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IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL (The 15th Judicial Circuit of Florida)

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15
th
Judicial Circuit- Date of Birth Form for Unified Family Court
IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT
IN AND FOR PALM BEACH COUNTY, FLORIDA
Case No: ________________________________
Division:
___________________________________,
Petitioner,
and
___________________________________,
Respondent.
Date of Birth Form for Unified Family Court
Instructions
Pursuant to Administrative Order 5.109, this form is to be completed and filed with the Clerk's Office in
all new and reopened Unified Family Court ("UFC") cases. UFC case types include but are not limited to
all family, juvenile, mental health, domestic violence and guardianship cases. A detailed list of UFC case
types can be found in Administrative Order 5.101.
Sensitive Information (month and day of birth/names of minors) will be redacted by the Clerk and
will not appear in a document accessible by the general public.
Information
Petitioner’s Name
Petitioner’s D.O.B
Petitioner’s Address
Respondent’s Name
Respondent’s D.O.B
Respondent’s Address
Child’s Name
Child’s D.O.B
Child’s Name
Child’s D.O.B
Child’s Name
Child’s D.O.B
Child’s Name
Child’s D.O.B
Child’s Name
Child’s D.O.B
*Please attach an additional page for additional Party or Child
Filed by: _______________________________
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IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL (The 15th Judicial Circuit of Florida)

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Completed 13 June 2021

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