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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW (Florida)

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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY
LAW FORM 12.950(a)
AGREEMENT FOR RELOCATION WITH MINOR CHILD(REN)
(02/18)
When should this form be used?
This form should be used when the parents and every other person entitled to access to,
visitation, or time-sharing with the minor child(ren) are in agreement and are asking the court to
permit the relocation of the child(ren)’s principal residence. “Other Person” means an individual
who is not the parent, but with whom the child resides pursuant to court order, or who has the
right of access to, time-sharing with, or visitation with the child(ren). This form can be used at any
time after either a petition or supplemental petition to relocate has been filed and the parties
reach an agreement; OR can be used when the parties are in agreement and there is an existing
cause of action, judgment, or decree of record pertaining to the child(ren)’s residence or time-
sharing schedule. Either an agreement for relocation or a petition to relocate is required when:
1. You plan to relocate the child(ren)’s residence more than 50 miles from the child(ren)’s
principal residence at the time of the last order which established or modified either a
Parenting Plan or time-sharing schedule or at the time of filing of the pending action.
2. The court has not already entered an order granting permission to relocate.
3. The relocation will be for a period of 60 consecutive days or more, not including any absence
for purposes of vacation, education, or health care for the child(ren).
4. Your order or final judgment defining custody, primary residence, the Parenting Plan, or time-
sharing was entered before October 1, 2009 and the order does not expressly govern the
relocation of the child(ren); or was entered on or after October 1, 2009, or your case was
pending on October 1, 2009.
5. If the visitation or time-sharing schedule will change due to the relocation, a Parenting Plan
with a time-sharing schedule must be included with the Agreement. Regardless of whether
there is an agreement, the court reserves jurisdiction to modify issues relating to the minor
child(ren).
This form should be typed or printed in black ink. You must fill in all sections of the form. If you
are an “other person” entitled to access, visitation, or time-sharing with the child(ren), substitute
your name for a Parent in the form and “parties” for “parents.” After completing the form, you
should sign the form before a notary public or deputy clerk.
Instructions for Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation
with Minor Child(ren)
(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.
What should I do next?
For your case to proceed, you must properly notify the court by filing the original of the
Agreement and a Motion for Order Permitting Relocation by Agreement, Florida Supreme Court
Approved Family Law Form, 12.950 (b), with the clerk of the circuit court of one of the following:
the circuit court which has jurisdiction in accordance with the Uniform Child Custody Jurisdiction
and Enforcement Act; the circuit court in the county in which either parent and the child(ren)
reside; or the circuit court in which the original action was adjudicated. If the order was entered
in another state, or if the child(ren) live(s) in another state, you should speak with an attorney
about where to file this form. You should file the original with the clerk of the circuit court and
keep a copy for your records.
If the issue of the child(ren)’s physical residence is already before the court in an ongoing
proceeding or through a judgment issued by the court, the court may enter an order adopting the
Agreement without holding a hearing once both parties have signed it and neither has requested
a hearing. When a hearing is not timely requested, the court shall presume that relocation is in
the best interest of the child(ren) and may adopt the Agreement without holding a hearing.
If one or more of the parties to the Agreement timely requests a hearing in writing within 10 days
after the date the Agreement is filed with the court, then you must notify the other party(ies) 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. The court will then enter an order after
the hearing.
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.
Instructions for Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation
with Minor Child(ren) (02/18)
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.
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 61, Florida Statutes.
If your case involves a modification of any provision relating to child support, you should also
check with the clerk of the circuit court in the county in which you are filing this Agreement for
Relocation to determine if any other forms must be filed.
If the parties agree to a modification of child support, the following forms should be filed with this
Agreement:
A Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e),
A completed Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form
12.902(b) or (c).
A completed Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit,
Florida Supreme Court Approved Family Law Form 12.902(d).
Special notes...
The Agreement for Relocation with Minor Children must contain a Parenting Plan with a time-
sharing schedule. At a minimum, the Parenting Plan must describe in adequate detail:
How the parties will share and be responsible for the daily tasks associated with the
upbringing of the child(ren),
The time-sharing schedule that specifies the time that the minor child(ren) will spend with
each parent and every other person entitled to access or time-sharing,
A designation of who will be responsible for any and all forms of health care, school-related
matters, including the address to be used for school-boundary determination and
registration, and any other activities,
The methods and technologies that the parents will use to communicate with the child(ren),
and
Any transportation arrangements related to access or time-sharing.
The best interests of the child(ren) is the primary consideration in the Parenting Plan. In creating
Instructions for Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation
with Minor Child(ren) (02/18)
the Parenting Plan, all circumstances between the parties, including the parties’ historic
relationship, domestic violence, and other factors must be taken into consideration.
Determination of the best interests of the child(ren) shall be made by evaluating all of the
factors affecting the welfare and interest of the particular minor child(ren) and the
circumstances of the family as listed in s. 61.13(3), Florida Statutes.
This standard form does not include every possible issue that may be relevant to the facts of
your case. The Parenting Plan should be as detailed as possible to address the time-sharing
schedule. Additional provisions should be added to address all of the relevant factors. The
parties should give special consideration to the age and needs of each child.
The Parenting Plan and time-sharing schedule may be set forth in the body of the Agreement for
Relocation with Minor Children or may be attached as a separate document. You may attach a
Relocation/Long-Distance Parenting Plan, Florida Supreme Court Approved Family Law Form
12.995(c), or similar form.
In developing the Parenting Plan, you may wish to consult or review other materials which are
available at your local library, law library or through national and state family organizations.
Nonlawyer. . . 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 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 12.950(a), Agreement for Relocation
with Minor Child(ren) (02/18)
-
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT,
IN AND FOR ______________________________ COUNTY, FLORIDA
Case No: __________________
Division: __________________
_________________________________,
Petitioner,
And
_________________________________,
Respondent.
AGREEMENT FOR RELOCATION WITH MINOR CHILD(REN)
____INCLUDING OR___ NOT INCLUDING MODIFICATION OF
CHILD SUPPORT
I, {full legal name} ____________________________________, Petitioner, referred to in the
Parenting Plan as Parent _______________ {name or designation} and I, {full legal name}
__________________________, Respondent, referred to in the Parenting Plan as Parent {name
or designation}___________________ being sworn, certify that the following information is
true:
1. The parties to this action were granted a final judgment of:
_____ dissolution of marriage
_____ paternity
on {date} ______________.
A copy of the final judgment and any modification(s) is/are attached.
2. {If Applicable}. The following other person is an individual who is not a parent, but with
whom the child resides pursuant to a court order, or who has the right of access to, time-
sharing with, of visitation with the child(ren)____________________________________.
3. Paragraph(s) ________________ of the ____ final judgment or ____ most recent
modification thereof describes the present custody, visitation, or time-sharing schedule.
4. The dependent or minor child(ren) referred to in this Agreement are:
Name(s) Birth Date(s)
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
_______________________________________________________________
_________________________________________________________________
SECTION I. RELOCATION
A. Both parties consent and stipulate to the following terms regarding modification of the
final judgment or last modification thereof to allow Parent {name or designation}
_____________________ to relocate with the minor child (ren) and modify the terms
regarding visitation or time-sharing, with or without a hearing.
B. The following relocation information is true and correct:
1. The location of the intended new residence, including the state, city, and
physical address, if known, is: _______________________________________
2. The mailing address of the new physical residence, if not the same as the
physical address, is:
__________________________________________________________.
3. The telephone number of the intended new residence, if known is:
is:__________________.
4. The date of the intended move or proposed relocation is:_______________
SECTION II: JURISDICTION
A. The United States is the country of habitual residence of the child(ren).
B. The State of Florida is the child(ren)’s home state for the purposes of the Uniform hild
Custody Jurisdiction and Enforcement Act.
C. This Parenting Plan is a child custody determination for the purposes of the Uniform Child
Custody Jurisdiction and Enforcement Act, the International Child Abduction Remedies
Act, 42 U.S.C. Sections 11601 et seq., the Parental Kidnapping Prevention Act, and the
Convention on the Civil Aspects of International Child Abduction enacted at the Hague on
October 25, 1980, and for all other state and federal laws.
D. Other: _____________________________________________________________.
SECTION III: PARENTAL RESPONSIBILITY AND TIME-SHARING SCHEDULE {Choose only one}
A. _____Parental Responsibility and Time-Sharing shall remain the same as previously set
out in the: {choose only one}
______ Final Judgment of Dissolution;
______ Final Judgment of Paternity;
______ Other {title of supplemental order of judgment}____________________
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
dated {date of order or judgment}______________________ and will continue without
modification;
OR
B. ____The parties shall comply with the Parenting Plan which is attached and incorporated
herein as Exhibit ______.
OR
C. _____The parties shall comply with the following Parenting Plan and time-sharing
schedule set forth below.
Parental Responsibility, Parenting Plan, and Time-Sharing Schedule
1. Parental Responsibility {Choose only one}
{Insert the name or designation of the appropriate parent or other person}
______ Sole Parental Responsibility.
It is in the best interests of the child(ren) that Parent {name or designation}
____________________ shall have sole authority to make major decisions for the
child(ren.) It is detrimental to the child(ren) for the parents to share decision-
making because: __________________________________________________
_________________________________________________________________.
______Shared Parental Responsibility.
It is in the best interests of the child(ren) that the parents confer and jointly make
all major decisions affecting the welfare of the child(ren). Major decisions include,
but are not limited to, decisions about the child(ren)’s education, healthcare, and
other responsibilities unique to this family.
______ Shared Parental Responsibility with Decision-Making Authority.
It is in the best interests of the child(ren) that the parents confer and attempt to
agree on the major decisions involving the child(ren). If the parents are unable
to agree, the authority for making major decisions regarding the child(ren) shall
be as follows:
Education/Academic
decisions
Parent__________
Parent___________
Other
Person___
_________
Non-emergency
health care
Parent__________
Parent___________
Other
Person
_________
________________
Parent__________
Parent___________
Other
Person
_________
Parent__________
Parent___________
Other
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
________________
Person
_________
________________
Parent__________
Parent___________
Other
Person
_________
2. Day-to-Day Decisions
Unless otherwise specified in this Parenting Plan, each parent shall make
decisions regarding day-to-day care and control of each child, including the
performance of daily tasks, while the child is with that parent. Regardless of the
allocation of decision making in the Parenting Plan, either parent may make
emergency decisions affecting the health or safety of the child(ren) when the
child is residing with that parent. A parent who makes an emergency decision
shall share the decision with the other parent as soon as reasonably possible.
3. Education
a. School Designation. For purposes of school boundary determination
and registration, Parent ___________________’s address shall be
designated.
b. Private or Home Schooling.{If Applicable} The following provisions are
made regarding private or home schooling: ______________________
__________________________________________________________.
c. School Calendar
If necessary, on or before ________ of each year, both parents should
obtain a copy of the school calendars for the next school year. The
parents shall discuss the calendars and the time-sharing schedule so
that any differences or questions can be resolved.
The parents shall follow the school calendar of: {Indicate all that apply}
______ the oldest child
______ the youngest child
______ the school calendar for ______________ County
______ the school calendar for _________________ School
d. Academic Break Definition
When defining academic break periods, the period shall begin at the end
of the last scheduled day of classes before the holiday or break and shall
end on the first day of regularly scheduled classes after the holiday or
break.
e. Other: _____________________________________________________
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
4. Extracurricular Activities
{Indicate all that apply} {Insert the name or designation of the parent or other
person}.
_____Either parent may register the child(ren) and allow them to participate in
the activity of the child(ren)’s choice.
_____The parents must mutually agree to all extra-curricular activities.
_____The costs of the extra-curricular activities shall be paid by:
Parent_________________ ______%
Parent_________________ _______ %
_____The uniforms and equipment required for the extra-curricular activities
shall be paid by: Parent_______________________%
Parent________________ ________%
____Other: _____________________________________________
5. Information Sharing.
{The following shall apply unless the court orders otherwise}
Unless otherwise prohibited by law, both parents shall have access to medical
and school records pertaining to the child(ren) and shall be permitted to
independently consult with any and all professionals involved with the child(ren).
The parents shall cooperate with each other in sharing information related to the
health, education, and welfare of the child(ren) and they shall sign any necessary
documentation ensuring that both parents have access to said records.
Each parent shall be responsible for obtaining records and reports directly from
the school and health care providers.
Both parents have equal rights to inspect and receive governmental agency and
law enforcement records concerning the child(ren).
Both parents shall have equal and independent authority to confer with the
child(ren)’s school, day care, health care providers, and other programs with
regard to the child(ren)’s educational, emotional, and social progress.
oth parents shall be listed as “emergency contacts” for the child(ren).
Each parent has a continuing responsibility to provide a residential and mailing
address, and contact telephone number(s) to the other parent. Each parent shall
notify the other parent in writing within 24 hours of any changes. Each parent
shall notify the court in writing within seven (7) days of any changes.
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
_____________________________________________________
____________________________________________
________________________________________
_____________________________________________________
Other: _________________________________________________________
_______________________________________________________________.
6. Time-Sharing Schedule:
{Insert the name or designation of each parent or other person. There must be
a time-sharing schedule for each parent or other person.
a. Weekday and Weekend Schedule:
The following schedule shall apply beginning on {date} _____________ with
Parent {insert name of parent or other person}________________________
and continue as follows:
i. The child(ren) shall spend time with Parent {name or designation}
________________________ on the following dates and times:
WEEKENDS: ____ Every ____ Every Other ____ Other (Specify):
From_______________________ to _________________________
WEEKDAYS: {Specify days} _______________________________
From _________________________ to ______________________
OTHER: {Specify} ___________________________________
ii. The child(ren) shall spend time with Parent {name or designation}
___________________________ on the following dates and times:
WEEKENDS: ____ Every ____ Every Other ____ Other {specify}:
From_____________________ to ____________________________
WEEKDAYS: {Specify days} __________________________________
From __________________ to _______________________________
OTHER: {specify} ___________________________________________
iii. {If applicable} The child(ren) shall spend time with the Other Person
{name or designation} ____________ on the following dates and times:
WEEKENDS: ____ Every ____ Every Other ____ Other {specify}:
From ________________________to_______________________
WEEKDAYS: {Specify days}__________________________________
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
Holidays
From ________________________to_________________________
OTHER: {specify} _________________________________________
b. Please indicate below if there is a different time-sharing schedule for
any child. Complete a separate Attachment for each child for whom
there is a different time- sharing schedule.
______ There is a different time-sharing schedule for the following
child(ren) in Attachment ____.
________________________, and _______________________.
{Name of Child} {Name of Child}
c. Holiday Schedule {Choose only one}
_____No holiday time sharing shall apply. The regular time-sharing
schedule set forth above shall apply.
_____Holiday time-sharing shall be as the parties agree.
_____Holiday time-sharing shall be in accordance with the following
schedule. The holiday schedule will take priority over the regular
weekday, weekend, and summer schedules. Fill in the blanks with the
name or designation of the appropriate parent or the other person, to
indicate where the child(ren) will be for the specific holiday. Provide
the beginning and ending times. If a holiday is not specified as even,
odd, or every year with one parent, then the child(ren) will remain with
the parent in accordance with the regular schedule
Even Years
Odd Years
Every Year
Begin/End Time
New Year’s Day
Martin Luther King Wknd
President’s Day Wknd
Easter
Passover
Mother’s Day
Memorial Day Wknd
Father’s Day
4th of July
Labor Day Weekend
Rosh Hashanah
Yom Kippur
{name}
{name}
{name}
{from/to}
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
_________________________________________________________
_________________________________________________________
Columbus Day Wknd
Veteran’s Day
Thanksgiving
Hanukkah
Christmas
Other _______________
hildren’s irthday’s
d. Winter Break
Winter Break {Choose only one} {Insert the name or designation of
parent or other person.}
_____Parent {name or designation} ______________ shall have the
child(ren) from the day and time school is dismissed until December
_____ at _____ a.m./p.m in _____odd-numbered years _____ even-
numbered years _____ every year. The other parent will have the
children for the second portion of the Winter Break. The parties shall
alternate the arrangement each year.
_____Parent {name or designation} ______________ shall have the
child(ren) for the entire Winter Break during _____ odd-numbered
years _____ even-numbered years _____ every year.
_____Other: __________________________________________
Specific Winter Holidays
If not addressed above, specific Winter Holidays such as Christmas, New
Year’s Eve, Hanukkah, Kwanzaa, etc. shall be shared as follows:
e. Spring Break
{Choose only one} {Insert the name or designation of parent or other
person}
_____The parents shall follow the regular schedule.
_____The parents shall alternate the entire Spring Break with Parent
{name or designation} __________ having the child(ren) during the
_____ odd-numbered _____ even-numbered years.
_____Parent {name or designation}______________
shall have the child(ren) for the entire Spring Break every year.
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
7.
8.
______The Spring Break will be evenly divided. The first half of the
Spring Break will go to the parent whose regularly scheduled weekend
falls on the first half with the second half going to the parent whose
weekend falls during the second half.
____ Other: ____________________________________________
f. Summer Break
{Choose only one}{Insert the name or designation of parent or other
person}
_____ The parents shall follow the regular time-sharing schedule
through the summer.
_____ Parent [name or designation} ________________ shall have the
entire Summer Break from __________________ after school is out
until ________________________ before school starts.
_____The parents shall equally divide the Summer Break. During
_____ odd-numbered years ____ even-numbered years, Parent {name
or designation} __________________ shall have the child(ren) from
_______________ before after school is out until _________________.
The other parent shall have the child(ren) for the second half of the
summer break. The parents shall alternate the first and second halves
of Summer Break each year unless otherwise agreed. During the
extended periods of time-sharing, the other parent shall have the
child(ren)____________________________________________.
_____ Other: ____________________________________________
_________________________________________________________.
Number of Overnights:
{Insert name or designation of parent or other person}
Based upon the time-sharing schedule, Parent {name or designation}
___________________ has a total of _____ overnights per year and Parent
{name or designation} __________________ has a total of _____
overnights per year.
Note: The two numbers must equal 365.
Schedule Changes {Indicate all that apply}
____A parent making a request for a schedule change will make the request
as soon as possible, but in any event, except in cases of emergency, no less
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
9.
than ______________ before the change is to occur.
____A parent requesting a change of schedule shall be responsible for any
additional child care, or transportation costs caused by the change.
____Other ______________________________________________.
Transportation and Exchange of Children
{Insert the name or designation of the parent or other person}
Both parents shall have the child(ren) ready on time with sufficient clothing
packed and ready at the agreed upon time of exchange. All necessary information
and medicines will accompany the child(ren).
The parties shall exchange travel information and finalize travel plans at least
_______ days in advance of the date of travel. Except in cases of emergency,
any parent requesting a change of travel plans after the date of finalization shall
be solely responsible for any additional costs.
a. Automobile Transportation and Exchange
If a parent is more than _____ minutes late without contacting the
other parent to make other arrangements, the parent with the
child(ren) may proceed with other plans and activities.
{Choose only one} {Insert the name or designation of parent or other
person}
____Parent {name or designation}____________________ shall
provide all transportation.
_____Parent {name or designation} __________ shall pick up the
child(ren) at the beginning of the visit and the other parent shall pick up
the child(ren) at the end of the visit. The exchange shall take place:
____!t the parents’ homes unless otherwise agreed
_____At the following location unless the parties agree in advance to a
different place__________________________________________.
____The parents shall meet at the following central location:
_________________________________________________________.
_____Other: _______________________________________________.
b. Airplane and Other Public Transportation and Exchange
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
Airline regulations govern the age at which a child may fly unescorted. An older
child or children may fly under such regulations as each airline may establish.
Airline reservations should be made well in advance, and preferably non-stop.
All flight information shall be sent to the other party(ies) at least
_____days in advance of the flight by the party purchasing the tickets.
If the child(ren) are flying accompanied by a party, the parent picking up the
child(ren) shall exchange the child(ren) with the other parent at
________________________and the parent returning the child(ren) shall
exchange the child(ren) at_____________________________________.
If the exchange is to be made at the airport, the party flying in to pick up or drop
off the child(ren) from/to the airport must notify the other party of any flight
delays.
Unless otherwise agreed in advance, if the child(ren) are flying
unaccompanied, the parent taking the child(ren) to the airport must call the
other parent immediately upon departure to notify the other parent that the
child(ren) is/are arriving, and the parent who meets the child(ren) must
immediately notify the other parent upon the child(ren)’s arrival. {Indicate
all that apply}
_____Until a child reaches the age of _____, the parties agree that the
child(ren) shall take a direct flight and/or fly accompanied by
__________________________________.
_____Once a child reaches the age of ____ the child shall be permitted
to fly accompanied by an airline employee.
_____Once a child reached the age of ____ the child shall be permitted to
fly unescorted.
____Other: __________________________________________________.
c. Costs of Airline and Other Public Transportation
The parents shall work together to purchase the most convenient and least
expensive tickets.
Unless otherwise agreed or in the case of an unavoidable emergency, any costs
incurred by a missed travel connection shall be the sole responsibility of the
parent who failed to timely deliver the child(ren) to the missed connection.
{Indicate all that apply} {Insert name or designation of parent or other person}
_____ Transportation costs are included in the Child Support Worksheets
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
_______________________________________________________________________
_______________________________________________________________________
and/or the Order for Child Support and should not be included here.
_____ Parent _______________ shall pay ______% and Parent ________________ shall
pay ______ % of the transportation costs.
_____ Parent_____________ shall pay ______% and Parent _______________ shall pay
_____% of the transportation costs for an adult to accompany the child(ren) during
travel.
_____ If the parents are sharing travel costs, the non-purchasing parent shall reimburse
the other parent within ______ days of receipt of documentation establishing the travel
costs.
_____ Other: ___________________________________________.
10. Foreign and Out-Of-State Travel
{Indicate all that apply}
_____ Either parent may travel within the United States with the child(ren) during
his/her time-sharing. The parent traveling with the child(ren) shall give the other parent
at least _____ days written notice before traveling out of state unless there is an
emergency, and shall provide the other parent with a detailed itinerary, including
locations and telephone numbers where the child(ren) and parent can be reached at
least _____ days prior to traveling.
_____ Either parent may travel out of the country with the child(ren) during his/her
time-sharing. At least _____ days prior to traveling, the parent shall provide a detailed
itinerary, including locations, and telephone numbers where the child(ren) and parent
may be reached during the trip. Each parent agrees to provide whatever
documentation is necessary for the other parent to take the child(ren) out of the
country.
_____ If a parent wishes to travel out of the country with the child(ren), he/she shall
provide the following security for the return of the child(ren) ____________________
______________________________________________________________________.
_____ Other _________________________________________________________.
11. Other travel and exchange arrangements:
____________________________________________________________________.
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
__________________________________________________________________
__________________________________________________________________
12. Communication
_____Between Parents
All communications regarding the child(ren) shall be between the parents. The parents
shall not use the child(ren) as messengers to convey information, ask questions, or set
up schedule changes. The parents shall communicate with each other by: {Indicate all
that apply}
_____in person
_____ by telephone
_____ by letter
_____by e-mail
_____ Other:_____________________________________________________.
_____Between Parent and Child(ren)
Both parents shall keep contact information current. Telephone or other electronic
communication between the child(ren) and the other parent shall not be monitored by
or interrupted by the other parent. “Electronic communication” includes telephones,
electronic mail or e-mail, webcams, video-conferencing equipment and software or
other wired or wireless technologies or other means of communication to supplement
face to face contact.
______The child(ren) may have _____ telephone ____ e-mail _____ other electronic
communication in the form of ___________________________________ with the other
parent:{(Choose only one
____Anytime
_____Every day during the hours of _________________ to _____________________.
____On the following days________________________________________________
during the hours of _____ to _______.
____ Other: ___________________________________________________________.
13. Costs of Electronic Communication
The costs of electronic communication between parents and the minor child(ren) shall
be allocated as follows:
__________________________________________________________________.
14. Designation for Other Legal Purposes
{Insert name or designation of parent or other person.}
The child(ren) named in this Parenting Plan are scheduled to reside the majority of the
time with Parent __________________. This majority designation is SOLELY for
purposes of all other state and federal laws which require such designation. This
designation does not affect either parent’s rights or responsibilities under this
Relocation Agreement.
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
15. Changes or Modifications of the Parenting Plan
Temporary changes may be made informally without a written document. When the
parents do not agree, the Parenting Plan remains in effect until further order of the
court.
Any substantial changes to the Parenting Plan must be sought through the filing of a
supplemental petition for modification.
16. Disputes or Conflict Resolution
Parents shall attempt to cooperatively resolve any disputes which may arise over the
terms of the Parenting Plan. The parents may wish to use mediation or other dispute
resolution methods and assistance, such as Parenting Coordinators and Parenting
Counselors, before filing a court action.
SECTION IV: CHILD SUPPORT AND INSURANCE
{Insert the name or designation of the appropriate parent in the spaces provided.}
1. Modification of Child Support
If the requested modification is granted, the parties:
_____ agree that child support should be modified, consistent with the modification of
the time-sharing schedule
_____ agree that child support will NOT be modified.
2. Amount of Child Support
Parent {name or designation} _______________ (hereinafter “Obligor”) will pay child
support, under Florida’s child support guidelines, section 61.30, Florida Statutes, to the
other parent. The Child Support Guidelines Worksheet, Florida Family Law Rules of
Procedure Form 12.902(e), is completed and attached.
This parent shall be obligated to pay child support at the rate of $____________, per
month for the ______children {number of parties’ minor or dependent children| beginning
{month, day, year} ______________________ and terminating
_______________________{month, day, year}. Child support shall be paid in the amount
of $______________ per ____________ {week, month, other}, which is consistent with
the Obligor’s current payroll cycle.
Upon the termination of the obligation of child support for one of the parties’ children,
child support in the amount of $________________ for the remaining________ children
{total number of remaining children} shall be paid beginning ____________________
{month, day, year} and terminating ______________________ {month, day, year}. This
child support shall be paid in the amount of $________________ per _____________
{week, month, other} consistent with the Obligor’s current payroll cycle.
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
_______________________________________________________________________
{Insert schedule for the child support obligation, including the amount, and
commencement and termination dates, for the remaining minor or dependent
children, which shall be payable as the obligation for each child ceases. Please indicate
whether the schedule either ______ appears below or _______is attached as part of
this form.
The Obligor shall pay child support until all the minor or dependent children: reach the
age of 18, become emancipated, marry, die, joins the armed services; or become self-
supporting; or until further order of the court or agreement of the parties. The child
support obligation shall continue beyond the age of 18, and until high school graduation
for any child who is: dependent in fact; between the ages of 18 and 19; and is still in
high school, performing in good faith with a reasonable expectation of graduation
before the age of 19.
If the child support amount above deviates from the guidelines by 5% or more, explain
the reason(s) here: ______________________________________________________
_______________________________________________________________________.
3. Retroactive Child Support and/or Arrearages.
a. ________There is no retroactive child support or child support arrearage at the
time of this Agreement.
OR
b. _______ Petitioner ________Respondent shall pay child support to the other
party in the amount of:
$_____________for retroactive child support, as of {date} __________________
$ _____________for previously ordered unpaid child support, as of
{date}_____________ The total of $ ______________ in retroactive and unpaid child
support shall bepaid at the rate of $ ______________every: ______ week ______ other
week ________ month, beginning {date} __________, until paid in full including
statutory interest.
4. Health Insurance.
{Choose one only} {Insert the name or designation of the parent or other person}
Parent {name or designation}__________________ will maintain health insurance for
the parties’ minor child(ren). The party providing health insurance will provide
insurance cards to the other party showing coverage.
OR
_____ Health insurance is either not reasonable in cost or accessible to the child(ren) at
this time. Any uninsured/ unreimbursed medical costs for the minor child(ren) shall be
assessed as follows
_____Shared equally by both parents.
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
______________________________________________________________________________
_____Prorated according to the child support guideline percentages.
_____Other {explain}: ___________________________________________________
As to these uninsured/unreimbursed medical expenses, the party who incurs the expense
shall submit a request for reimbursement to the other party within 30 days, and the other
party, within 30 days of receipt, shall submit the applicable reimbursement for that
expense, according to the schedule of reimbursement set out in this paragraph.
5. Dental Insurance.
{Choose only one} {Insert the name or designation of the parent or other person}
Parent {name or designation} _________________ will maintain dental insurance for
the parties’ minor child(ren). The party providing dental insurance will provide
insurance cards to the other party showing coverage.
OR
____ Dental insurance is either not reasonable in cost or available to the children at this
time. Any uninsured/unreimbursed dental costs for the minor child(ren) shall be
assessed as follows:
_____Shared equally by both parents.
_____Prorated according to the child support guideline percentages.
____Other {explain}: ______________________________________________________
As to these uninsured/unreimbursed dental expenses, the party who incurs the expense
shall submit a request for reimbursement to the other party within 30 days, and the other
party, within 30 days of receipt, shall submit the applicable reimbursement for that
expense, according to the schedule of reimbursement set out in this paragraph.
6. Life Insurance. {Insert the name or designation of the parent or other person}
Parent {name or designation} ___________________shall be required to maintain life
insurance coverage for the benefit of the parties’ minor child(ren) in the amount of
$ _________________ until the youngest child turns 18, becomes emancipated,
marries, joins the armed services, or dies.
SECTION VII: OTHER
Florida Supreme Court Approved Family Law Form 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
___________________________________
_______________________________________
_______________________________________
I certify that I have been open and honest in entering into this relocation agreement. I am
satisfied with this agreement and intend to be bound by it.
Dated: ______________________ _______________________________________
Signature of Petitioner/Parent______________
Printed Name: ___________________________
Address: _______________________________
City, State, Zip: __________________________
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 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
_______________________________________
_______________________________________
________________________________
I certify that I have been open and honest in entering into this relocation agreement. I am
satisfied with this agreement and intend to be bound by it.
Dated: ______________________ _______________________________________
Signature of Respondent/Parent_____________
Printed Name: ___________________________
Address: _______________________________
City, State, Zip: __________________________
Telephone Number: ______________________
Fax Number: ____________________________
Designated E-mail Address(es):____________
____________________________________
STATE OF FLORIDA
COUNTY OF ____________________
Sworn to or affirmed and signed before me on __________ by ___________________________.
____ Personally known
____ Produced identification
____ Type of identification produced
NOTARY PUBLIC or DEPUTY CLERK
[Print, type, or stamp commissioned name of
notary or deputy clerk.]
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: {choose only one} _______Petitioner ______Respondent
_____Other Person.
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 12.950(a), Agreement for Relocation with
Minor Child(ren) (02/18)
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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW (Florida)

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Completed 10 January 2021

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