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IN THE CIRCUIT COURT OF THE l5TH JUDICIAL (The 15th Judicial Circuit of Florida)

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IN THE CIRCUIT COURT OF THE l5TH
JUDICIAL CIRCUIT OF FLORIDA, IN
AND FOR PALM BEACH COUNTY.
FAMILY DIVISION.
CASE NO.
____________________________,
Petitioner,
and
____________________________,
Respondent.
_______________________________________/
JOINT PRETRIAL STATEMENT
I. INFORMATION ABOUT THE PARTIES
Petitioner’s Name:
Petitioner’s Address:
Petitioner’s Age:
Does Petitioner wish to have former name restored? Yes/No
If yes, what is name to be restored to?
Petitioner’s Employer:
Address of Petitioner’s Employer:
Petitioner’s Net Monthly Income:
Is Petitioner’s Net Monthly Income Disputed by Respondent? Yes/No
Respondent’s Name:
Respondent’s Address:
Respondent’s Age:
Respondent’s Employer:
Address of Respondent’s Employer:
Respondent’s Net Monthly Income:
Is Respondent’s Net Monthly Income Disputed by Petitioner? Yes/No
Name of each child, their date of birth, and current place of residence:
Name D.O.B. Current Place of Residence
Date and Place of Marriage:
Date of Final Separation:
Is There a Written Settlement Agreement? Yes/No
Is Child Support an issue? Yes/No If yes, attach a fully completed child support calculation
worksheet (Florida Family Rule Form 12.902(e).
II. TRIAL INFORMATION
Date Petition Filed:
Docket Number:
Date Answer Filed:
Docket Number:
Date Counter-Petition Filed:
Docket Number:
Date Answer to Counter-Petition Filed:
Docket Number:
Pending Motions:
Docket Number:
Date Parties Attended Mediation:
Attach Petitioner’s Witness List
Attach Petitioner’s Exhibit List (all exhibits must be pre-marked for trial)
Attach Respondent’s Witness List
Attach Respondent’s Exhibit List (all exhibits must be pre-marked for trial)
Are There Any Support Arrearages? Y/N
If yes, state the amount of the arrearage, the date and amount of the next payment due, and
the date and docket entry number for the court order establishing the support that is in arrears.
List Relief Sought by Petitioner:
List Relief Sought by Respondent:
Stipulated Facts:
Issues for the Court to Decide:
MARITAL ASSETS
(Complete this section if this is a dissolution of marriage action. If value is disputed, list the asset again on the next line and fill out
columns 2, 3, 4, & 5 for each party. Footnote any item for which a special equity is claimed. List legal description on a separate
page, if necessary)
(1) (2) (3) (4) (5)
Wife’s Proposal
Husband’s Proposal
Description
Value Liens Net Equity
Opinion
Source
Wife Husband Wife Husband
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
MARITAL LIABILITIES
(Complete this section if this is a dissolution of marriage action)
Description Monthly
Payment
Balance Due Name of
Person on
this Liability
Opinion
Source
Wife’s Proposal
Husband’s Proposal
Wife Husband Wife Husband
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Non-Marital Assets Claimed
(Complete this section if this is a dissolution of marriage action)
Description Owner Reason for Claim Disputed?
Non-Marital Liabilities Claimed
(Complete this section if this is a dissolution of marriage action)
Description Obligor Reason for Claim Disputed?
Attorney for Petitioner/Pro Se Petitioner Attorney for Respondent/Pro Se Respondent
Florida Bar Number: Florida Bar Number:
Telephone Number: Telephone Number:
Date: Date:
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IN THE CIRCUIT COURT OF THE l5TH JUDICIAL (The 15th Judicial Circuit of Florida)

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Completed 13 June 2021

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