IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
CONSENT TO LIMITED APPEARANCE BY ATTORNEY
{Name} _______________________________________, the [check one only]
( ) Petitioner ( ) Respondent, consents to the limited representation by counsel,
{attorney’s name| ___________________________________________, for the following limited
purpose(s) [ check all that apply]:
1. ____The hearing set for {date} ___________________, at {time}________ on the issue(s) of {specify}
___________________________________________________________________.
2. ___To represent [ check one only] ( ) Petitioner ( ) Respondent on the following issues
throughout the proceedings:
a. ___Parental responsibility and time-sharing.
b. ___ Equitable distribution of marital assets and liabilities.
c. ___ Alimony.
d. ___ Child support.
e. ___ Other {specify}: _______________________________________________________
The clerk of the above-styled court is requested to enter this notice of record.
I certify that a copy of this consent to limited appearance was: [check all used] ( ) e-mailed ( )
mailed ( ) faxed ( ) hand delivered to the person(s) listed below on {date} _________.
Other party or his/her attorney:
Name: ________________________________
Address: _____________________________
City, State, Zip: _________________________
Telephone Number: _____________________
Fax Number: _____________________________
E-mail Address(es):_________________________
Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by Attorney (09/12)
