Fill - FORM 12.980(g): INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Florida)

INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW

FORM 12.980(g)

SUPPLEMENTAL AFFIDAVIT IN SUPPORT OF PETITION FOR 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 your Petition for Injunction for Protection Against Domestic Violence, Florida

Supreme Court Approved Family Law Form 12.980(a), your Petition for Injunction for Protection Against

Repeat Violence, Florida Supreme Court Approved Family Law Form 12.980(f), your Petition for

Injunction for Protection Against Dating Violence, Florida Supreme Court Approved Family Law Form

12.980(n), your Petition for Injunction for Protection Against Sexual Violence, Florida Supreme Court

Approved Family Law Form 12.890(q), or your Petition for Injunction for Protection Against Stalking,

Florida Supreme Court Approved Family Law Form 12.980(t), was denied by thejudge.

You should use this supplemental affidavit to add facts or clarify the facts you wrote in your original

petition.

For a domestic violence case, you should include facts that establish that you have been a victim of

violence or are in imminent danger of becoming a victim of violence from the respondent.

For a repeat violence case, you should include facts that establish that you or a member of your immediate

family have or has been a victim of at least two prior incidents of violence, that one of those incidents

occurred within the last six months and that there is an immediate and present risk of danger to you or

a member of your immediate family.

For a dating violence case, you should include fact that establish that you have been a victim of violence

or are in imminent danger of becoming a victim of violence from the respondent who is an individual with

whom you have or have had a continuing and significant relationship of a romantic or intimate nature, to

be determined by consideration of such facts as: whether the dating relationship existed within the past

six months; whether the nature of the relationship included an expectation of affection or sexual

involvement; and whether the frequency and type of interaction between you and the individual included

involvement over time and on a continued basis. Dating violence does not include violence in a casual

acquaintanceship or violence between individuals who have only engaged in ordinary fraternization in a

business or social context.

For a sexual violence case, you should include facts that establish that you are a victim of sexual violence

or the parent of a minor child living at home who is a victim of sexual violence, and that you have reported

the sexual violence to law enforcement and are cooperating in the criminal proceeding if there is one. If

the respondent was in state prison for sexual violence against you or the minor child and the respondent

is out of prison or is getting out within 90 days of the petition, include that information in your

supplemental affidavit, along with a copy of the notice of inmate release.

For a stalking case, you should include facts that establish that you are either a victim of stalking or

cyberstalking, or that you are the parent or legal guardian of a minor child living at home who is a victim

of stalking or cyberstalking. The facts must establish that stalking exists in order for the judge to order a

Instructions for Florida Supreme Court Approved Family Law Form 12.980(g), Supplemental Affidavit in Support of

Petition for Injunction for Protection Against Domestic, Repeat, Dating, or Sexual Violence, or Stalking (11/15)

temporary injunction for protection against stalking. Please be specific as to where the incidents of

stalking took place. These locations may include, but need not be limited to, a home, school, or place of

employment. For cyberstalking, please include a description of all evidence of contacts and/or threats

made by the respondent in voice messages, texts, emails, or other electronic communication.

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 the clerk in

the county where the petition was filed 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.

What should I do next?

After you complete this supplemental affidavit, the clerk will attach it to your original petition and all the

documents will be submitted to the judge as your Amended Petition.

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 Administration2.516.

Instructions for Florida Supreme Court Approved Family Law Form 12.980(g), Supplemental Affidavit in Support of

Petition for Injunction for Protection Against Domestic, Repeat, Dating, or Sexual Violence, or Stalking (11/15)

______________________________________________________________________________

IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT,

IN AND FOR __________________________ COUNTY, FLORIDA

Case No: _________________________

Division: _________________________

____________________________________,

Petitioner,

and

__,

Respondent,

SUPPLEMENTAL AFFIDAVIT IN SUPPORT OF PETITION FOR

INJUNCTION FOR PROTECTION AGAINST

( ) DOMESTIC VIOLENCE ( ) REPEAT VIOLENCE

( ) DATING VIOLENCE ( ) SEXUAL VIOLENCE ( ) STALKING

I, {full legal name} __________________________________________________________, being sworn,

certify that the following statements are true:

{Please complete all paragraphs that relate to your case}

1. On {date} ____________________, at {place and address} _______________________________

______________________________________________________________________________,

Respondent said or did the following things that hurt me or a member of my immediate family

and made me afraid for my or my family member’s safety:

_____ Please indicate here if you are attaching additional pages to continue these facts.

Florida Supreme Court Approved Family Law Form 12.980(g), Supplemental Affidavit in Support of Petition for

Injunction for Protection Against Domestic, Repeat, Dating, or Sexual Violence, or Stalking (11/15)

______________________________________________________________________________

2. On {date} ____________________, at {place and address} ______________________________,

the following event(s) took place: ___________________________________________________

_____ Please indicate here if you are attaching additional pages to continue these facts.

3. On {date} ____________________, the following incidents of stalking occurred at the following

locations: {the locations may include, but need not be limited to, a home, school, or place of

employment}

__________________________________________________________________________________________________________________________________________________________________________________________________

For cyberstalking, the following is a description of all evidence of contacts and/or threats made

by Respondent in voice messages, texts, emails, or other electroniccommunication: __________

_____ Please indicate here if you are attaching additional pages to continue these facts.

4. _____ Please indicate here if you are attaching copies of medical records for treatment you may

have received for injuries referred to in your petition or in this supplemental affidavit, copies of

any police or sheriff reports concerning incidents of violence involving you and Respondent, or

any notice of inmate release.

Florida Supreme Court Approved Family Law Form 12.980(g), Supplemental Affidavit in Support of Petition for

Injunction for Protection Against Domestic, Repeat, Dating, or Sexual Violence, or Stalking (11/15)

______________________________________________

_________________________________________________

_____________________________________________

I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this

supplemental affidavit and that the punishment for knowingly making a false statement includes fines

and/or imprisonment.

Dated: _______________

STATE OF FLORIDA

COUNTY OF ____________________

Signature of Petitioner

Printed Name:

Address:

City, State, Zip Code:

Telephone Number:

Number:

E-Mail Address(es):

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 12.980(g), Supplemental Affidavit in Support of Petition for

Injunction for Protection Against Domestic, Repeat, Dating, or Sexual Violence, or Stalking (11/15)

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