Fillable INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW

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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW

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Instructions for Florida Supreme Court Approved Family Law Form 12.902(j), Notice of Social Security Number (9/00)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM
12.902(j),
NOTICE OF SOCIAL SECURITY NUMBER
When should this form be used?
This form must be completed and filed by each party in all paternity
, child support, and dissolution of
marriage cases, regardless of whether the case involves a minor child(ren) and/or property.
This form should be typed or printed in black ink. After completing this form, you should file
the original with
the &OHUNDQG&RPSWUROOHU
in the county where your case was filed and keep a copy for your records.
What should I do next?
A copy of this form must be mailed or hand delivered to the other party in your case, if it is not served
on
him or her with your initial papers.
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 sections 61.052 and 61.13, Florida Statutes.
Special notes...
If this is a domestic violence case and you want to keep your address confidential for safety
reasons, do not enter the address, telephone, and fax information at the bottom of this form.
Instead, file Petitioner’s Request for Confidential Filing of Address, O’ Florida Supreme Court
Approved Family Law Form 12.980(i).
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, O‘ Florida Family Law Rules
of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also
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.
Florida Supreme Court Approved Family Law Form 12.902(j), Notice of Social Security Number (9/00)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR
COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
NOTICE OF SOCIAL SECURITY NUMBER
I, {full legal name}
,
certify that my social security number is , as required in section
61.052(7), sections 61.13(9) or (10), section 742.031(3), sections 742.032(1)–(3), and/or sections
742.10(1)–(2), Florida Statutes. My date of birth is .
[/ one only]
1. This notice is being filed in a dissolution of marriage case in which the parties have no minor
children in common.
2. This notice is being filed in a paternity or child support case, or in a dissolution of marriage in
which the parties have minor children in common. The minor child(ren)'s name(s), date(s) of
birth, and social security number(s) is/are:
Name Birth date Social Security Number
{Attach additional pages if necessary.}
Disclosure of social security numbers shall be limited to the purpose of administration of the Title IV-D
program for child support enforcement.
SIXTH
PASCO
Florida Supreme Court Approved Family Law Form 12.902(j), Notice of Social Security Number (9/00)
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in
this notice and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated:
Signature
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
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GHSXW\ clerk]
Personally known
Produced identification
Type of identification produced
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE
BLANKS BELOW: [ N fill in all blanks]
I, {full legal name and trade name of nonlawyer}
,
a nonlawyer, located at {street}
, {city} ,
{state}
, {phone} , helped {name} ,
who is the [ / one only]
petitioner or respondent, fill out this form.
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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW

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Completed 22 June 2021

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