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FORM 12.941(a),: INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Florida)

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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.941(a),
VERIFIED MOTION FOR TEMPORARY INJUNCTION TO PREVENT
REMOVAL OF MINOR CHILD(REN) AND/OR DENIAL OF PASSPORT
SERVICES
(11/15)
When should this form be used?
You should use this form if you want the court to enter an order that your minor child(ren) is (are) not to
be removed from the State of Florida while a case involving parenting or time-sharing is pending, that
passport services for the minor child(ren) be prohibited, and/or that existing passports be turned over to
you.
This form should be typed or printed in black ink. If you want the court to enter an ex parte order,
without giving the other side advance notice of the hearing, you should explain your reasons in
paragraph 5 of this form. After completing this form, you should sign the form before a notary public.
You should file the original with the clerk of the circuit court in the county where your case is pending and
keep a copy for your records. You should also ask the clerk to process your motion though their
emergency procedures.
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.
What should I do next?
If the court enters an order without advance notice to the other party, you should take a certified copy
of the order to the sheriff’s office for further assistance. You must have this form and the court’s order,
served by personal service on the other party. You should read the court’s order carefully. Look for
directions in the order that apply to you and note the time and place of the hearing scheduled in the
order. You should go to the hearing with whatever evidence you have regarding yourmotion.
If the court will not enter an order without advance notice to the other side, you should check with the
clerk of court, family law intake staff, or judicial assistant for information on the local procedure for
scheduling a hearing on your motion, unless the court sets a hearing in its order denying your request
for an ex parte hearing. When you know the date and time of your hearing, you should file Notice of
Hearing (General), Florida Supreme Court Approved Family Law Form 12.923 or other appropriate
notice of hearing form, and use personal service to notify the other party of your motion, the court’s
order, if any, and the hearing.
Instructions for Florida Supreme Court Approved Family Law Form 12.941(a), Verified Motion for Temporary
Injunction to Prevent Removal of Minor Child(ren) and/or Denial of Passport Services (11/15)
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. For further information, see chapter 61, Florida Statutes, and rule 1.610,
Florida Rules of Civil Procedure.
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 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 Administration 2.516.
Special notes...
If you have an attorney, your attorney must certify in writing the efforts that have been made to give the
other party notice, if no notice is given. The court may require you to post a bond as a condition of the
injunction.
With this form you must also file the following, if you have not already done so, and provide a copy to
the other party:
Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit, Florida Supreme
Court Approved Family Law Form 12.902(d).
Temporary Injunctions... These family law forms contain a Temporary Injunction to Prevent Removal of
Minor Child(ren) and/or Denial of Passport Services (Ex Parte), Florida Supreme Court Approved Family
Law Form 12.941(b), which the judge may use if he or she enters an order without a hearing, and a
Temporary Injunction to Prevent Removal of Minor Child(ren) and/or Denial of Passport Services
(After Notice), Florida Supreme Court Approved Family Law Form 12.941(c), which the judge may use if
he or she enters an order after a hearing. You should check with the clerk, family law intake staff, or
judicial assistant to see if you need to bring a blank order form with you to the hearing. If so, you should
Instructions for Florida Supreme Court Approved Family Law Form 12.941(a), Verified Motion for Temporary
Injunction to Prevent Removal of Minor Child(ren) and/or Denial of Passport Services (11/15)
type or print the heading, including the circuit, county, case number, division, and the parties’ names,
and leave the rest blank for the judge to complete at your hearing.
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 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 Supreme Court Approved Family Law Form 12.941(a), Verified Motion for Temporary
Injunction to Prevent Removal of Minor Child(ren) and/or Denial of Passport Services (11/15)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
IN THE CIRCUIT COURT OF THE _______________________ JUDICIAL CIRCUIT,
IN AND FOR ________________________ COUNTY, FLORIDA
__________________________________,
Petitioner,
and
__________________________________,
Respondent,
Case No.: ___________________________ ___
Division:
__________________________________________________________________________________ ________
VERIFIED MOTION FOR TEMPORARY INJUNCTION TO PREVENT
REMOVAL OF MINOR CHILD(REN) AND/OR DENIAL OF PASSPORT
SERVICES
_____ Petitioner _____ Respondent requests the Court to enter a temporary injunction to prevent
removal of the following listed minor child(ren) from the jurisdiction of this Court and deny passport
services for the child(ren) and says:
1. The minor child(ren) subject to this request is (are):
Name Birth date
2. The child(ren) has (have) been a resident(s) of County, Florida
since {date} .
3. A completed Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit, Florida
Supreme Court Approved Family Law Form 12.902(d), _____ is filed with this motion or _____
has already been filed.
4. It is in the best interests of the minor child(ren) that the Court order the following:
{Indicate all that apply}
a. _____ The child(ren) not be removed from the jurisdiction of this Court while litigation is
pending because:
b. _____ Passport services for the minor child(ren) be prohibitedbecause: ____________________
Florida Supreme Court Approved Family Law Form 12.941(a), Verified Motion for Temporary Injunction to Prevent
Removal of Minor Child(ren) and/or Denial of Passport Services (11/15)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
c. _____ Existing passports for the minor child(ren) be immediately turned over to _____
Petitioner _____ Respondent because: ______________________________________________
5. This motion should be granted _____ with _____ without notice to the other party. {If without
notice, explain why there would be immediate and irreparable harm if the other party is given notice.}
WHEREFORE, _____ Petitioner _____ Respondent requests the following from the Court:
{Indicate all that apply}
a. _____ enter a temporary injunction to prevent removal of the child(ren) named above
from the jurisdiction of this Court while this action is pending;
b. _____ enter an order denying passport services for the minor child(ren);
c. _____ enter an order requiring that any existing passports for the minor child(ren) be
immediately delivered to _____ Petitioner _____ Respondent;
d. _____ enter a temporary injunction without notice to the other party.
Florida Supreme Court Approved Family Law Form 12.941(a), Verified Motion for Temporary Injunction to Prevent
Removal of Minor Child(ren) and/or Denial of Passport Services (11/15)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
______________________________________________
_____________________________________________
_______________________________________
_______________________________________
I certify that a copy of this document was ( ) e-mailed ( ) mailed ( ) faxed ( ) hand-delivered to
the person(s) listed below on {date} __________________________ or ( ) was not delivered to the
person(s) listed below because ___________________________________________________________
Other party or his/her attorney:
Name: ________________________________________
Address: ______________________________________
City, State, Zip: _________________________________
Fax Number: ___________________________________
Designated E-mail Address(es): ____________________
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
verified motion and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
Dated: _______________________ _____________________________________________
Signature of Party
Printed Name: _________________________________
Address: ______________________________________
City, State, Zip: _________________________________
Fax Number: ___________________________________
Designated E-mail Address(es): ____________________
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 ___________________________________________________________
If the party filing this motion is represented by an attorney, the attorney must complete the following:
Florida Supreme Court Approved Family Law Form 12.941(a), Verified Motion for Temporary Injunction to Prevent
Removal of Minor Child(ren) and/or Denial of Passport Services (11/15)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________
_____________________________________________
I, the undersigned attorney for the movant, hereby certify in that the following efforts have been made
to give notice. {if no efforts have been made, why} ____________________________________________
Signature
Printed Name: _________________________________
Florida Bar Number: _____________________________
Address: ______________________________________
City, State, Zip: _________________________________
Fax Number: ___________________________________
Designated E-mail Address(es): ____________________
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: {choose only one} ( ) Petitioner ( ) Respondent
This form was completed with the assistance of:
{name of individual} ____________________________________________________________________,
{name of business} _____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} ______________, {state} _____, {zip code} ___________, {telephone number} ________________
Florida Supreme Court Approved Family Law Form 12.941(a), Verified Motion for Temporary Injunction to Prevent
Removal of Minor Child(ren) and/or Denial of Passport Services (11/15)
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FORM 12.941(a),: INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Florida)

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Completed 10 January 2021

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