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FORM 12.902(f)(3): INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES (Florida)

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INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.902(f)(3)
MARITAL SETTLEMENT AGREEMENT FOR
SIMPLIFIED DISSOLUTION OF MARRIAGE (10/21)
When should this form be used?
This form should be used when a Petition for Simplified Dissolution of Marriage, Florida Family Law Rules
of Procedure Form 12.901(a), has been filed and the parties have reached an agreement on all of the
issues at hand.
This form should be typed or printed in black ink. Both parties must sign the agreement and have their
signatures witnessed by a notary public or deputy clerk. After completing this form, you should file this
document with the clerk of the circuit court in the county where the petition was filed and keep a copy
for your records. You should then refer to the instructions for your petition, answer, or answer and
counterpetition concerning the procedures for setting a hearing or trial (final hearing).
What should I do next?
A copy of this form must be filed with the court and served on the other party or his or her attorney in
your case. The copy you are serving to the other party must be either mailed, e-mailed, or hand-delivered
to the opposing party or his or her attorney on the same day indicated on the certificate of service. If it is
mailed, it must be postmarked on the date indicated in the certificate of service. Service must be in
accordance with Florida Rule of General Practice and Judicial Administration 2.516.
IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of General Practice and 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 General Practice and 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 General Practice and 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 Florida Rules of General Practice and 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 General Practice and Judicial
Instructions for Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for
Simplified Dissolution of Marriage (10/21)
Administration 2.516. You may find this rule at www.flcourts.org through the link to the Rules of General
Practice and 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 email, 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 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 General Practice and Judicial
Administration 2.516.
Where can I look for more information?
Before proceeding, you should read General Information for Self-Represented Litigants found at the
beginning of these forms. The words that are in bold underline in these instructions are defined there.
For further information, see chapter 61, Florida Statutes, and the instructions for the petition which was
filed in this case.
Special notes . . .
This form does not act to transfer title to the property. Such transfer must be done by deed or
supplemental final judgment.
Remember, 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 a Disclosure from Nonlawyer, Florida Family Law Rules of
Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also
must put his or her name, address, and telephone number on the bottom of the last page of every form
he or she helps you complete.
Instructions for Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for
Simplified Dissolution of Marriage (10/21)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
In re: the Marriage of:
,
Petitioner,
and
,
Respondent.
MARITAL SETTLEMENT AGREEMENT FOR
SIMPLIFIED DISSOLUTION OF MARRIAGE
We, {Petitioner’s full legal name}_______________________________, and {Respondent’s full legal
name} __________________________________________, being sworn, certify that the following
statements are true:
1. We were married to each other on {date} .
2. 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 to receive 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 that we believe the other has been
open and honest in writing this agreement.
3. Each of us agrees to execute and exchange any documents that might be needed to complete
this agreement, including deeds, title certificates, etc.
SECTION I. MARITAL ASSETS AND LIABILITIES
A. Division of Assets. We divide our assets (everything we own and that is owed to us) as follows: Any
personal item(s) not listed below is the property of the party currently in possession of the item(s).
1. Petitioner shall receive as his/her own and Respondent shall have no further rights or
responsibilities regarding these assets:
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
ASSETS: DESCRIPTION OF ITEM(S) PETITIONER SHALL RECEIVE
To avoid confusion at a later date, describe each item as clearly as possible.
LIST ONLY THE LAST FOUR DIGITS OF ACCOUNT NUMBERS.
Where applicable, include whether the name on any title/deed/account described
below is in one spouse’s name, or in both spouses’ names.
Current Fair
Market Value
Cash (on hand)
$
Cash (in banks/credit unions)
Stocks/Bonds
Notes (money owed to you in writing)
Money owed to you (not evidenced by a note)
Real estate: (Home)
(Other)
Business interests
Automobiles
Boats
Other vehicles
Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)
Furniture & furnishings in home
Furniture & furnishings elsewhere
Collectibles
Jewelry
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
Life insurance (cash surrender value)
Sporting and entertainment (T.V., stereo, etc.) equipment
Other assets
Total Assets to Petitioner $
2. Respondent shall receive as his/her own and Petitioner shall have no further rights or
responsibilities regarding these assets:
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
To avoid confusion at a later date, describe each item as clearly as possible.
LIST ONLY THE LAST FOUR DIGITS OF ACCOUNT NUMBERS.
Where applicable, include whether the name on any title/deed/account described
below is in one spouse’s name or in both spouses’ names.
Current Fair
Market Value
Cash (on hand)
Cash (in banks/credit unions)
Stocks/Bonds
Notes (money owed to you in writing)
Money owed to you (not evidenced by a note)
Real estate: (Home)
(Other)
Business interests
Automobiles
Boats
Other vehicles
Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)
Furniture & furnishings in home
Furniture & furnishings elsewhere
Collectibles
Jewelry
$
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
Life insurance (cash surrender value)
Sporting and entertainment (T.V., stereo, etc.) equipment
Other assets
Total Assets to Respondent
$
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
b
B. Division of Liabilities/Debts. We divide our liabilities (everything we owe) as follows:
1. Petitioner shall pay as his/her own the following and will not at any time ask Respondent to pay
these debts/bills:
LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY PETITIONER
To avoid confusion at a later date, describe each item as clearly as
possible.
LIST ONLY THE LAST FOUR DIGITS OF ACCOUNT NUMBERS.
Where applicable, include whether the name on any mortgage, note, or
account described below is in one spouse’s name or in both spouses’
names.
Monthly
Payment
Current
Amount
Owed
Mortgages on real estate: (Home)
$
(Other)
Charge/credit card accounts
Auto loan
Auto loan
Bank/credit union loans
Money you owe (not evidenced by a note)
Judgments
Other
Total Debts to Be Paid by Petitioner
$
$
$
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
2. Respondent shall pay as his/her own the following and will not at any time ask Petitioner to pay
these debts/bills:
LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY RESPONDENT
To avoid confusion at a later date, describe each item as clearly as
possible.
LIST ONLY THE LAST FOUR DIGITS OF ACCOUNT NUMBERS.
Where applicable, include whether the name on any mortgage, note, or
account described below is in one spouse’s name or, or in both spouses’
names.
Monthly
P
ayment
Current
Amount
Owed
Mortgages on real estate: (Home)
$
$
(Other)
Charge/credit card accounts
Auto loan
Auto loan
Bank/credit union loans
Money you owe (not evidenced by a note)
Judgments
Other
Total Debts to Be Paid by Respondent
$
$
C. Contingent Assets and Liabilities (listed in Section III of our Family Law Financial Affidavits) will be
divided as follows:
.
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
______________________________________________________________________________
______________________________________________________________________________
SECTION II. SPOUSAL SUPPORT (ALIMONY) Each of us forever gives up any right to spousal support
(alimony) that we may have.
SECTION III. OTHER
I certify that I have been open and honest in entering into this settlement agreement. I am satisfied
with this agreement and intend to be bound by it.
Dated:
Signature of Petitioner
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
STATE OF FLORIDA
COUNTY OF
Sworn to or affirmed and signed before me on
E-mail Address(es): _____ ________________________
by .
NOTARY PUBLIC or DEPUTY CLERK
{Print, type, or stamp commissioned name of notary or
clerk.}
_____ Personally known
_____ Produced identification
Type of identification produced
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:
[fill in all blanks]
This form was prepared for the Petitioner.
This form was completed with the assistance of:
{name of individual} _________________________________________________________________,
{name of business} __________________________________________________________________,
{address} __________________________________________________________________________,
{city} __________________, {state} _____, {zip code} _______, {telephone number} ______________.
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
I certify that I have been open and honest in entering into this settlement agreement. I am satisfied
with this agreement and intend to be bound by it.
Dated:
STATE OF FLORIDA
COUNTY OF
Sworn to or affirmed and signed before me on
Signature of Respondent
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
E-mail Address(es):
by .
NOTARY PUBLIC or DEPUTY CLERK
{Print, type, or stamp commissioned name of notary or
clerk.}
_____ Personally known
_____ Produced identification
Type of identification produced
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:
[fill in all blanks]
This form was prepared for the Respondent.
This form was completed with the assistance of:
{name of individual} ____________________________________________________________________,
{name of business} _____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} __________________, {state} _____, {zip code} _______, {telephone number} ________________.
Florida Family Law Rules of Procedure Form 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution
of Marriage (10/21)
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FORM 12.902(f)(3): INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES (Florida)

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Completed 15 June 2022

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