INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.980(w)
PETITION BY AFFIDAVIT FOR ORDER TO SHOW CAUSE FOR A VIOLATION
OF FINAL JUDGMENT OF INJUNCTION FOR PROTECTION AGAINST
DOMESTIC, REPEAT, DATING, OR SEXUAL VIOLENCE, OR STALKING
(11/15)
When should this form be used?
You may use this form if you have a valid Final Judgment of Injunction for Protection Against Domestic,
Repeat, Dating, or Sexual Violence, or Stalking, in force which has been violated. You should use this
affidavit to state the essential facts which establish a violation of the Final Judgment ofInjunction.
This form should be typed or printed in black ink. After completing this form, you should sign the form
before a notary public or the clerk of the circuit court. You should then file the original with such clerk
or judge as determined by the chief judge of your circuit to be the recipient of affidavits of violation,
provide a copy to the state attorney of that circuit and keep a copy for your records.
IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of Judicial Administration now require that all petitions, pleadings, and documents be
filed electronically except in certain circumstances. Self-represented litigants may file petitions or other
pleadings or documents electronically; however, they are not required to do so. If you choose to file
your pleadings or other documents electronically, you must do so in accordance with Florida Rule of
Judicial Administration 2.525, and you must follow the procedures of the judicial circuit in which you file.
The rules and procedures should be carefully read and followed.
IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION
After the initial service of process of the petition or supplemental petition by the Sheriff or certified
process server, the Florida Rules of Judicial Administration now require that all documents required or
permitted to be served on the other party must be served by electronic mail (e-mail) except in certain
circumstances. You must strictly comply with the format requirements set forth in the Rules of Judicial
Administration. If you elect to participate in electronic service, which means serving or receiving pleadings
by electronic mail (e-mail), or through the Florida Courts E-Filing Portal, you must review Florida Rule of
Judicial Administration 2.516. You may find this rule at www.flcourts.org through the link to the Rules of
Judicial Administration provided under either Family Law Forms: Getting Started, or Rules of Court in the
A-Z Topical Index.
SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT
REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by e-mail, the
procedures must always be followed once the initial election is made.
To serve and receive documents by e-mail, you must designate your e-mail addresses by using the
Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form
12.915, and you must provide your e-mail address on each form on which your signature appears. Please
Instructions for Florida Supreme Court Approved Family Law Form 12.980(w), Petition by Affidavit for
Order to Show Cause for a Violation of Final Judgment of Injunction for Protection Against Domestic,
Repeat, Dating, or Sexual Violence, or Stalking (11/15)
CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme Court
Approved Family Law Form 12.914; Designation of Current Mailing and E-mail Address, Florida Supreme
Court Approved Family Law Form 12.915; and Florida Rule of Judicial Administration2.516.
Instructions for Florida Supreme Court Approved Family Law Form 12.980(w), Petition by Affidavit for
Order to Show Cause for a Violation of Final Judgment of Injunction for Protection Against Domestic,
Repeat, Dating, or Sexual Violence, or Stalking (11/15)
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IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT,
IN AND FOR __________________________ COUNTY, FLORIDA
______________________________,
Petitioner,
and
______________________________,
Respondent,
Case No: _________________________
Division: _________________________
PETITION BY AFFIDAVIT FOR ORDER TO SHOW CAUSE FOR A VIOLATION OF FINAL JUDGMENT OF
INJUNCTION FOR PROTECTION AGAINST ( ) DOMESTIC VIOLENCE ( ) REPEAT VIOLENCE ( )
DATING VIOLENCE ( ) SEXUAL VIOLENCE ( ) STALKING
I, {full legal name} __________________________________________________________, being sworn,
certify that I have actual knowledge of the following facts as set forth and the following statements are
true:
1. The Court previously issued a {Choose one only}
a. _____ Final Judgment of Injunction for Protection Against Domestic Violence
b. _____ Final Judgment of Injunction for Protection Against Repeat Violence
c. _____ Final Judgment of Injunction for Protection Against Dating Violence
d. _____ Final Judgment of Injunction for Protection Against Sexual Violence
e. _____ Final Judgment of Injunction for Protection Against Stalking
in this case on {date} ________________.
2. The Final Judgment of Injunction for Protection was served on Respondent on
{date} _______________.
3. On {dates} __________________, at {place and address} ________________________________.
the following event(s) took place: ___________________________________________________
Florida Supreme Court Approved Family Law Form 12.980(w), Petition by Affidavit for Order to Show
Cause for a Violation of Final Judgment of Injunction for Protection Against Domestic, Repeat, Dating, or
Sexual Violence, or Stalking (11/15)
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4.
5.
6.
{For cyberstalking, please include a description of all evidence of contacts and/orthreats made
by Respondent in voice messages, texts, emails, or other electroniccommunication}
_____ Please indicate here if you are attaching additional pages to continue these facts.
Respondent has willfully violated the Injunction by: {explain what Respondent did that violated
the Order of Protection}
_____ Please indicate here if you are attaching additional pages to continue these facts.
_____ Please indicate here if you are attaching copies of medical records for treatment you may
have received for injuries referred to in your affidavit, or copies of any police or sheriff reports
concerning incidents of violence involving you and Respondent.
Respondent acted to impair, interfere with, delay, hinder, lessen the authority of, dignity of, and
embarrass the cause of justice in a manner contemptuous of this court.
Florida Supreme Court Approved Family Law Form 12.980(w), Petition by Affidavit for Order to Show
Cause for a Violation of Final Judgment of Injunction for Protection Against Domestic, Repeat, Dating, or
Sexual Violence, or Stalking (11/15)
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________________________________
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WHEREFORE, I respectfully request that the Court issue an Order to Show Cause, requiring Respondent to
appear before the Court to show cause why Respondent should not be held in contempt of court for
failure to abide by the terms and conditions of the Final Judgment of Injunction for Protection.
I understand that by filing this affidavit, I am asking the court to hold a hearing, that both Respondent
and I will be notified of the hearing, and that I must appear at the hearing. In addition to my own
testimony, I understand that I can bring other proof of the violation such as, for example, people who
saw Respondent violate the order, pictures, medical records, police reports, or anything might help
show the judge how Respondent violated the Final Judgment of Injunction forProtection.
I have read every statement made in this affidavit and each statement is true and correct. I understand
that the statements made in this affidavit are being made under penalty of perjury, punishable as
provided in Section 837.02, Florida Statutes and that the punishment for knowingly making a false
statement includes fines and/or imprisonment.
Dated: ____________________ ________________________________
Signature of Petitioner
STATE OF FLORIDA
COUNTY OF _______________________
Sworn to or affirmed and signed before me on __________ by __________________________________.
NOTARY PUBLIC or DEPUTY CLERK
{Print, type, or stamp commissioned
name of notary or clerk.}
_____ Personally known
_____ Produced identification
Type of identification produced ____________________
I certify that a copy of this document was ( ) mailed (
delivered to the person(s) listed below on {date}
) faxed and mailed (
.
Other party or his/her attorney:
Name: _______________________________________
Address: ______________________________________
City, State, Zip: _________________________________
Fax Number: ___________________________________
Designated E-mail Address(es): ____________________
) e-mailed ( ) hand
Florida Supreme Court Approved Family Law Form 12.980(w), Petition by Affidavit for Order to Show
Cause for a Violation of Final Judgment of Injunction for Protection Against Domestic, Repeat, Dating, or
Sexual Violence, or Stalking (11/15)