility for the minor child(ren) is given to one parent by the court, with or without rights of visitation to the other parent. Generally, the court cannot order sole parental responsibility to one parent unless it finds that shared parental responsibility would be detrimental (harmful) to the child(ren). • Primary Residence: Where the child(ren) will live most of the time must be decided. If the parents cannot agree, the court will make this decision by determining the best interest of the child(ren), and considering and evaluating all of the following factors: a. Which parent is more likely to allow the child(ren) frequent and continuing contact with the other parent. b. The love, affection, and emotional ties existing between the parents and the child(ren). c. The capacity and disposition of the parents to provide the child(ren) with food, clothing, and medical care. d. The length of time the child(ren) has/have lived in a stable, satisfactory environment and the desirability of maintaining this environment. e. The permanence as a family unit of existing or proposed parent's home. f. The moral fitness of the parents. g. The mental and physical health of the parents. h. The home, school, and community records of the child(ren). i. The reasonable preference of a child, if the court feels the child has sufficient intelligence, understanding, and experience to express a preference. j. The willingness and ability of each parent to encourage and make possible and close and continuing relationship between the child and the other parent. k. Any other factors considered to be relevant to your case. The law requires the court to give equal consideration to both parents in determining primary residence regardless of the age or sex of the children. $ Child Support: Florida law sets child support guidelines for the court to use in ordering support. A table of minimum amounts is provided for parents whose combined net annual income is $120,000 or less. If the parents' combined income is more, a formula is applied to calculate support. See Appendix 3 and section 61.30, Florida Statutes, for further information. Equitable Distribution section 61.075, Florida Statutes: The court can divide all marital assets and obligations between the spouses. 1/2 The court begins with an equal (50%/50%), but make an unequal division based if it can be justified under the facts of the case: a. Contribution to the marriage by each spouse, including care and education of the child(ren) and services as a homemaker. b. Economic circumstances of both spouses. c. Duration of the marriage. *1295 d. Any interruptions of personal careers or educational opportunities, by either spouse. e. Desirability of keeping any asset, including an interest in a business, corporation, or professional business, intact and free from claim or interference from the other spouse. f. Contribution of each spouse to the acquisition, enhancement, and production of income or improvement of or the incurring of debts to both the marital and nonmarital assets. g. Desirability of maintaining the marital home as a residence for a minor child or a party, if it is in the best interest of the child or party and financially feasible. h. Any intentional waste, depletion, or destruction of marital assets after filing the petition for dissolution or within 2 years before filing. i. Any other factor necessary to do justice between the parties. $ Alimony: After making an equitable distribution of assets and debts, the court may grant alimony (support) to either spouse. The alimony may be rehabilitative (temporary payments to allow for education, retraining, etc.) or permanent in nature. The court may order periodic payments, payments in lump sum, or both. The court may consider the adultery of either spouse. Alimony may be structured so that it is taxable to the payee and deductible to the payor or the court or the parties may designate it as nontaxable to the payee and nondeductible to the payor. In determining a proper award of alimony, the court considers all relevant factors, including, but not limited to: a. Standard of living established during the marriage. b. Duration of the marriage. c. Age and physical and emotional condition of each party. d. Financial resources of each party and the nonmarital and marital assets and debts distributed to each. e. When applicable, the time necessary for either party to get sufficient education or training to find an appropriate job. f. The contribution of either spouse to the marriage, including but not limited to, services rendered in homemaking, child care, education, or career building. g. All sources of income available to either party. h. Any other factor needed to be considered to do justice between the spouses. See section 61.08, Florida Statutes for more information. Marital Asset: Everything that a husband and wife acquire during the marriage, it includes, in most cases, the following: a. Money that you now have which either of you earned during the time you were living together as husband and wife. b. Anything either of you bought with money earned during that period. c. Vested and nonvested benefits, rights, and funds earned during the marriage in a retirement pension, profit sharing, annuity, deferred compensation, and/or insurance plan and program. d. Enhancement in value and appreciation of nonmarital assets resulting either from the efforts of either spouse or from the contribution of marital funds or other forms of marital assets. e. Gifts from one spouse to the other during the marriage. f. All real property (house, land) held as tenancy by entireties (held as husband and wife), whether obtained before or during the marriage. Nonmarital assets can be construed as marital assets if they commingled with marital assets and/or put into joint accounts. *1296 Nonmarital Asset/Separate Property: Everything that a husband or wife owns separately, it includes: a. Anything that you owned before you got married. b. Anything you earned or received after you filed your petition for dissolution of marriage. If there were earnings prior to the petition but received after the petition it remains a marital asset. c. Anything that either of you received, as a gift or by inheritance, at any time. Marital Debts: The debts that a husband and wife owe together, or that either one incurred during the marriage are marital obligations. In most cases this includes anything that you still owe on any debts either of you took on during the time you were living together as husband and wife. (For example, if you bought furniture on credit while you were married and living together, the unpaid balance is a part of your obligations.) If you do not understand these legal terms and how these terms would be applied to your case, see an attorney before you use these forms. STEPS TO A REGULAR DISSOLUTION OF MARRIAGE 1 You need to fill out the following Florida Family Law Forms to go with your request for regular dissolution of marriage: 1. Family Law Form 12.901(b) — Petition/Request for Dissolution of Marriage. 2. Family Law Form 12.901(d) or 12.901(e) — Financial Affidavit (Use Family Law Form 12.901(d) if your income and expenses are $50,000 or less; use Florida Family Law Form 12.901(e) if your income or expenses are $50,000 or more). 3. Family Law Florida Family Law Form 12.901(f) — UCCJA Affidavit. If you have minor children, this form must be completed. 4. Family Law Form 12.912(a) — Memorandum for Certificate of Military Service. If your spouse may be in the military, you need to complete this form. 5. Family Law Form 12.912(b) — Non-Military Affidavit. If your spouse is not in the military, you need to complete this form. 6. In addition to the financial affidavit, you must also file certain mandatory information regarding your financial status. For a list of this mandatory information, see Florida Family Rule of Procedure 12.285. 2 You need to prove that you or your spouse has resided in Florida for 6 months before petitioning for a divorce. You may prove this by: 1. presenting a valid driver's license or voter registration card to the court; 2. bringing another person to court who can testify that you meet this requirement; or 3. completing and filing with the court Family Law Form 12.901(i) — Certificate of Corroborating Witness. 3 You need to fill out the forms listed in number one or two below concerning service of your request for dissolution of marriage on your spouse. • 1. If you know where your spouse lives, use the following Florida Family Law Forms: a. Family Law Form 12.910(a) — Summons. b. Family Law Form 12.910(b) — Process Service Memorandum to Sheriff. 2. If you do not know where your spouse lives, or your spouse lives outside the State of Florida and has never resided in the State of Florida, use the following Florida Family Law Forms: *1297 a. Family Law Form 12.913(a) — Notice of Action. b. Family Law Form 12.913(b) — Affidavit for Service by Publication. If service is by publication, the court cannot order financial relief or distribution of assets unless money or assets can be found and described in the affidavit. 4 Take all the Florida Family Law Forms that you completed as instructed in Steps 1-3 to the courthouse and file all the completed forms. You or the clerk will need to complete a Civil Cover Sheet, Form 1.997, Florida Rules of Civil Procedure. This form is available from the clerk's office. You need to make sure you keep a copy of all of these papers for your records. Generally, you file your regular dissolution of marriage papers in the courthouse in the county where you and your spouse last lived as husband and wife. However, you may file in another location under certain circumstances. You should talk to a lawyer if you do not know where to file the papers. $ You must pay a filing fee and costs at the time you file these forms. If you are unable to afford to pay these costs and wish to ask the clerk to waive these costs, use Family Law Form 12.901(c), Affidavit of Insolvency 5 Since there is a delay before you can get a final hearing or trial date for your divorce, you can ask the court for temporary help until the final hearing or trial. See Family Law Form 12.923 Notice of Hearing (General Form). After you have obtained proper service over your spouse (after the deputy sheriff or process server has served your spouse with your request or after your notice of action was published or posted as required), you can get a temporary hearing to ask the court to give you one or all of the following as applicable: ✓ temporary child support; ✓ temporary alimony; ✓ temporary determination of primary residence of the child(ren); ✓ temporary injunctions (see Family Law Form 12.980(a)-(g)); or ✓ other matters requested. If service is made by publication, no temporary relief can be obtained unless there are funds or assets in Florida that are fully described in the notice of action. You need to get a hearing date from the court to consider your temporary request. After you get the hearing date, you need to fill out Florida Family Law Form 12.923 and send it to you spouse. If you and your spouse reach a voluntary, acceptable agreement resolving your differences, you can get a final hearing in your case. You would not need a temporary hearing. You need to get a hearing date before the court for the court to consider your agreement. Follow the same steps outlined in the preceding paragraph, but this time you would use Family Law Form 12.921. 6 You should prepare for your final hearing unless you have reached an acceptable written agreement with your spouse. You may take one or more of the following actions in order to prepare for your final hearing: If you do not know your spouse's income, assets, obligations, and benefits from his/her business or organization, you can get this information by using all or one of these discovery forms: a. Family Law Form 12.931(a) — Notice of Production From Non-Party (you can use this form to get information from a spouse's employer or other third party). b. Family Law Form 12.931(c) — Request for Copies, Family Law Form 12.930(a) — Notice of Service of Interrogatories, and Family Law Form 12.930(b) — Standard Interrogatories. *1298 If your income is over $50,000, much of this information will be REQUIRED to be filed by both you and your spouse. See Florida Family Law Rule of Procedure 12.285. If you are disputing child custody, you can ask the court to appoint a guardian ad litem to represent the child(ren)'s interests. (See Family Law Form 12.942(a) and (b)). You should decide if you need any witnesses to go with you to court. 7 Once you have finished preparing for your final hearing, you should get a final hearing date from the judge. If your spouse failed to respond to your request for a divorce as required, fill out and file Florida Family Law Form 12.922(a), Request to Enter Default, before you ask for a trial date. At the time of the hearing, you must bring all your evidence and witnesses with you. $ You must provide the court with proper evidence of your spouse's income if you are asking for child support or support for yourself. If you have a child, you will need to complete Family Law Form 12.901(g), Child Support Guidelines Worksheet, and bring it with you to the final hearing. This form will show the amount of child support that should be ordered. If you or your spouse have assets and debts, you must bring a list of all your spouse's and your assets and debts to court. This list must classify these assets and debts as marital or nonmarital assets or debts. You also must include the value of each asset and the balance due on each of your debts listed on the list. (See Florida Family Law Forms 12.901(d) or 12.901(e)) ✓ You will be expected to follow all the Rules of Evidence at trial. You should read these rules before trial. The Rules of Evidence can be found in a law library. There may be a law library you can use in your local courthouse or a law school in your area. You should bring a proposed order with you to court at the final hearing. See, for example, Family Law Form 12.990(a). If the judge rules in your favor, the proposed order will be signed at that time. If the judge rules differently from your proposed order, you will be told to prepare another order stating the judge's ruling. Bring paper and pen to the hearing so you can write down the judge's ruling. • If you disagree with the judge's ruling in your case, you may have a right to a rehearing or an appeal. You must request a rehearing or an appeal within a very short time limit after the final hearing. You should see an attorney regarding these rights immediately or find the answer in the law library. There may be a law library you can use in your local courthouse or a law school in your area. APPENDIX 3 CHILD SUPPORT The court determines the basic child support obligation based on the guidelines in section 61.30(6), Florida Statutes, (see chart below). The child support guidelines establish the basic child support obligation for parents whose combined net income is between $7,800 and $120,000 annually. If the parents' combined income is more than $120,000 annually, a formula is provided to establish support beyond the guidelines amount. If the parents' combined net annual income is below $7,800, the court determines the child support on a case-by-case basis. The child support guidelines amount is based on the number of children and combined income of the parents. The child support obligation is divided between the parents in direct *1299 proportion to their income or earning capacity. The parent with whom the child lives most of the time (the "custodial parent") is paid the appropriate portion of the support by the other ("noncustodial") parent. The court at its discretion may raise or lower the guidelines support amount by up to 5%. The court may raise or lower the guidelines support amount by more than 5% if written reasons are given for the variation. The court may make additional adjustments based on the following considerations: a. Extraordinary medical, psychological, educational, or dental expenses. b. Independent income of the child(ren). c. The payment of both child support and spousal support to the custodial parent or the payment of support for a parent which regularly has been paid and for which there is a demonstrated need. d. Seasonal variations in one or both parents' incomes or expenses. e. The age of the child(ren), taking into account the greater needs of older children. f. Special needs that have traditionally been met within the family budget even though the fulfilling of those needs will cause the support to exceed the proposed guidelines. g. The particular shared parenting arrangement, such as 1. if the children spend a great deal of time with the noncustodial parent, thereby reducing the financial expenditures incurred by the custodial parent; 2. the noncustodial parent refuses to become involved in the activities of the child(ren); 3. to give due consideration to the custodial parent's homemaking services; 4. visitation with the noncustodial parent for more than 28 consecutive days. h. Total available assets of both parents and the child(ren). i. The impact of the federal income tax dependency exemption and waiver of the exemption. The court may order the custodial parent to sign a waiver of the dependency exemption if the noncustodial parent's support payments are current. j. If the guidelines amount from one child support order is more than 55% of the paying parent's income. k. Any other adjustment which is needed to achieve an equitable result which may include, but not be limited to, a reasonable and necessary existing expense or debt. Such an expense or debt may include, but is not limited to, a reasonable and necessary expense or debt which the parties jointly incurred during the marriage. Child support can be modified (changed) by the court if there is a substantial change in the circumstances of the family. The child support guidelines themselves may be the basis for modifying child support if the resulting change is at least 15% or $50, whichever is greater. The court also may consider a parent's need to support other children if an upward modification of support is requested, but only if the income of those children's other parent is considered. See section 61.30(12), Florida Statutes. *1300 You must complete Family Law Form 12.901(g), Child Support Guidelines Worksheet, to calculate the child support obligation. An example of a completed form follows to help you complete the form. • From time to time, some of the amounts in the child support guidelines chart will change. Make sure you have the most recent version of the chart before using it. $ If you do not know the other parent's income, you should request this information by using the following discovery forms: a. Family Law Form 12.931(a) — Notice of Production From Non-Party (you can use this form to get information from a spouse's employer or other third party). b. Family Law Form 12.931(c) — Request for Copies, Family Law Form 12.930(a) — Notice of Service of Interrogatories, and Family Law Form 12.930(b) — Standard Interrogatories. Please see sections 61.13 and 61.30, Florida Statutes, for further information. CHILD SUPPORT GUIDELINES CHART Combined Monthly Available One Two Three Four Five Six Income Child Children Children Children Children Children 650 74 75 75 76 77 78 700 119 120 121 123 124 125 750 164 166 167 169 171 173 800 190 211 213 216 218 220 850 202 257 259 262 265 268 900 213 302 305 309 312 315 950 224 347 351 355 359 363 1000 235 365 397 402 406 410 1050 246 382 443 448 453 458 1100 258 400 489 495 500 505 1150 269 417 522 541 547 553 1200 280 435 544 588 594 600 1250 290 451 565 634 641 648 1300 300 467 584 659 688 695 1350 310 482 603 681 735 743 1400 320 498 623 702 765 790 1450 330 513 642 724 789 838 1500 340 529 662 746 813 869 1550 350 544 681 768 836 895 1600 360 560 701 790 860 920 1650 370 575 720 812 884 945 1700 380 591 740 833 907 971 1750 390 606 759 855 931 996 1800 400 622 779 877 955 1022 1850 410 638 798 900 979 1048 1900 421 654 818 923 1004 1074 1950 431 670 839 946 1029 1101 2000 442 686 859 968 1054 1128 2050 452 702 879 991 1079 1154 2100 463 718 899 1014 1104 1181 2150 473 734 919 1037 1129 1207 2200 484 751 940 1060 1154 1234 2250 494 767 960 1082 1179 1261 2300 505 783 980 1105 1204 1287 2350 515 799 1000 1128 1229 1314 2400 526 815 1020 1151 1254 1340 *1301 2450 536 831 1041 1174 1279 1367 2500 547 847 1061 1196 1304 1394 2550 557 864 1081 1219 1329 1420 2600 568 880 1101 1242 1354 1447 2650 578 896 1121 1265 1379 1473 2700 588 912 1141 1287 1403 1500 2750 597 927 1160 1308 1426 1524 2800 607 941 1178 1328 1448 1549 2850 616 956 1197 1349 1471 1573 2900 626 971 1215 1370 1494 1598 2950 635 986 1234 1391 1517 1622 3000 644 1001 1252 1412 1540 1647 3050 654 1016 1271 1433 1563 1671 3100 663 1031 1289 1453 1586 1695 3150 673 1045 1308 1474 1608 1720 3200 682 1060 1327 1495 1631 1744 3250 691 1075 1345 1516 1654 1769 3300 701 1090 1364 1537 1677 1793 3350 710 1105 1382 1558 1700 1818 3400 720 1120 1401 1579 1723 1842 3450 729 1135 1419 1599 1745 1867 3500 738 1149 1438 1620 1768 1891 3550 748 1164 1456 1641 1791 1915 3600 757 1179 1475 1662 1814 1940 3650 767 1194 1493 1683 1837 1964 3700 776 1208 1503 1702 1857 1987 3750 784 1221 1520 1721 1878 2009 3800 793 1234 1536 1740 1899 2031 3850 802 1248 1553 1759 1920 2053 3900 811 1261 1570 1778 1940 2075 3950 819 1275 1587 1797 1961 2097 4000 828 1288 1603 1816 1982 2119 4050 837 1302 1620 1835 2002 2141 4100 846 1315 1637 1854 2023 2163 4150 854 1329 1654 1873 2044 2185 4200 863 1342 1670 1892 2064 2207 4250 872 1355 1687 1911 2085 2229 4300 881 1369 1704 1930 2106 2251 4350 889 1382 1721 1949 2127 2273 4400 898 1396 1737 1968 2147 2295 4450 907 1409 1754 1987 2168 2317 4500 916 1423 1771 2006 2189 2339 4550 924 1436 1788 2024 2209 2361 4600 933 1450 1804 2043 2230 2384 4650 942 1463 1821 2062 2251 2406 4700 951 1477 1838 2081 2271 2428 4750 959 1490 1855 2100 2292 2450 4800 968 1503 1871 2119 2313 2472 4850 977 1517 1888 2138 2334 2494 4900 986 1530 1905 2157 2354 2516 4950 993 1542 1927 2174 2372 2535 5000 1000 1551 1939 2188 2387 2551 5050 1006 1561 1952 2202 2402 2567 5100 1013 1571 1964 2215 2417 2583 5150 1019 1580 1976 2229 2432 2599 *1302 5200 1025 1590 1988 2243 2447 2615 5250 1032 1599 2000 2256 2462 2631 5300 1038 1609 2012 2270 2477 2647 5350 1045 1619 2024 2283 2492 2663 5400 1051 1628 2037 2297 2507 2679 5450 1057 1638 2049 2311 2522 2695 5500 1064 1647 2061 2324 2537 2711 5550 1070 1657 2073 2338 2552 2727 5600 1077 1667 2085 2352 2567 2743 5650 1083 1676 2097 2365 2582 2759 5700 1089 1686 2109 2379 2597 2775 5750 1096 1695 2122 2393 2612 2791 5800 1102 1705 2134 2406 2627 2807 5850 1107 1713 2144 2418 2639 2820 5900 1111 1721 2155 2429 2651 2833 5950 1116 1729 2165 2440 2663 2847 6000 1121 1737 2175 2451 2676 2860 6050 1126 1746 2185 2462 2688 2874 6100 1131 1754 2196 2473 2700 2887 6150 1136 1762 2206 2484 2712 2900 6200 1141 1770 2216 2495 2724 2914 6250 1145 1778 2227 2506 2737 2927 6300 1150 1786 2237 2517 2749 2941 6350 1155 1795 2247 2529 2761 2954 6400 1160 1803 2258 2540 2773 2967 6450 1165 1811 2268 2551 2785 2981 6500 1170 1819 2278 2562 2798 2994 6550 1175 1827 2288 2573 2810 3008 6600 1179 1835 2299 2584 2822 3021 6650 1184 1843 2309 2595 2834 3034 6700 1189 1850 2317 2604 2845 3045 6750 1193 1856 2325 2613 2854 3055 6800 1196 1862 2332 2621 2863 3064 6850 1200 1868 2340 2630 2872 3074 6900 1204 1873 2347 2639 2882 3084 6950 1208 1879 2355 2647 2891 3094 7000 1212 1885 2362 2656 2900 3103 7050 1216 1891 2370 2664 2909 3113 7100 1220 1897 2378 2673 2919 3123 7150 1224 1903 2385 2681 2928 3133 7200 1228 1909 2393 2690 2937 3142 7250 1232 1915 2400 2698 2946 3152 7300 1235 1921 2408 2707 2956 3162 7350 1239 1927 2415 2716 2965 3172 7400 1243 1933 2423 2724 2974 3181 7450 1247 1939 2430 2733 2983 3191 7500 1251 1945 2438 2741 2993 3201 7550 1255 1951 2446 2750 3002 3211 7600 1259 1957 2453 2758 3011 3220 7650 1263 1963 2461 2767 3020 3230 7700 1267 1969 2468 2775 3030 3240 7750 1271 1975 2476 2784 3039 3250 7800 1274 1981 2483 2792 3048 3259 7850 1278 1987 2491 2801 3057 3269 *1303 7900 1282 1992 2498 2810 3067 3279 7950 1286 1998 2506 2818 3076 3289 8000 1290 2004 2513 2827 3085 3298 8050 1294 2010 2521 2835 3094 3308 8100 1298 2016 2529 2844 3104 3318 8150 1302 2022 2536 2852 3113 3328 8200 1306 2028 2544 2861 3122 3337 8250 1310 2034 2551 2869 3131 3347 8300 1313 2040 2559 2878 3141 3357 8350 1317 2046 2566 2887 3150 3367 8400 1321 2052 2574 2895 3159 3376 8450 1325 2058 2581 2904 3168 3386 8500 1329 2064 2589 2912 3178 3396 8550 1333 2070 2597 2921 3187 3406 8600 1337 2076 2604 2929 3196 3415 8650 1341 2082 2612 2938 3205 3425 8700 1345 2088 2619 2946 3215 3435 8750 1349 2094 2627 2955 3224 3445 8800 1352 2100 2634 2963 3233 3454 8850 1356 2106 2642 2972 3242 3464 8900 1360 2111 2649 2981 3252 3474 8950 1364 2117 2657 2989 3261 3484 9000 1368 2123 2664 2998 3270 3493 9050 1372 2129 2672 3006 3279 3503 9100 1376 2135 2680 3015 3289 3513 9150 1380 2141 2687 3023 3298 3523 9200 1384 2147 2695 3032 3307 3532 9250 1388 2153 2702 3040 3316 3542 9300 1391 2159 2710 3049 3326 3552 9350 1395 2165 2717 3058 3335 3562 9400 1399 2171 2725 3066 3344 3571 9450 1403 2177 2732 3075 3353 3581 9500 1407 2183 2740 3083 3363 3591 9550 1411 2189 2748 3092 3372 3601 9600 1415 2195 2755 3100 3381 3610 9650 1419 2201 2763 3109 3390 3620 9700 1422 2206 2767 3115 3396 3628 9750 1425 2210 2772 3121 3402 3634 9800 1427 2213 2776 3126 3408 3641 9850 1430 2217 2781 3132 3414 3647 9900 1432 2221 2786 3137 3420 3653 9950 1435 2225 2791 3143 3426 3659 10000 1437 2228 2795 3148 3432 366 *1304 IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT IN AND FOR SEMINOLE COUNTY, FLORIDA IN RE: The Marriage of JOHN DOE , CASE NO: 91-00007-DR-02-B Husband and , CHILD SUPPORT WORKSHEET JANE DOE Wife. Father : JOHN DOE Mother : JANE DOE Occupation : Electrician Helper Occupation : Clerk Employer : Electric Works, Inc. Employer : Wal-Mart SSN : XXX-XX-XXXX SSN : XXX-XX-XXXX CHILD SUPPORT SUMMARY Children (Section I) number: 2 FATHER MOTHER 1. Gross Monthly Income (Section III) $ 1204.00 $ 860.00 2. Imputed Income $ 0.00 $ 0.00 3. Less Monthly Deductions (Section IV) $ 204.10 $ 69.79 4. Total Net Monthly Income [add lines 1 + 2 and subtract line 3] $ 999.90 $ 790.21 5. COMBINED NET MONTHLY INCOME $1790.11 6. Basic Obligation (from chart) $ 606.00 7. Pro rata Financial Responsibility [line 4 divided by line 5] 55.8569% 44.1431% 8. Pro rata share of Basic Obligation [line 6 multiplied by line 7] $ 338.49 $ 267.51 9. Additions to the Basic Obligation (Section II) a. Pro rata share of 75% of child care costs equaling $200.00 [this amount multiplied by line 7] $ 111.72 $ 88.29 b. Pro rata share of Child(ren)'s Health Insurance premiums of $100.00 [this amount multiplied by line 7] $ 55.86 $ 44.12 10. Statutory Child Support Obligation** [Add lines 7 + 8 + 9] $ 506.07 $ 399.94 11. Statutory Adjustments (Section V) $ 0.00 $ 0.00 12. Adjustment for Secondary Residential Parent paying 100% of child-care expenses [If Secondary Residential is paying 100% of child-care expenses, multiply the total amount by -1 and place in Secondary Residential Parent's column] $ 0.00 $ 0.00 13. Adjustment for Secondary Residential Parent paying Child(ren)'s Health Insurance premiums [If Secondary Residential is paying 100% of child-care expenses, multiply the total amount by -1 and place in Secondary Residential Parent's column] $- 100.00 $ 0.00 14. Total Child Support Responsibility** [add lines 10 + 11 + 12 + 13] $ 406.07 $ 399.94 ** If recurring income is not sufficient to meet the needs of the child(ren), the Court may order support to be paid from non-recurring income or assets. The court also may order the obligor to pay the clerk's fee for payments ordered to be paid through the Central Governmental Depository. *1305 SECTION I-CHILDREN Child's Name Date of Birth Age John Doe, Jr. December 6, 1988 4 Years Sally Doe April 10, 1990 3 Years SECTION II-ADDITIONS TO THE BASIC OBLIGATION Childrens' Health Insurance Costs $100.00 75% of allowable child care costs due to job search or education to enhance income or current employment. Allowable Amount $266.66 $200.00 TOTAL ADDITIONS TO THE BASIC OBLIGATION $300.00 SECTION III-GROSS MONTHLY INCOME PRESENT GROSS MONTHLY INCOME FROM EMPLOYMENT $1204.00 $860.00 Bonuses, commissions, allowances, overtime, tips, and similar payments. $ 0.00 $ 0.00 Business income from sources such as self employment, partnerships, close corporations, or independent contracts, (gross receipts minus ordinary and necessary expenses required to produce income) $ 0.00 $ 0.00 Disability benefits/SSI $ 0.00 $ 0.00 Workers' Compensation $ 0.00 $ 0.00 Unemployment Compensation $ 0.00 $ 0.00 Pension, retirement, and annuity payments $ 0.00 $ 0.00 Social Security benefits $ 0.00 $ 0.00 Spousal Support received from previous marriage(s) $ 0.00 $ 0.00 Interest and dividends $ 0.00 $ 0.00 Rental Income (gross receipts minus ordinary and necessary expenses required to produce income) $ 0.00 $ 0.00 Income from royalties, trusts, and/or estates $ 0.00 $ 0.00 Reimbursed expenses and in-kind payments to the extent that they reduce personal living expenses. $ 0.00 $ 0.00 Gains derived from dealing in real property (not including non-recurring gains) $ 0.00 $ 0.00 $ 0.00 $ 0.00 TOTAL GROSS MONTHLY INCOME $1204.00 $860.00 SECTION IV-MONTHLY DEDUCTIONS Federal Income tax, including estimated income tax payments $ 112.00 $ 4.00 FICA or self-employment taxes $ 92.10 $ 65.79 Medicare tax $ 0.00 $ 0.00 Mandatory Union Dues $ 0.00 $ 0.00 Mandatory Retirement $ 0.00 $ 0.00 Health Insurance and dental payments excluding portion paid for children of the parties $ 0.00 $ 0.00 Ordered support actually paid for children not of this relationship $ 0.00 $ 0.00 TOTAL MONTHLY DEDUCTIONS $ 204.10 $ 69.79 *1306 SECTION V-STATUTORY ADJUSTMENTS Extraordinary medical, psychological, educational, or dental expenses $ 0.00 $ 0.00 Independent income of the child $ 0.00 $ 0.00 Payment of both child and Spousal support for a parent which regularly has been paid and for which there is a demonstrated need Seasonal variations in a parent's income $ 0.00 $ 0.00 The age of the child, taking into account the greater needs of older children $ 0.00 $ 0.00 Special needs that have traditionally been met within the family budget even though fulfilling those needs will cause support to exceed the proposed guidelines $ 0.00 $ 0.00 That particular shared parental arrangement, such as when: a. The children spend a substantial amount of their time with the non-residential parent thereby reducing the expenses of the residential parent $ 0.00 $ 0.00 b. Refusal of the non-residential parent to become involved in the activities of the child(ren) $ 0.00 $ 0.00 c. Due consideration is given to the residential parent's homemaking services $ 0.00 $ 0.00 d. Visitation with the non-residential parent for more than 28 consecutive days $ 0.00 $ 0.00 Total available assets of obligor, obligee, and children $ 0.00 $ 0.00 Impact of IRS dependency exemption and waiver of the exemption $ 0.00 $ 0.00 Application of the Child Support Guidelines requires the obligor to pay more than 55% of his/her gross income for a single support order $ 0.00 $ 0.00 Any other adjustment that is needed to produce an equitable result which may include reasonable and necessary expenses jointly incurred during the marriage $ 0.00 $ 0.00 Residency of subsequently born or adopted children with obligor including consideration of the subsequent spouse's income only in the case of an upward notification proceeding $ 0.00 $ 0.00 TOTAL ADJUSTMENTS $ 0.00 $ 0.00 The child support worksheet is based on MONTHLY paychecks and bills. Many people are not paid monthly and many bills (like daycare) are not paid monthly. To help you figure out what the MONTHLY payment is for something that is paid weekly or hourly do this: --------------------------------------------------------------------------- HELPFUL HINTS ×: multiplied by, times ÷: divided by wages: gross income, the money paid to a person before taxes, benefits or debts are taken out There are 40 hours in the regular fulltime work week. There are 52 weeks in a year. There are 12 months in a year. There are 7 days in a week. --------------------------------------------------------------------------- Hourly wage × hours per week, × weeks per year, ÷ 12 = monthly wage Daily wage × days per week, × weeks per year, ÷ 12 = monthly wage Weekly wage × weeks per year, ÷ 12 = monthly wage *1307 Bi-weekly wage × 26, ÷ 12 = monthly wage Semi-monthly wage × 24, ÷ 12 = monthly wage Bi-monthly wage × 6, ÷ 12 = monthly wage Quarterly wage × 4, ÷ 12 = monthly wage Semi-annual wage × 2, ÷ 12 = monthly wage Annual wage, ÷ 12 = monthly wage APPENDIX 4 INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE Under Florida law, courts can enter orders to protect people from physical violence of a spouse, former spouse, relative, person living with you now or in the past, or the other parent of your child, whether or not you have ever been married or lived together. If you are a victim of any act of violence, or reasonably believe you are about to become a victim, you can ask for a protective order enjoining this violence. You still will have the right to this protective order after the person moves out of your residence. The person asking for the protection is the "Petitioner/Plaintiff" and the person who the order is entered against is the "Respondent/Defendant." WHAT KIND OF ORDERS ARE AVAILABLE TO PREVENT DOMESTIC VIOLENCE? 1. If there is an immediate and present danger of violence, the court can issue an order without notice to the respondent. It will go into effect immediately when the respondent is served. (A Temporary Injunction for Protection Against Domestic Violence (Ex Parte) and Notice of Hearing Family Law Form 12.980(d)). It lasts until the next court hearing, but no longer than 15 days. In this order, the judge may: a. Order the respondent not to "contact, molest, attack, strike, threaten, sexually assault, batter, telephone, stalk, or otherwise disturb the Petitioner." b. Order the respondent to move out and not return to your home, and to take only personal clothing and effects. c. Order the respondent to stay away from you and members of your immediate family at places such as your house or place of employment. d. Decide who has temporary custody and temporary visitation of children born to you and the respondent. e. Enter other orders special to your situation to assure your safety. 2. After service on the respondent and a hearing with notice, the court may issue an order effective for up to one year. (Injunction for Protection Against Domestic Violence (After Notice) Family Law Form 12.980(e)). It can order the items listed in number 1 and also can order the respondent to pay child support as permitted under chapter 61, Florida Statutes. The court also shall order the respondent to enter into treatment, intervention, or counseling services unless the court makes written factual findings in its judgment why such programs would be inappropriate. The court also may enter a support order for you if permitted by chapter 61, Florida Statutes. Chapter 61 would permit support for you if you are married to the respondent and child support if the child was born of the marriage between you and the respondent or the respondent has been adjudicated to be the *1308 parent of the child. The petitioner may move to have the court extend the order for additional one-year periods before the expiration of this one year order. 3. The court may not issue mutual injunctions (against both you and the respondent); however, the court may issue separate orders of protection if: a. Both you and the respondent have filed petitions and they have been served on both of you. b. Both of you appear in court. c. The judge finds that each person meets the criteria for an order of protection and enters written findings of fact and conclusions of law in the orders. WHAT ARE DOMESTIC VIOLENCE PREVENTION FORMS? 1. Family Law Form 12.980(b) — Petition for Injunction for Protection Against Domestic Violence. This form describes the facts of your case and lists what protective orders you are asking from the court. 2. Family Law Form 12.980(c) — Order Denying Injunction. The court will use this form if the court denies your ex parte request for an injunction. 3. Family Law Form 12.980(f) — Final Order of Dismissal. The court will use this form if the court is denying the injunction after hearing the evidence at the 15-day hearing or if the petitioner fails to appear for the hearing. 4. Family Law Form 12.980(a) — Affidavit and Request for Waiver of Fee in Action for Petition for Injunction for Protection Against Domestic Violence. You can use this form to ask the court to waive your fees and costs, if you are financially unable to pay them. 5. Family Law Form 12.980(d) — Temporary Injunction for Protection Against Domestic Violence (Ex Parte) and Notice of Hearing. The judge will use this or a similar form to grant the relief which you have requested as described in paragraph 1a through 1e above and to notice you and the respondent of the hearing which will take place within 15 days. 6. Family Law Form 12.980(e) — Injunction for Protection Against Domestic Violence (After Notice). The court will use this form or a similar form to grant the relief requested in paragraph 2. 7. Family Law Form 12.901(f) — Uniform Child Custody Jurisdiction Act Affidavit. If you and the respondent are the parents of a child(ren) and you are asking the court to say where the child(ren) will live and when or if each of you can see the child(ren) then you must fill out this form. 8. Family Law Form 12.901(d) or 12.901(e) — Financial Affidavit. If you are asking the court to have the respondent pay money to you for your needs or those of your children to which the respondent is the other parent, you must fill out this form. WHAT STEPS DO YOU TAKE TO GET THE COURT ORDERS? 1. The office of the civil clerk of the circuit court or other intake personnel located at the courthouse must by law provide you with the forms you need and help you fill them out. 2. If the judge signs Family Law Form 12.980(d), The Temporary Injunction for Protection Against Domestic Violence (Ex Parte), the clerk will stamp all the papers with a case number, along with the date of filing, and will stamp the *1309 judge's signature and date of signing on the copies. The clerk will file the originals and give you copies. Keep two copies for yourself. Carry one with you and keep one in a safe place. You may need one if you have to call the police. Make sure your copies are certified (stamped by the clerk). 3. If the judge signs Family Law Form 12.980(d), The Temporary Injunction Against Domestic Violence (Ex Parte), the clerk of the court must by law make sure that the right law enforcement (police or sheriff) office gets this court order. The law enforcement (police or sheriff) office will personally give them to the respondent. This is called personal service. You cannot "serve" the respondent yourself. "Service" is very important. It tells the respondent about the order and the hearing. Without it, there will not be a court hearing and your orders will not help you. The temporary injunction against domestic violence (ex parte) is effective immediately upon service of the respondent by the law enforcement officer. 4. When you fill out your forms you will be given a Notice of Hearing. This will tell you the date and time when you need to come back to court for a hearing. The notice will tell you where the hearing is going to take place. Read this notice carefully. The hearing may be in a different place, even a different building, than where you filled out the forms. 5. Go to the court hearing with any papers you have or people who can show or tell the judge that what you are saying is true and why you should get the relief you are asking for. If you are seeking child support or support for yourself, bring with you any recent pay stubs for yourself or the respondent and the most recent tax return, if available. 6. If the judge signs Family Law Form 12.980(e), The Injunction for Protection Against Domestic Violence (After Notice), the clerk will stamp all the papers with the case number, along with the date of filing, and will stamp the judge's signature and date of signing on the copies. The clerk will file the originals and give you copies. Keep two copies for yourself. Carry one with you and keep one in a safe place. You may need one if you have to call the police. Make sure your copies are certified copies (stamped by the clerk). If the respondent was at the hearing your order is effective immediately. HOW DO I KNOW WHEN THE ORDER BECOMES EFFECTIVE? If the respondent was at the hearing, the order is effective immediately. The clerk of the court will give both the petitioner and respondent certified copies of the order. If the respondent fails to acknowledge receipt of the certified copy of the order, the clerk will note on the original order that service was effected. If delivery of the order at the hearing is not possible, the clerk shall mail certified copies of the order to the parties at the last known address of each party. Service by mail is complete upon mailing. When the clerk mails the order, the clerk will prepare a written certification to be placed in the court file specifying the time, date, and method of service and shall notify the sheriff. If the respondent was not at the hearing but was served by the police or sheriff the ex parte injunction and/or a notice of the hearing, the order may be served by certified mail by the clerk or personal service by police officer or sheriff. If the respondent is served by a law enforcement (police or sheriff) officer, the officer will send a paper to the clerk of the court saying that the respondent has been given the order. You can call the clerk's office to find out if the respondent has been given the order. Keep your own copy of the order with you at all times. You also may want to deliver copies to other people protected by the orders or to schools or places of employment the respondent has been ordered to stay away from. If you have been given custody of a minor child, you may want to deliver a copy to the child's school, day care center, or babysitter. Within 24 hours after the police or sheriff has made service upon the respondent and the police or sheriff has been so notified, the police or sheriff must make information relating to *1310 the service available to other law enforcement agencies by electronically transmitting such information to the department. WHAT DO I DO IF THE RESPONDENT VIOLATES THE ORDER? Once the respondent has been given the order, you should report anything the respondent does that the order tells the respondent not to do. This is called a violation of the court order. You should go back to the office that helped you fill out the original forms, either the clerk of the court or the intake office. That office must by law give you the proper forms to report a violation of the court order and they will help you fill them out. You should call the police or sheriff immediately if what the respondent has done makes you afraid or hurts you. Report violations of orders as soon as possible to your local law enforcement agency. Keep a written record of incidents and get copies of police reports concerning the incidents. If you receive treatment for any injuries caused by the respondent, get copies of medical reports prepared by attending physicians. Violation of a court order is punishable by criminal or civil contempt of court. You must file a criminal or civil contempt action in the same court that issued the restraining order. Many violations of a restraining order will subject the respondent to criminal prosecution. The state attorney will determine whether or not to file such a prosecution. The court, however, may act on the violation and order the state attorney to file an order to show cause as to why the respondent should not be held in contempt. Many circuits will have administrative orders which spell out in detail the procedures to be followed; intake personnel will direct you on the procedures to be followed in each circuit. A person who is arrested for domestic violence must be held until the first appearance hearing before a magistrate judge. The magistrate will set bail, if appropriate, and will consider the safety of the victim, the children, and any one else who would be in danger if the respondent is released. Any person who suffers an injury and/or loss as a result of a violation of injunction for protection against domestic violence may be awarded damages for that injury and/or loss by the court issuing the injunction. Damages include the costs and attorney's fees for the enforcement of the injunction. To pursue a remedy for monetary compensatory damages for an injury or loss or for punitive damages, you should consult with an attorney or proceed on your own behalf. The clerk does not have the responsibility to provide you with forms for this relief. WHAT DO I DO IF I WISH TO RECONCILE WITH THE OPPOSING PARTY? The parties cannot amend the injunction verbally, in writing, or by invitation to the residence or invite any other violation of an injunction which is entered by the court. If the petitioner no longer wishes for the injunction to be enforced, the petitioner must voluntarily dismiss the action. The clerk of the court or intake personnel can provide you with a form for voluntary dismissal. You must appear personally to do so. The respondent is subject to arrest for violation of the injunctive order even if you consent to the respondent's return to the residence unless the action is dismissed. For further information, see Florida Family Court Rule of Procedure 12.610 and section 741.30, Florida Statutes (1995). APPENDIX 5 STEPPARENT ADOPTIONS What is an adoption? An adoption creates a legal relationship between a parent and a child that previously did not exist. It declares that the child is legally the child of the adoptive parent. The child *1311 becomes the adopting parent's legal heir. The child is entitled to all of the rights and privileges and subject to all of the obligations of a child born to the adoptive parent. An adoption ends the rights of a birth parent and creates rights for the adoptive parent. Who may be adopted? Any person, a child or an adult, may be adopted. In adoption proceedings the person who is being adopted is known as the "adoptee." Who may adopt? The following persons generally may adopt: 1. a husband and wife together; 2. an unmarried adult, including the birth parent of the adoptee; 3. the unmarried minor birth parent of the adoptee. A married person also may adopt alone if the person to be adopted is not his or her spouse and if the other spouse is a parent of the person to be adopted and consents or the other spouse's failure to consent is excused by the court because of prolonged unexplained absence, unavailability, incapacity, or circumstances the court decides constitute unreasonable withholding of consent. A person who is otherwise eligible to adopt may not be prohibited from doing so solely because of a physical disability or handicap, unless the disability or handicap prevents the person from serving as an effective parent. A homosexual may not adopt in Florida. The person adopting must be a Florida resident. Who must consent to an adoption? Unless the court does not require it, a petition to adopt a child under age 18 may be granted only if 1. the mother signed a written consent after the birth of the child; 2. the father signed a written consent if a. the child was conceived or born while he was married to the mother; b. the child is his by a previous adoption; c. the child has been established to be his by a court proceeding; or d. he has acknowledged in writing, signed in the presence of a competent witness, that he is the father of the child and has filed the acknowledgment with the Vital Statistics Office of the Department of Health and Rehabilitative Services and he has supported the child in a repetitive manner; and 3. the child, if older than 12 years, has signed a written consent. A petition to adopt an adult may be granted if 1. the adult and the adult's spouse, if any, have signed written consents to the adoption; and *1312 2. the adult's birth parents have signed written consents to the adoption or proof of service has been filed showing that notice was served on them and they have failed to respond. The court may choose not to require consent to an adoption by: 1. a parent who has deserted a child without giving a means of identification or who has abandoned a child (note, however, that a diligent effort must be made to notify the parent and get consent); 2. a parent whose parental rights have been terminated by a court order; 3. a parent who has been declared incapacitated by a court and for whom restoration of capacity is medically improbable; 4. a legal guardian or custodian of a person to be adopted, other than a parent, who has failed to respond to a request for consent for 60 days or who, after examination by the court, is found to be withholding consent unreasonably. What is the procedure for an adoption? 1. File an original and one copy of a. the petition, Family Law Form 12.981(a), and the child's birth certificate; b. the necessary consents, Family Law Form 12.981(b) Family Law Form 12.981(c); c. the Affidavit of Diligent Search, Family Law Form 12.981(d), if necessary; and d. the UCCJA Affidavit Family Law Form 12.901(f) in the office of the clerk of the court in the courthouse of the county you live in or where the child lives. Keep one set of copies for yourself and send a set of copies to the Department of Health and Rehabilitative Services office in your county. 2. The judge will set a time and place for the hearing on the petition. In an adoption by a stepparent, the hearing can be held immediately after the petition is filed and a copy has been sent to the Department of Health and Rehabilitative Services. 3. The person who filed the petition to adopt must give the following people notice about the time and place of the hearing: a. any person whose consent was required but who did not consent; and b. any person who gave consent but wants to withdraw it. If the petition is for adoption of an adult, notice of the time and place of the hearing must be given to anyone who was required to consent to the adoption but did not. 4. The judge may order an appropriate investigation to assist in determining if the adoption is in the best interest of the people involved. 5. The adopting stepparent and the adoptee are required to appear at the hearing, unless the adoptee is under 12 years of age or the presence of either of them is excused by the judge. 6. Fill out items 1-9 of the Final Judgment of Adoption, Family Law Form 12.981(e) and take it with you to the hearing. At the hearing, the judge may ask you questions about the information you provided in these forms. If the judge determines that all *1313 necessary consents have been obtained and the adoption is in the best interest of the adoptee, the judge will complete and sign the final judgment of adoption. 7. After the final hearing, go to the clerk of the court's office and ask for the following: a. an application for an amended birth certification; b. at least three certified copies of the final judgment (note that the file is sealed 72 hours after the final hearing and after that an order from the judge will be needed to open it). What forms are required? The following forms are required for a stepparent to adopt his or her spouse's biological child: 1. Petition For Adoption By Stepparent Family Law Form 12.981(a) — This is filled out and signed by the adopting stepparent and the birth parent to whom the adopting stepparent is married. A copy of the child's birth certificate must be attached. 2. Consent and Waiver By Parent Family Law Form 12.981(b) — This is filled out and signed by the parent to whom the adopting stepparent is not married (the "nonresidential parent"), unless consent is waived or not required. See "Who is required to consent to the adoption?" 3. Consent to Adoption By Adoptee Family Law Form 12.981(c) — This is filled out and signed by the person being adopted (the "adoptee") if he or she is more than 12 years old. 4. Affidavit of Diligent Search Family Law Form 12.981(d) — This must be filled out by the adopting stepparent and the birth parent to whom the stepparent is married if the child's other birth parent could not be located to consent to the adoption. It is not to be used if the other parent has been contacted but refused to give consent. 5. Final Judgment of Adoption Family Law Form 12.981(e) — This must be filled out and given to the judge at the final hearing. 6. Uniform Child Custody Jurisdiction Act Affidavit Family Law Form 12.901(f) — This must be completed and filed with the petition and consents. How do I complete these forms? Read all of the forms carefully before filling in the blanks. If there is something you do not understand, have an attorney explain it to you. Every person who completes and signs a form should understand it. All of the blanks must be filled in. If someone helps you fill out the form, their name and address must be shown on the bottom of the form. If that person is not an attorney they must complete the form for nonlawyers who assist others in completing forms at the front of this book. At the top of each form, fill in the judicial circuit number (the clerk's office can give you this information) and the county where the petition will be filed. Leave the case number blank. Fill in the blank following "In the Matter of the Adoption of" with the full name by which the person being adopted will be known after the adoption. Please note that a number of these forms must be signed under oath in the presence of a notary public. If the information you put on the form later is determined to be false, the adoption judgment may be overturned and you may be subject to penalties for perjury. Specific instructions are provided before each of the forms. For more information see Chapter 63, Florida Statutes.