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FORM 12.970(b): INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Florida)

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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.970(b)
PETITION FOR CONCURRENT CUSTODY BY EXTENDED FAMILY
(02/18)
When should this form be used?
This form should be used by an extended family member to obtain concurrent custody of a child or
children pursuant to Chapter 751, Florida Statutes. This form should not be used if you are a parent
seeking to establish parental responsibility or time-sharing with a child or children. “Concurrent custody”
means that an eligible extended family member is awarded custodial rights to care for a child or children
concurrently with the child(ren)’s parent or parents.
An Extended Family Member is:
A relative of a minor child within the third degree by blood or marriage to the parent;
OR
The stepparent of a minor child if the stepparent is currently married to the parent of the child and is not
a party in a pending dissolution, separate maintenance, domestic violence, or other civil or criminal
proceeding in any court of competent jurisdiction involving one or both of the child(ren)’s parents as an
adverse party.
You may file a Petition for Concurrent Custody if:
You have the signed, notarized consents of the child(ren)’s legal parents;
OR
You are an extended family member who is caring full time for the child(ren) in the role of a substitute
parent and with whom the child(ren) is (are) presently living.
In addition, you must currently have physical custody of the child(ren) and have had physical custody of
the child(ren) for at least 10 days in any 30-day period within the last 12 months; and not have signed,
written documentation from a parent which is sufficient to enable you to do all the things necessary to
care for the child(ren).
If you do not meet the qualifications above, you should talk to an attorney about other options. You may
also report any suspected abuse, abandonment, or neglect to the appropriate authorities.
This form should be typed or printed in black ink. After completing this form, you should sign the form
before a notary public or deputy clerk. You should file the original with the clerk of the circuit court in
the county where you live and keep a copy for your records.
Instructions for Florida Supreme Court Approved Family Law Form 12.970(b), Petition for Concurrent Custody By
Extended Family (02/18)
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
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.
What should I do next?
IF YOU HAVE SIGNED AND NOTARIZED WAIVERS OF SERVICE OF PROCESS AND CONSENTS from the
child(ren)’s parents , you may contact the clerk, family law intake staff, or judicial assistant, to set a final
hearing. You must notify the child(ren)’s parents of the hearing by using a Notice of Hearing (General),
Florida Supreme Court Approved Family Law Form 12.923, or other appropriate notice of hearing form.
If one of the parents is deceased, you must file a certified copy of the proof of death.
If one of the minor child(ren)’s parents objects to the Petition for Concurrent Custody in writing, the court
may not grant the petition even if the other parent consents, in writing, to the entry of the order. If a
Instructions for Florida Supreme Court Approved Family Law Form 12.970(b), Petition for Concurrent Custody By
Extended Family (02/18)
parent objects, you have the option of converting the Petition to a Petition for Temporary Custody by
Extended Family, Florida Supreme Court Approved Family Law Form 12.970(a). If the Petition is not
converted into a Petition for Temporary Custody by Extended Family, it shall be dismissed without
prejudice.
At any time, the Petitioner or either or both of the child(ren)’s parents may move the court to terminate
the order granting concurrent custody. The court shall terminate the order upon a finding that either or
both of the child(ren)’s parents objects to the order. The fact that the order for concurrent custody has
been terminated does not preclude any person who is otherwise eligible to petition for temporary custody
from filing such petition.
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 751 and Chapter 39, Florida Statutes.
Special Notes. . .
If you do not have the money to pay the filing fee, you may obtain an application for Determination of
Civil Indigent Status, fill it out, and the clerk will determine whether you are eligible to have filing fees
deferred.
With this petition, you must file the following 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).
Notice of Related Cases, Florida Family Law Rules of Procedure Form 12.900(h).
Family Court Cover Sheet, Florida Family Law Rules of Procedure Form 12.928.
Non-Military Affidavit, Florida Supreme Court Approved Family Law Form 12.912(b). (Required
only for obtaining a default on petitions that have been personally or constructively served. Not
required if both parents have signed a waiver and consent.)
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 must
also 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 12.970(b), Petition for Concurrent Custody By
Extended Family (02/18)
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
IN THE CIRCUIT COURT OF THE _______________ JUDICIAL CIRCUIT,
IN AND FOR _______________________________ COUNTY, FLORIDA
Case No: _______________________
Division: _______________________
IN THE INTEREST OF:
_________________________________,
Child(ren)
__________________________________,
Petitioner,
and
__________________________________,
Respondent/____________________,
__________________________________,
Respondent/ ______________________.
PETITION FOR CONCURRENT CUSTODY BY EXTENDED FAMILY
Petitioner, {full legal name} _________________________________, being sworn, certifies that the
following information is true:
1. This is an action for concurrent custody pursuant to Chapter 751, Florida Statutes.
2. Petitioner requests concurrent custody of the following minor child(ren):
Name Date of Birth Current Address
3. Petitioner completed a Uniform Child Custody Jurisdiction and Enforcement Act Affidavit,
Florida Supreme Court Approved Family Law Form 12.902(d), which was filed with this Petition.
The affidavit includes the names and current addresses of the persons with whom the child(ren)
has (have) lived during the past 5 years, the places where the child(ren) has(have) lived during the
past 5 years, and information concerning any custody proceeding in this or any other state with
respect to the child(ren). If the Affidavit is not completely filled out, signed under oath, and filed
with the Petition, the case may be dismissed without a hearing.
4. Petitioner is an extended family member who is: {Choose one only}
_____ Related to the minor child(ren) within the third degree by blood or marriage to a parent;
OR
Florida Supreme Court Approved Family Law Form 12.970(b), Petition for Concurrent Custody By Extended Family
(02/18)
______________________________________________________________________________
_____________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____ The stepparent of the minor child(ren), is married to Respondent {full legal name}
__________ and is not a party in a pending dissolution, separate maintenance, domestic violence,
or other civil or criminal proceeding in any court of competent jurisdiction involving one or both
of the child(ren)’s parents as an adverse party.
5. Petitioner’s relationship to the minor child(ren) is: ____________________________________.
6. The residence and post office address of the Petitioner is: ______________________________
______________________________________________________________________________.
7. The legal parents are:
a. __________________________________________________, whose current address is:
_______________________________________________________________________;
b. ____________________________________________________, whose current address is:
___________________________________________________________________________.
8. Petitioner currently has physical custody of the child(ren) and has had physical custody of the
child(ren) for at least 10 days in any 30-day period within the last 12 months. Detail the time
periods during the past 12 months when the child(ren) have resided with the Petitioner:
______________________________________________________________________________.
9. Petitioner does not have signed, written documentation from a parent which is sufficient to
enable the Petitioner to do all of the things necessary to care for the child(ren).
10. {If applicable} Describe the type of documents, if any, provided by the parent or parents which
enables the Petitioner to act on behalf of the child(ren): __________________________
______________________________________________________________________________.
These documents are attached to this Petition as Exhibit ________.
11. Petitioner is unable to obtain or undertake the following services or actions without an order of
custody:
______________________________________________________________________________.
12. The Consents of Parent {full legal name}___________________________ and/or Parent {full legal
name} _________________________________ is/are attached to the Petition.
OR
{If applicable} The Consent of Parent {full legal name} ______________________________ is not
attached because that parent is deceased. A certified copy of the proof of death is attached.
13. Petitioner requests concurrent custody be granted for the following period of time: _________
Florida Supreme Court Approved Family Law Form 12.970(b), Petition for Concurrent Custody By Extended Family
(02/18)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_____________________________________________________________________________.
The reasons that support this request are: ___________________________________________
______________________________________________________________________________.
14. It is in the best interests of the child(ren) that the Petitioner have concurrent custody of the
child(ren) for the following reasons: _____________________________________________
_____________________________________________________________________________.
15. ORDER OF PROTECTION
a._____Petitioner IS NOT aware of any temporary or permanent order for protection entered on
behalf of or against either parent, the Petitioner, or the child(ren) in Florida or any other
jurisdiction.
OR
b_____ Petitioner IS aware of the following temporary or permanent orders for protection
entered on behalf of or against either parent, the Petitioner, or the child(ren) in Florida
or any other jurisdiction. The court entering the order and the case number is: _______
_______________________________________________________________________.
16. TEMPORARY OR PERMANENT CHILD SUPPORT ORDERS
a._____Petitioner IS NOT aware of any temporary or permanent orders for child support for the
minor child(ren).
OR
b._____Petitioner IS aware of the following temporary or permanent order for child support for
the minor child(ren). The court entering the order and the case number is:__________
_______________________________________________________________________.
17. CHILD SUPPORT (If Petitioner is seeking child support) {Choose one only}
(You must have proof of service upon or waiver of process by the parent(s) or a Waiver of Service
of Process and Consent for the court to consider an award for child support)
a.____ Petitioner requests the court to order the parents to pay child support.
b.____ Petitioner requests the court to redirect all or part of the parents’ existing child support
obligation(s) to the Petitioner.
c.____ Petitioner requests the court to redirect all or part of the parents’ existing child support
obligation(s) to the Petitioner, and to award the Petitioner retroactive child support.
Florida Supreme Court Approved Family Law Form 12.970(b), Petition for Concurrent Custody By Extended Family
(02/18)
______________________________________________________________________________
______________________________________________________________________________
_______________________________________
________________________________________
18. Petitioner ____ requests _____ does not request that the court establish reasonable visitation or
a time-sharing schedule with the parents.
19. Other _________________________________________________________________________
______________________________________________________________________________.
WHEREFORE, Petitioner requests that this Court grant the Petitioner concurrent custody of the child(ren)
subject to this proceeding; award the Petitioner other relief as requested; and award any other relief that
the Court deems necessary.
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
petition and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated: _____________________________ _________________________________________
Signature of Petitioner
Printed Name: _____________________________
Address: __________________________________
City, State, Zip Code: ________________________
Telephone Number: _________________________
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
deputy clerk.
____ Personally known
____ Produced identification
Type of identification produced _________________________
Florida Supreme Court Approved Family Law Form 12.970(b), Petition for Concurrent Custody By Extended Family
(02/18)
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 Supreme Court Approved Family Law Form 12.970(b), Petition for Concurrent Custody By Extended Family
(02/18)
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FORM 12.970(b): INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Florida)

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Completed 10 January 2021

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