Fillable FORM 12.980(h): INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Pinellas County Clerk of the Circuit Court and Comptroller)

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FORM 12.980(h): INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Pinellas County Clerk of the Circuit Court and Comptroller)

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Instructions for Florida Supreme Court Approved Family Law Form 12.980(h), Request for Confidential Filing of
Address (03/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.980(h)
REQUEST FOR CONFIDENTIAL FILING OF ADDRESS
(03/15)
When should this form be used?
If you fear that disclosing your address would put you in danger because you are the victim of sexual
battery, aggravated child abuse, stalking, aggravated stalking, harassment, aggravated battery, or
domestic violence, you should complete this form and file it with the clerk of the circuit court.
This form should be typed or printed in black ink. After completing this form, you should file the original
with the clerk of the circuit court in the county where your 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.
Florida Supreme Court Approved Family Law Form 12.980(h), Request for Confidential Filing of Address
(03/15)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
___________________,
Petitioner,
and
___________________,
Respondent.
REQUEST FOR CONFIDENTIAL FILING OF ADDRESS
I, {full legal name} , request that the Court
maintain and hold as confidential, the following address:
Address
City State Zip
Telephone (area code and number)
This request is being made for the purpose of keeping the location of my residence unknown for safety
reasons pursuant to section 119.071(2)(j)1, section 784.0485(3)(b)1, Florida Statutes, or other statutory
provision providing for the separate confidential filing for safety reasons.
Dated: __________________________________________
Signature
CLERK’S CERTIFICATE AS TO REQUEST FOR
CONFIDENTIAL FILING OF ADDRESS
I, , as Clerk of the Circuit Court, do hereby certify that I
received and filed the above and will keep the above address confidential, subsequent to further order
of the Court relative to such confidentiality.
CLERK OF THE CIRCUIT COURT
(SEAL)
By:
{Deputy Clerk}
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FORM 12.980(h): INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED (Pinellas County Clerk of the Circuit Court and Comptroller)

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Completed 10 February 2021

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