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Joseph Abruzzo Clerk of The Circuit Court & (Clerk of the Circuit Court & Comptroller, Palm Beach County)

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Jr
Want to learn more? Attend one of our free Self
Service Center DIY Workshops at the Main
Courthouse on
the first Wednesday of
each month
from 3:30pm to
4:30pm. Topic varies from month to
month. Visit www.mypalmbeachclerk.com for more
information.
Joseph Abruzzo
Clerk of The Circuit Court & Comptroller
Self Service Center
Your Guide Through The Courts
Packet #48
Revised 01/2021
Landlord Tenant Eviction for Failure to Pay Rent-
Possession and Recover Damages (Residential Property)
File completed forms in room:
2.22 (Main Branch)
Non-Refundable
$10.00
Self Service Center Services
All instructions and forms distributed by the Clerk of the Circuit Court & Comptroller are
provided as a public service to persons seeking to represent themselves in court without the
assistance of an attorney. These documents are meant to serve as a guide only, and to assist pro
se (self-represented) litigants with their cases. Any person using these instructions and/or forms
does so at his or her own risk, and the Clerk shall not be responsible for any losses incurred by
any person in reliance on the instructions and/or forms.
Below are a few of the services available at the Self Service Center:
(Please review current pricing as fees are subject to change without notice)
Navigator Appointments (for document preparation assistance)
Free
Navigators do not provide legal advice but will assist you in completing the forms and
provide you with procedural information.
Community Resource Referral- pamphlets
Free
Photocopies prior to filing
$.15/page
Photocopies after filing
$1.00/page
Deputy Clerk signing
$3.50/signature
Notary signing
$10.00/signature
Single forms
$1.00/page
For more information, please go to www.mypalmbeachclerk.com, email us at
Selfservice@mypalmbeachclerk.com, or visit one of the following locations:
Palm Beach County Courthouse
205 N. Dix
ie Highway, Rm #1.25
West Palm Beach, Florida 33401
Self Service line: 561-355-7048
South County Courthouse
200 W. Atlantic
Ave.
Delray Beach, Florida 33444
561-274-1588
North
County Courthouse
3188 PGA Blvd
Palm Beach Gardens, Florida 33410
561-624-6650
West County C
ourthouse
2950 State Road 15, Rm. #S-100
Belle Glade, Florida 33430
561-996-4843
Additional Legal Resources:
Florida Rural Legal
Se
rvices
www.frls.org
561-820-8902
Legal Aid Society of
Pa
lm Beach County
www.legalaidpbc.org
561-655-8944
Lawyer Referral
Service
www.palmbeachbar.org
561-687-3266 (to hire a
lawy
er to represent you
in court or give you
legal advice)
Palm Beach County
La
w Library
https://www.15thcircu
it.c
om/services/law-
library
561-355-2928
Self Service Packet #48 Page 2 of 46
ABRUZZO
Landlord Tenant Eviction for Failure to Pay Rent- Possession and
Recover Damages (Residential Property) (Packet #48)
When should this packet be used?
This packet should be used to evict a tenant and recover unpaid rent (damages). If you would
only like to evict a tenant and not recover past due rent, you should use packet #47- Landlord
Tenant Eviction for Failure to Pay Rent-Possession Only.
Fees:
Unless otherwise noted, fees may be paid by cash, credit card, personal check, or money order
payable to Joseph Abruzzo, Clerk of the Circuit Court, Palm Beach County. If you cannot afford
to pay the filing fee, you may obtain an Application for Determination of Civil Indigent Status
from the clerk. Once submitted, the clerk will determine whether you are eligible to have filing
fees, per Florida Statute.
• Filing
$185.00 (Damage Claims $2,500.00 or less)
$300.00 (Damage Claims $2,500.01 - $15,000.00)
$400.00 (Damage Claims $15,000.01 - $30,000.00)
• Summons $20.00 per defendant ($10 per summons).
Two summons required per tenant.
• Service $40.00 per defendant, payable to Palm Beach County Sherriff
Offic
e (P.B.S.O.) by check or money order, OR you may hire a
private process server. Private process server fees vary.
• Writ
of
Posses
sion $90.00, payable to P.B.S.O. by check/money order
(If applicable – Paid after the issuance of Final Judgment)
STEP BY STEP FORMS CHECKLIST
STEP
ONE:
Complete and provide
the Defendant(s)/Tenant(s) with the
following form:
(May be posted, mailed,
or hand
delivered)
___ Notice from Landlord to Tenant-Termination for Failure to Pay Rent, Form 1 (Pg.
8)
Self Service Packet #48
Page 3 of 46
STEP TWO: Wait 3 court days (excludes weekends and holidays) and, if the tenant does not
comply or vacate the premises, complete and file the following paperwork with the Clerk:
___ Civil Cover Sheet (Pages 13-15)
___ Complaint for Landlord to Evict Tenants for Failure to Pay Rent and to Recover Past
Due Rent, Form 5A, (Pages 17-18)
(Attach a copy of the Notice from Landlord to Tenant to the Complaint)
___ Pre-Addressed Stamped Envelopes (One for each party in your case)
___ Four (4) copies of all documents for each defendant (service and mailing)
NOTE: At this time the Clerk will issue an Eviction 5 day Summons, and a 20 day summons.
A Certificate of Mailing per Defendant will be prepared. If you request service and pay the
$40 se
rvice fee, the clerk will forward your paperwork to the Sheriff for service on the
Defendant/Tenant. If you do not request that the Clerk forward your paperwork to the Sheriff
you will be responsible for arranging service on the Tenant with the Sheriff or a private process
server. Please note that a Summons for Damages must be personally served on the
Defendant(s). If you have any questions concerning the service of summons by the Sheriff
please contact their Civil Office at (561-355-2760).
STEP THREE: Wait 5 court days (excluding weekends & holidays) from the date the Tenant
was served and file the following paperwork, depending on whether the Defendant/Tenant files
an answer:
• If the Tenant DOES NOT file an answer with the court you must file the following
pape
rwork to receive a final judgment for possession in your favor from the court:
___ Nonmilitary Affidavit, Form 81 (Pg. 20)
___ Motion for Clerk’s Default- Residential Eviction, Form 76, (Pg. 22)
___ Motion for Default Final Judgment- Residential Eviction, Form 78, (Pg. 23)
___ Final Judgment, Eviction, (Pages 25-26) –
File the original plus a copy for each party in
your case.
___ Pre-Addressed Stamped
Envelopes (One for each
party in your case).
•
If the Defendant DOES
file an a
nswer with the court: The Judge will review the case file and
determine if a hearing needs to be set on the matter. If a hearing is set the court will notify
you of the court date by mail. Bring the Final Judgment form (Pages 25-26)
to the hearing.
Self Service Packet #48
Page 4 of 46
ABRUZZO
STEP FOUR: Once you have a Final Judgment signed by the Judge, if the Tenant refuses to
vacate the premises, you must complete and provide the following to the Clerk to request a Writ
of Possession. The Writ of Possession instructs the Sheriff to remove the Tenant from the
property. The Sheriff’s Department will post a notice on the property giving the Defendant 24
hours to vacate the premises:
___ Sheriff Information Sheet (Pg. 27) - Along with $90 fee made payable to P.B.S.O.
STEP FIVE: Wait 20 calendar days from the day the Defendant(s) was served and file the
following paperwork, depending on whether the Defendant(s) files an answer:
• If the Defendant DOES NOT file an answer with the court in response to your request for
damage
s, you must file the following paperwork to receive a final judgment for damages in
your favor:
___ Motion for Clerk’s Default- Damages (Residential Eviction), Form 77 (Pg. 29)
___ Affidavit of Damages, Form 80 (Pages 31-32)
___ Motion for Default Final Judgment-Damages (Residential Eviction), Form 79 (Pg. 34)
___ Final Judgment- Damages, Form 9 (Pages 36-37) File the original plus a copy for each
party in your case.
___ Pre-Addressed Stamped Envelopes (one for each party in your case).
• If the Defendant DOES file an answer with the court: The Judge will review the case file and
determine if a hearing needs to be set on the matter. If a hearing is set the court will notify
you of the court date by mail. Bring the Final Judgment-Damages form (Pages 36-37)
to
the hearing.
File if Applicable to Your Case
___ Notice of Intention to Impose Claim on Security Deposit, Form 12 (Pg. 39)
___ Notice of Voluntary Dismissal (Pg. 40):
You may use this form if you (the Landlord)
decide to dismiss your case any time prior to a final hearing.
___ Notice of Designation of Email Address for E-Service, (Pages 42-43): Use this form if
you would like to receive notices and documents from the court and the other party to your
case by email or would like to change
your notice email address of record with the court.
Bring to your Final Hearing
___Final Disposition Form, Form 1.998, (Pg. 46)
Self Service Packet #48
Page 5 of 46
Filing Instructions
• Paper/ Original Documents:
▪ You may file your paperwork either by visiting one of our four courthouse locations (see
Page 2 of our instructions) or by U.S. mail to:
County Civil Court
P.O. Box 3406
West Palm Beach, FL 33402
▪ In addition to the copies mentioned above, make a copy of all the documents you
complete for yourself. (See pages 3-5 of our step by step guide).
▪ Next, file all the applicable documents with the Clerk & Comptroller’s office. Have all
pages c
lipped together before filing (copies may be stapled together).
▪ If you mail your documents, make sure you provide pre-addressed stamped
enve
lopes for each party to your case (yourself and each tenant).
• Electronic Documents:
▪ Self-represented litigants may file petitions or other pleadings or documents
electronically, but 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 the procedures of the judicial circuit in which you
file.
The rules and procedures should be carefully read and followed. Instructions
regarding e-filing are included in this packet.
▪ You must first register in the Florida E-Filing Portal. Directions, a manual, and a short
step by step video a
re available if you wish to learn to e-file your documents with the
Clerk & Comptroller instead of filing a hard copy. Go to:
www.mypalmbeachclerk.com/court-services/e-filing/self-represented-filers
Please note certain documents must be filed in original, hard copy format. A list of
these documents are available on our website.
Self Service Packet #48
Page 6 of 46
FORM 1
NOTICE FROM LANDLORD TO TENANT—
TERMINATION FOR FAILURE TO PAY RENT
INSTRUCTIONS
This notice may be delivered by mail or by delivering a copy to the dwelling unit, or, if the
Te
nant is absent from the dwelling unit, by leaving a copy thereof at the dwelling unit.
If the Tenant fails to pay rent when due and the default continues for three (3) days (excluding
Sa
turday, Sunday, and legal holidays) after delivery of written demand by the Landlord for
payment of the rent or possession of the premises, the Landlord may terminate the rental
agreement. This written demand is a prerequisite to an action to evict the Tenant or recover past
due rent. Your written rental agreement may have allowed for a longer period than three days
and should be reviewed.
SOURCE: Section 83.56(3) and (4), Florida Statutes (2007).
Self Service Packet #48
Page 7 of 46
NOTICE FROM LANDLORD TO TENANT-
TERMINATION FOR FAILURE TO PAY RENT
To:
Tenant’s Name
Address
City, State, Zip Code
From:
Date:
You are hereby notified that you are indebted to me in the sum of $
[insert amount owed by Tenant] for the rent and use of the premises located at
, Florida
[insert address of premises, including county], now occupied by you and that I demand payment
of the rent or possession of the premises within three days (excluding Saturday, Sunday and legal
holidays) from the date of delivery of this notice to-wit: on or before the day
of , 20 [insert the date which is three days from the delivery of this
notice, excluding the date
of delivery, Saturday, Sunday, and legal holidays.]
Signature
Name of Landlord/ Property Manager [circle one]
Address [street address where Tenant can deliver rent]
City, State, Zip Code
Phone Number
Hand Delivered On:
Posted On:
Approved for use under rule 10-2.1(a) of the
Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name:
Address:
Telephone Number:
Self Service Packet #48 (Page 8 of 46)
Florida Bar Form #1
Notice from Landlord to Tenant, Page 1 of 1
click to sign
signature
click to edit
FORM 1.997. INSTRUCTIONS FOR COMPLETING CIVIL
COVER SHEET
Plaintiff must file this cover sheet with the first document filed in the action or proceeding
(ex
cept small claims cases, probate, or family cases). Domestic and juvenile cases should be
accompanied by a completed Florida Family Law Rules of Procedure Form 12.928, Cover
Sheet for Family Court Cases. Failure to file a civil cover sheet in any civil case other than
those excepted above may result in sanctions.
I. Case Style. Enter the name of the court, the appropriate case number assigned at the
time of fil
ing of the original complaint or petition, the name of the judge assigned (if
applicable), and the name (last, first, middle initial) of plaintiff(s) and defendant(s).
II. Amount of Claim. Enter the estimated amount of the claim, rounded to the nearest
dollar
. The estimated amount of the claim is requested for data collection and clerical
processing purposes only. The amount of the claim shall not be used for any other purpose.
III. Type of Case. Place an “X” on the appropriate line. If the cause fits more than one
type of case, select the most definitive. If the most definitive label is a subcategory (indented
under a broader category label), place an “X” on the category and subcategory lines.
Definitions of the cases are provided below in the order they appear on the form.
Circuit Civil
(A) Condominium—all civil lawsuits pursuant to Chapter 718, Florida Statutes,
in wh
ich a condominium association is a party.
(B) Contracts and indebtedness—all contract actions relating to promissory notes
and other debts, including those arising from the sale of goods, but excluding contract
disputes involving condominium associations.
(C) Eminent domain—all matters relating to the taking of private property for
public use, including inverse condemnation by state agencies, political subdivisions, or
public service corporations.
(D) Auto negligence—all matters arising out of a party’s allegedly negligent
operation of a motor vehicle.
(E) Negligence—other—all actions sounding in negligence, including statutory
claims for relief on account of death or injury, that are not included in other main
categories.
(F) Business governance—all matters relating to the management, administration,
or control of a company.
(G) Business torts—all matters relating to liability for economic loss allegedly
caused by interference with economic or business relationships.
Self Service Packet #48 Page 9 of 46
(H) Environmental/Toxic tort—all matters relating to claims that violations
of environmental regulatory provisions or exposure to a chemical caused injury or
disease.
(I) Third party indemnification—all matters relating to liability transferred to a
third party in a financial relationship.
(J) Construction defect—all civil lawsuits in which damage or injury was
all
egedly caused by defects in the construction of a structure.
(K) Mass tort—all matters relating to a civil action involving numerous
plain
tiffs against one or more defendants.
(L) Negligent security—all matters involving injury to a person or property
all
egedly resulting from insufficient security.
(M) Nursing home negligence—all matters involving injury to a nursing
home re
sident resulting from negligence of nursing home staff or facilities.
(N) Premises liability—commercial—all matters involving injury to a person
or prope
rty allegedly resulting from a defect on the premises of a commercial property.
(O) Premises liability—residential—all matters involving injury to a person
or property allegedly resulting from a defect on the premises of a residential property.
(P) Products liability—all matters involving injury to a person or property
allegedly resulting from the manufacture or sale of a defective product or from a failure to
warn.
(Q) Real property/Mortgage foreclosure—all matters relating to the possession,
tit
le, or boundaries of real property. All matters involving foreclosures or sales of real
property, including foreclosures associated with condominium associations or condominium
units. (The amount of claim specified in Section II. of the form determines the filing fee
pursuant to section 28.241, Florida Statutes.)
(R) Commercial foreclosure—all matters relating to the termination of a
business owner’s interest in commercial property by a lender to gain title or force a sale to
satisfy the unpaid debt secured by the property.
(S) Homestead residential foreclosure—all matters relating to the termination of a
resi
dential property owner’s interest by a lender to gain title or force a sale to satisfy the
unpaid debt secured by the property where the property has been granted a homestead
exemption.
(T) Nonhomestead residential foreclosure—all matters relating to the termination of
a residential property owner’s interest by a lender to gain title or force a sale to satisfy the
unpaid debt secured by the property where the property has not been granted a homestead
exemption.
(U) Other real property actions—all matters relating to land, land improvements,
or property rights not involving commercial or residential foreclosure.
(V) Professional malpractice—all professional malpractice lawsuits.
(W) Malpractice—business—all matters relating to a business’s or business person’s
Self Service Packet #48 Page 10 of 46
failure to exercise the degree of care and skill that someone in the same line of work would
use under similar circumstances.
(X) Malpractice—medical—all matters relating to a doctor’s failure to exercise
the de
gree of care and skill that a physician or surgeon of the same medical specialty would
use under similar circumstances.
(Y) Malpractice—other professional—all matters relating to negligence of those
other than medical or business professionals.
(Z) Other—all civil matters not included in other categories.
(AA) Antitrust/Trade regulation—all matters relating to unfair methods of
competit
ion or unfair or deceptive business acts or practices.
(AB) Business transactions—all matters relating to actions that affect financial
or e
conomic interests.
(AC) Constitutional challenge—statute or ordinance—a challenge to a statute
or ord
inance, citing a violation of the Florida Constitution.
(AD) Constitutional challenge—proposed amendment—a challenge to a legislatively
init
iated proposed constitutional amendment, but excluding challenges to a citizen-initiated
proposed constitutional amendment because the Florida Supreme Court has direct jurisdiction
of such challenges.
(AE) Corporate trusts—all matters relating to the business activities of
financial services companies or banks acting in a fiduciary capacity for investors.
(AF) Discrimination—employment or other—all matters relating to
discrimination, including employment, sex, race, age, handicap, harassment, retaliation, or
wages.
(AG) Insurance claims—all matters relating to claims filed with an insurance company.
(AH) Intellectual property—all matters relating to intangible rights
protec
ting commercially valuable products of the human intellect.
(AI) Libel/Slander—all matters relating to written, visual, oral, or aural defamation
of c
haracter.
(AJ) Shareholder derivative action—all matters relating to actions by a corporation’s
shareholders to protect and benefit all shareholders against corporate management for
improper management.
(AK) Securities litigation—all matters relating to the financial interest or instruments
of a
company or corporation.
(AL) Trade secrets—all matters relating to a formula, process, device, or other
business information that is kept confidential to maintain an advantage over competitors.
(AM) Trust litigation—all civil matters involving guardianships, estates, or trusts and
not appropriately filed in probate proceedings.
Self Service Packet #48 Page 11 of 46
County Civil
(AN) Civil – all matters involving claims ranging from $8,001 through $30,000
in damages, exclusive of interest, costs, and attorney fees.
(AO) Real property/Mortgage foreclosure—all matters involving claims up to
$30,000 re
lating to the possession, title, or boundaries of real property. All matters involving
foreclosures or sales of real property up to $30,000, including foreclosures associated with
condominium associations or condominium units.
(AP)
Replevins—all lawsuits pursuant to Chapter 78, Florida Statutes, involving
claims up to $30,000.
(AQ) Evictions—
a
l
l ma
t
ter
s invo
lvi
ng the re
covery of possession of leased land or
rental property by process of law.
(AR)
Other civil (non-monetary)—includes all other non-monetary county civil matters
that were not described in other county civil categories.
IV. Remedies Sought. Place an “X” on the appropriate line. If more than one remedy
is sought in the complaint or petition, check all that apply.
V. Number of Causes of Action. If the complaint or petition alleges more than one cause
of action, note the number and the name of the cause of action.
VI. Class Action. Place an “X” on the appropriate line.
VII. Related Cases. Place an “X” on the appropriate line.
VIII. Is Jury Trial Demanded In Complaint? Check the appropriate line to indicate
whether a jury trial is being demanded in the complaint.
ATTORNEY O
R P
AR
T
Y
S
I
GNATURE. Sign the civil cover sheet. Print legibly the name of
the person signing the civil cover sheet. Attorneys must include a Florida Bar number. Insert
the date the civil cover sheet is signed. Signature is a certification that the filer has provided
accurate information on the civil cover sheet, and has read and complied with the
requirements of Florida Rule of Judicial Administration 2.425.
Self Service Packet #48 Page 12 of 46
FORM 1.997. CIVIL COVER SHEET
The c
iv
i
l c
ove
r
she
e
t
a
nd the i
nfo
rma
ti
on c
on
tai
ne
d in
it neither replace nor supplement the
filing and service of pleadings or other documents as required by law. This form must be filed
by the plaintiff or petitioner with the Clerk of Court for the purpose of reporting uniform data
pursuant to section 25.075, Florida Statutes. (See instructions for completion.)
IN THE COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT, IN
AN
D FOR P
ALM BAECH COUNTY, FLORIDA
Plaintiff
vs.
Defendant
Case #
Judge
I. AMOUNT OF CLAIM
Please indicate the estimated amount of the claim, rounded to the nearest dollar. The estimated
amoun
t of the claim is requested for data collection and clerical processing purposes only. The
amount of the claim shall not be used for any other purpose.
_
_______
_
_
_
_
_
_______
_______
$8,000 or less
$ 8,001 - $30,000
$30,001 - $50,000
_______ $50,001 - $75,000
_
______
_______
Self Service Packet #46 (Page 11 of 20)
$75,001 - $100,000
over $100,000
II. TYPE OF CASE (If the case fits more than one type of case, select the
most definitive category.) If the most descriptive label is a subcategory (is indented under a
broader category), place an x on both the main category and subcategory lines.
CIRCUIT CIVIL
Condominium
Contracts and indebtedness
Eminent domain
Auto negligence
Negligence—other
Business governance
Business torts
Self Service Packet #48 (Page 13 of 46)
Civil Cover Sheet, Form 1.997 (09/20) , Page 1 of 3
Environmental/Toxic tort
Third party indemnification
Construction defect
Mass tort
Negligent security
Nursing home negligence
Premises liability—commercial
Premises liability—residential
Products liability
Real property/Mortgage foreclosure
Commercial foreclosure
Homestead residential foreclosure
Non-homestead residential foreclosure
Other real property actions
Professional malpractice
Malpractice—business
Malpractice—medical
Malpractice—other professional
Other
Antitrust/Trade regulation
Business transactions
Constitutional challenge—statute or ordinance
Constitutional challenge—proposed amendment
Corporate trusts
Discrimination—employment or other
Insura
nce claims
Intellectual property
Libel/Slander
Shareholder derivative action
Securities litigation
Trade secrets
Trust litigation
COUNTY CIVIL
Civil
Real Property/Mortgage foreclosure
Evictions
Residential Evictions
Non-residential Evictions
Other civil (non-monetary)
Self Service Packet #48 (Page 14 of 46)
Civil Cover Sheet, Form 1.997 (09/20) , Page 2 of 3
III. REMEDIES SOUGHT (check all that apply):
Monetary;
Nonmonetary declaratory or injunctive relief;
Punitive
IV. NUMBER OF CAUSES OF ACTION: [ ]
(Specify)
V. IS THIS CASE A CLASS ACTION LAWSUIT?
yes
no
VI. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?
no
y
e
s
If “
yes,” list all related cases by name, case number, and court.
VII. IS JURY TRIAL DEMANDED IN COMPLAINT?
yes
no
I CERTIFY that the information I have provided in this cover sheet is accurate to the best of
my knowledg
e and belief, and that I have read and will comply with the requirements of
Florida Rule of Judicial Administration 2.425.
Signature
Attorney or party
Fla. Bar #
(Bar # if attorney)
(type or print name) Date
Self Service Packet #48 (Page 15 of 46)
Civil Cover Sheet, Form 1.997 (09/20) , Page 3 of 3
FORM 5A
COMPLAINT FOR LANDLORD TENANT TO EVICT TENANTS FOR FAILUTE TO
PAY RENT AND TO RECOVER PAST DUE RENT
INSTRUCTIONS
Form 5 should be used if only eviction of the Tenant is sought. Form 5A should be used to
ev
ict the Tenant and recover damages (past due rent).
FORM NOTES ARE FOR INFORMATIONAL PURPOSES ONLY AND MAY NOT
CO
MPLETELY DESCRIBE REQUIREMENTS OF FLORIDA LAW. YOU SHOULD
CONSULT AN ATTORNEY AS NEEDED.
Self Service Packet #48
Page 16 of 46
IN THE COUNTY COURT OF THE FIFTEENTH
JUDICIAL CIRCUIT, IN AND FOR PALM BEACH COUNTY FLORIDA
Plaintiff,
,
vs.
Defendant.
,
Case No:
Division:
COMPLAINT FOR EVICTION
AND DAMAGES
Plaintiff, , sues
Defendant, and alleges:
COUNT I
Te
nant Eviction
1. This is an action to evict the Tenant from real property in Palm Beach County, Florida.
2.
Plaintiff owns the following described real property in the County:
.
3. Defendant has possession of the real property under a (oral
_____/written_____) agreement to
pay rent of $ payable [i.e.,
we
ekly, monthly, etc.]. A copy of the written agreement, if any, is attached as Exhibit “A.”
4. Defendant failed to pay the rent due .
5. Plaintiff served Defendant with a notice on , 20____ to pay the rent
or
deliver possession but
Defendant refuses to do either. A copy of the notice is attached as
Exhibit "B."
WHEREFORE, Plaintiff demands judgment for possession of the property against Defendant.
COUNT II
Damages
6. This is an action for damages that do not exceed $15,000.
7. Plaintiff restates those allegations contained in paragraphs 1 through 5 above.
8. Defendant owes Plaintiff $ that is due with interest since .
WHEREFORE, Plaintiff demands judgment for damages against Defendant.
Landlord’s Name
Address, Unit Number
Phone Number
Self Service Packet #48 (Page 17 of 46)
Florida Bar Form #5A, Complaint
for Eviction, Page 1 of 2
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name:
Address:
Telephone Number:
Self Service Packet #48 (Page 18 of 46)
Florida Bar Form #5A, Compliant
for Eviction, Page 2 of 2
FORM 81
NONMILITARY AFFIDAVIT
Armed Service Information: If you are requesting a default judgment in an eviction proceeding,
you must complete and file a Nonmilitary Affidavit. This affidavit states facts showing that the
defaulting party is or is not in the military service. This can be via admission of the defendant or
letters from the various military services denying knowledge of the party. If the defendant is in the
military service, this must be indicated. In accordance with the Service Members Civil Relief Act,
50 U.S.C. §521, unless based on facts admissible in evidence, an affidavit of non-military service
must have attached to it a statement from the Department of Defense or from each branch of the
armed services that the defendant is not in military service. Such a statement is available from the
following website, at no charge:
Defense Manpower Data Center
1600 Wilson Boulevard Suite 400
Arlington, VA 22209-2593
https://www.dmdc.osd.mil/appj/scra/
Self Service Packet #48
Page 19 of 46
IN THE COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT,
IN AND FOR PALM BEACH COUNTY, FLORIDA
Plaintiff,
___________________________________ _________________________
vs.
___________________________________
Defendant.
CASE NO.
NONMILITARY AFFIDAVIT
On this day personally appeared before me, the undersigned authority,
, who, after being first duly sworn, says:
Defendant, ____________________________________________________, is known
by
Affiant not to be in the military service or any governmental agency or branch subject to the
provisions of the Soldiers' and Sailors' Civil Relief Act.
DATED: ______________________
STATE OF FLORIDA
COUNTY OF
Signature of Affiant
Name:
Address:
Telephone No.:
______________________
Sworn
to (or affirmed) and subscribed before me by means of ☐ physical presence or ☐ online
notarization, this _____________ by ______________________ , who is personally known
to me or who has produced ______________________ as identification.
NOTARY PUBLIC-STATE OF FLORIDA
Name:
Commission No.:
My Commission Expires:
I CERTIFY that I ____ mailed, ____ faxed and mailed, or ____ hand delivered a copy of this
motion and attached affidavit to the Defendant at______________________________________
[insert address at which Tenant was served and fax number if sent by fax].
Name
Address
Fax No.
This form was completed with the assistance of: Name:
Address: Telephone N
umber:
Approved for use under rule 10-2.1(a) of the Rules Regulating The Florida Bar 2010.
Self Service Packet #48 (Page 20 of 46)
Florida Bar Form #81
Non Military Affidavit, Page 1 of
1
FORM 76
MOTION FOR CLERK'S DEFAULT – RESIDENTIAL EVICTION
The Tenant will have five days, after service, to file a written response to a Complaint for
ev
iction, and 20 days, after service, to file a written response to a complaint for back rent and
damages. If the Tenant fails to file a written response in that time the Landlord is entitled to a
judgment by default.
Obtaining the judgment is a two-step process. First, a Clerk's default should be obtained by
del
ivering to the Clerk of the Court an executed Motion-for Clerk's Default. Form 76 should be
used to obtain a Clerk's default when the Tenant has failed to respond to an eviction complaint
and Form 77 should be used to obtain a Clerk's default when the Tenant has failed to respond to
a complaint for back rent and damages. In order to be entitled to a default, Form
81, Nonmilitary Affidavit, must be filed with
the Clerk.
Second, based on the Clerk's default, a default final judgment should be obtained from the judge
han
dling the case. The default final judgment is obtained by delivering to the Court a Motion for
Default Final judgment-Residential Eviction (Form 78) and/or a Motion for Default Final
judgment - Damages (Residential Eviction) (Form 79) with an Affidavit of Damages (Form 80).
If the Landlord is seeking a Default Final judgment - Damages (Residential Eviction), a copy of
the motion and affidavit must be served on the Defendant. The forms provide a certificate of
service to be completed establishing proper service of the motion and affidavit.
Self Service Packet #48
Page 21 of 46
click to sign
signature
click to edit
IN THE COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT,
IN AND FOR PALM BEACH COUNTY, FLORIDA
[insert name of Landlord]
Plaintiff,
vs.
[insert name of Tenant]
CASE NO.:
MOTION FOR CLERK’S DEFAULT-
RESIDENTIAL EVICTION
Plaintiff asks the Clerk to enter a default against
[name], Defendant, for failing to respond as required by law to Plaintiff’s Complaint for
re
sidential eviction.
Name:
Address:
Telephone No.
DEFAULT- RESIDENTIAL EVICTION
A default is entered in this action against the Defendant for eviction for failure to respond
as required by law.
DATE: CLERK OF THE COURT
By:
Deputy Clerk
Cc:
[insert name of Landlord]
[insert name and address of Tenant]
Approved for use under rule 10-2.1(a) of the
Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name:________________
_________________
Address:___________________
____________
Telephone Number:
______________________
Self Service Packet #48 (Page 22 of 46)
Florida Bar Form #76, Motion for Clerk's Default -
Residential Eviction, Page 1 of 1
FORM 78
MOTION FOR DEFAULT FINAL JUDGMENT
(RESIDENTIAL EVICTION)
The Tenant will have five days, after service, to file a written response to a Complaint for
ev
iction, and 20 days, after service, to file a written response to a complaint for back rent and
damages. If the Tenant fails to file a written response in that time the Landlord is entitled to a
judgment by default.
Obtaining the judgment is a two-step process. First, a Clerk's default should be obtained by
del
ivering to the Clerk of the Court an executed Motion-for Clerk's Default. Form 76 should
be used to obtain a Clerk's default when the Tenant has failed to respond to an eviction
complaint and Form 77 should be used to obtain a Clerk's default when the Tenant has failed
to respond to a complaint for back rent and damages. In order to be entitled to a default, Form
81, Nonmilitary Affidavit, must be filed
with the Clerk.
Second, based on the Clerk's default, a default final judgment should be obtained from the
judg
e handling the case. The default final judgment is obtained by delivering to the Court a
Motion for Default Final judgment-Residential Eviction (Form 78) and/or a Motion for Default
Final judgment - Damages (Residential Eviction) (Form 79) with an Affidavit of Damages
(Form 80). If the Landlord is seeking a Default Final judgment - Damages (Residential
Eviction), a copy of the motion and affidavit must be served on the Defendant. The forms
provide a certificate of service to be completed establishing proper service of the motion and
affidavit.
Self Service Packet #48
Page 23 of 46
IN THE COUNTY COURT,
OF THE FIFTEENTH JUDICIAL CIRCUIT
IN AND FOR PALM BEACH COUNTY, FLORIDA
CASE NO.
Plaintiff,
MOTION FOR DEFAULT FINAL
JUDGMENT -
RESIDENTIAL EVICTION
vs.
Defendant.
Plaintiff asks the Clerk to enter a default against ,
Defendant, for failing to respond as required by law to Plaintiff's Complaint for damages.
1. Plaintiff filed a Complaint alleging grounds for residential eviction of Defendant.
2. A Default was entered by the Clerk of this Court on [date].
WHEREFORE, Plaintiff asks this Court to enter a Final judgment For
Residential Eviction against Defendant.
Name:
Address:
Telephone No.
cc:
Tenant
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida Bar
The
Florida
B
ar
2010
This form was completed
wit
h the assistance of:
Name:
Address:
Telephone Numb
er:
Self Service Packet #48 (Page 24 of 46)
Florida Bar Form #78, Motion for Default Final
Judgment - Residential Eviction, Page 1 of 1
IN THE COUNTY COURT
OF THE FIFTEENTH JUDICIAL CIRCUIT
,
IN AND FOR PALM BEACH COUNTY, FLORIDA
Plaintiff,
vs.
Defendant.
CASE NO.
FINAL JUDGMENT - EVICTION
THIS ACTION came before the Court upon Plaintiff’s Complaint for Eviction. On the
evi
dence presented, it is
ADJUDGED that Plaintiff
[insert Landlord’s name], recover from Defendant
[insert Tenant’s name], possession of the real property described as follows:
[insert legal or street description of rental premises including, if applicable, unit number]
and $ as court costs, WHICH LET WRITS OF POSSESSION AND
EXECUTION NOW ISSUE.
ORDERED in PALM BEACH COUNTY, FLORIDA on 20
County Judge
cc:
Landlord
Tenant
Self Service Packet #48 (Page 25 of 46)
Florida Bar Form #66
Final Judgment - Eviction, Page 1 of 2
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name:
Address:
Telephone Number:
Self Service Packet #48 (Page 26 of 46)
Florida Bar Form #66
Final Judgment - Eviction, Page 2 of 2
___________________________________
___________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SHERIFF INFORMATION SHEET
Case No: ___________________________
Plaintiff(s)
-vs-
Defendant(s)
The following information is required in order to make arrangements with the proper
pers
on regarding the changing of locks and the acceptance of possession of the premises.
___________1. Plaintiff will meet the Deputy Sheriff on the premises and change
own locks.
Phone Numbers: Home: ( )
Work: ( )
Cell: ( )
___________2. Plaintiff’s Agent, , will meet the
Deputy Sheriff on t he premises, change the locks and accept possession on be half of the
Plaintiff.
______________________________________
Phone Numbers: Home: ( )
Work: ( )
Cell:
( )
ADDITIONAL INFORMATION:
Self Service Packet #48 (Page 27 of 46)
Sheriff Information Sheet
Page 1 of 1
FORM
77
MOTION FOR
C
LE
RK
'
S
DEFAULT –
DA
M
A
G
E
S
(RESIDENTIAL
E
V
I
C
T
I
O
N)
The Tenant will have five days, after service, to file a written response to a Complaint for
evi
ction, and 20 days, after service, to file a written response to a complaint for back rent and
damages. If the Tenant fails to file a written response in that time the Landlord is entitled to a
judgment by default.
Obtaining the judgment is a two-step process. First, a Clerk's default should be obtained by
delivering to the Clerk of the Court an executed Motion-for Clerk's Default. Form 76 should
be used to obtain a Clerk's default when the Tenant has failed to respond to an eviction
complaint and Form 77 should be used to obtain a Clerk's default when the Tenant has failed to
respond to a complaint for back rent and damages. In order to be entitled to a default, Form
81, Nonmilitary Affidavit, must be filed with the Clerk.
Second, based on the Clerk's default, a default final judgment should be obtained from the judge
handling the case. The default final judgment is obtained by delivering to the Court a Motion
for Default Final judgment-Residential Eviction (Form 78) and/or a Motion for Default Final
judgment - Damages (Residential Eviction) (Form 79) with an Affidavit of Damages (Form 80).
If the Landlord is seeking a Default Final judgment - Damages (Residential Eviction), a copy of
the motion and affidavit must be served on the Defendant. The forms provide a certificate of
service to be completed establishing proper service of the motion and affidavit.
Self Service Packet #48
Page 28 of 46
IN THE COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT,
IN AND FOR PALM BEACH COUNTY, FLORIDA
[insert name of Landlord]
Plaintiff,
vs.
[insert name of Tenant]
Defendant.
CASE NO.
MOTION FOR CLERK’S DEFAULT –
DAMA
GES (RESIDENTIAL EVICTION)
Plaintiff asks the Clerk to enter a default against [name],
Defendant, for failing to respond as required by law to Plaintiff's Complaint for damages.
Name:
Address:
Telephone No.
DEFAULT - DAMAGES
A default is entered in this action against the Defendant for damages for failure to respond as
required by law.
DATE: CLERK OF THE COURT
By:
Deputy Clerk & Comptroller
Cc:
[insert name of Landlord]
[insert name and address of Tenant]
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name:
Address:
Telephone Number:
Self Service Packet #48 (Page 29 of 46)
Florida Bar Form #77, Motion for Clerk's Default -
Damages (Residential Eviction), Page 1 of 1
FORM 80
AFFIDAVIT OF DAMAGES
The Tenant will have five days, after service, to file a written response to a Complaint for
ev
iction, and 20 days, after service, to file a written response to a complaint for back rent and
damages. If the Tenant fails to file a written response in that time the Landlord is entitled to a
judgment by default.
Obtaining the judgment is a two-step process. First, a Clerk's default should be obtained by
deli
vering to the Clerk of the Court an executed Motion-for Clerk's Default. Form 76 should
be used to obtain a Clerk's default when the Tenant has failed to respond to an eviction
complaint and Form 77 should be used to obtain a Clerk's default when the Tenant has failed
to respond to a complaint for back rent and damages. In order to be entitled to a default, Form
81, Nonmilitary Affidavit, must be filed
with the Clerk.
Second, based on the Clerk's default, a default final judgment should be obtained from the
judge handling the case. The default final judgment is obtained by delivering to the Court a
Motion for Default Final judgment-Residential Eviction (Form 78) and/or a Motion for
Default Final judgment - Damages (Residential Eviction) (Form 79) with an Affidavit of
Damages (Form 80). If the Landlord is seeking a Default Final judgment - Damages
(Residential Eviction), a copy of the motion and affidavit must be served on the Defendant.
The forms provide a certificate of service to be completed establishing proper service of the
motion and affidavit.
Self Service Packet #48
Page 30 of 46
IN THE COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT,
IN AND FOR PALM BEACH COUNTY, FLORIDA
[insert name of Landlord]
Plaintiff,
vs.
[insert name of Tenant]
Defendant.
CASE NO.
AFFIDAVIT OF DAMAGES
STATE OF FLORIDA )
COUNTY OF PALM BEACH )
BEFORE ME, the undersigned authority, personally appeared
who being first duly sworn, states as follows:
1. I am the Plaintiff or the Plaintiff's agent in this case and am authorized to
make this affidavit.
2. This affidavit is based on my own personal knowledge.
3. Defendant has possession of the property which is the subject of this eviction under an
agr
eement to pay rent of $ per [week, month, or other
pay
ment period].
4. Defendant has not paid the rent due since [day of
payment Tenant has failed to make].
5. Defendant owes Plaintiff $ [past due rent amount] as
alleged in the Complaint plus interest.
6. Defendant owes Plaintiff $ [amount of other damages]
as alleged in the Complaint plus interest.
Name
Sworn and subscribed before me on ,
by
(name), who is personally known to me/
produced [document]as identification and who took an oath.
NOTARY PUBLIC-STATE OF FLORIDA
Name:
Commission No.
My Commission Expires:
Self Service Packet #48 (Page 31 of 46)
Florida Bar Form #80
Affidavit of Damages, Page 1 of 2
I CERTIFY that I mailed, faxed and mailed, or hand delivered a copy of this
motion and attached affidavit to the Defendant at
[address at which Tenant was served and fax number if sent by fax].
Approved for use under rule 10-2.1(a) of
the R
ules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name:
Address:
Telephone Number:
Self Service Packet #48 (Page 32 of 46)
Florida Bar Form #81,
Affidavit of Damages, Page 2 of 2
click to sign
signature
click to edit
FORM 79
MOTION FOR DEFAULT FINAL JUDGMENT – DAMAGES
(RESIDENTIAL EVICTION)
The Tenant will have five days, after service, to file a written response to a Complaint for
ev
iction, and 20 days, after service, to file a written response to a complaint for back rent and
damages. If the Tenant fails to file a written response in that time the Landlord is entitled to a
judgment by default.
Obtaining the judgment is a two-step process. First, a Clerk's default should be obtained by
del
ivering to the Clerk of the Court an executed Motion-for Clerk's Default. Form 76 should be
used to obtain a Clerk's default when the Tenant has failed to respond to an eviction complaint
and Form 77 should be used to obtain a Clerk's default when the Tenant has failed to respond
to a complaint for back rent and damages. In order to be entitled to a default, Form
81, Nonmilitary Affidavit, must be filed with the Clerk.
Second, based on the Clerk's default, a default final judgment should be obtained from the judge
han
dling the case. The default final judgment is obtained by delivering to the Court a Motion
for Default Final judgment-Residential Eviction (Form 78) and/or a Motion for Default Final
judgment - Damages (Residential Eviction) (Form 79) with an Affidavit of Damages (Form 80).
If the Landlord is seeking a Default Final judgment - Damages (Residential Eviction), a copy of
the motion and affidavit must be served on the Defendant. The forms provide a certificate of
service to be completed establishing proper service of the motion and affidavit.
Self Service Packet #48
Page 33 of 46
IN THE COUNTY COURT
OF THE FIFTEENTH JUDICIAL CIRCUIT
,
IN AND FOR PALM BEACH COUNTY, FLORIDA
[insert name of Landlord]
Plaintiff,
vs.
[insert name of Tenant]
Defendant.
CASE No.
MOTION FOR DEFAULT FINAL
JUDGMENT—DAMAGES
(RESIDENTIAL EVICTION)
Plaintiff asks the Clerk to enter a default against [name],
Defendant, for failing to respond as required by law to Plaintiff's Complaint for damages.
1.
Plaintiff filed a Complaint for damages against the Defendant.
2. Defendant has failed to timely file an answer and a Default has been entered by the
Clerk of this Court on [date].
3. In support of this Motion, Plaintiff submits the attached Affidavit of Damages.
WHEREFORE, Plaintiff asks this Court to enter a Final judgment against Defendant.
I CERTIFY that I mailed, faxed and mailed, or hand delivered a
copy of this motion and attached affidavit to the Defendant at
[insert address at which Tenant was served and fax number if sent by fax].
Name:
Address:
Telephone No.
Approved for use under 10-2.1(a) of
the Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name:
Address:
Telephone N
umber:
Self Service Packet #48 (Page 34 of 46)
Florida Bar Form #79, Motion for Default Final Judgment -
Damages Residential Eviction, Page 1 of 1
FORM 9
FINAL JUDGMENT - DAMAGES
After the Court enters this judgment you should obtain a certified copy of the judgment from
the Clerk of the Court and record the certified copy in the public records in any county in
which the Tenant owns real property. The Clerk of the Small Claims Court can probably
provide you with information concerning the collection of the amounts owed you.
A judgment for money (if properly recorded) is a lien upon the real or personal property of the
person
against whom the judgment is entered for a period of ten years. The lien may then
be extended for an additional period of ten years by re-recording a certified copy of the
judgment prior to the expiration of the lien, and by simultaneously recording an affidavit with
the current address who has a lien as a result of the judgment. The lien may not be
extended beyond twenty years from the date of entry of the judgment, or beyond the point the
lien is satisfied, whichever occurs first.
SOURCE: S ections 55.081 and 55.10, Florida
St
atutes (2007)
Self Service Packet #48
Page 35 of 46
IN THE COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT,
IN AND FOR PALM BEACH COUNTY FLORIDA
Plaintiff,
vs.
Defendant
Case No:
FINAL JUDGMENT - DAMAGES
THIS ACTION came before the Court upon Plaintiff’s Complaint for unpaid rent.
On t
he evidence
presented, it is ADJUDGED that Plaintiff,
[insert Landlord’s name], whose principal address is
[insert Landlord’s address], recover from
Def
endant, [insert Tenant’s name], whose
princ
ipal address is [insert Tenant’s
address],
the sum of $ , with costs in the sum of sum of $
, making a total of $ , that shall bear interest at the legal rate established
pursuant to section 55.03, Florida Statutes, FOR WHICH LET EXECUTION NOW ISSUE.
ORDERED in PALM BEACH COUNTY, FLORIDA on 20 .
(County/ Circuit)
Judge
Cc:_____________________________
Landlord
Self Service Packet #48 (Page 36 of 46)
Florida Bar Form #9
Final Judgment - Damages, Page 1
of 2
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed
with the assistance of:
Name:
Address:
T
elephone Number:
Self Service Packet #48 (Page 37 of 46)
Florida Bar Form #9
Final Judgment - Damages, Page 2 of 2
FORM 12
NOTI
CE OF INTENTION TO IMPOSE CLAIM ON SECURITY DEPOSIT
A Landlord must return a Tenant's security deposit, together with interest if otherwise required,
to
the Tenant no more than 15 days after the Tenant leaves the leased property. The
Landlord may claim all or a portion of the security deposit only after giving the Tenant
written notice, by certified mail to the Tenant's last known mailing address, of the Landlord's
intention to keep the deposit and the reason for keeping it. The Landlord’s notice must be
sent within 30 days of the date Tenant vacates the leased property. If the Landlord does not
send the notice within the 30-day period the Landlord cannot keep the security deposit. If the
Tenant does not object to the notice within 15 days after receipt of the Landlord’s notice of
intention to impose a claim on the deposit, the Landlord may then keep the amount stated in the
notice and must send the rest of the deposit to the Tenant within 30 days after the date of the
notice.
SOURCE: Section 83.49(3) Florida Statutes (2007)
Self Service Packet #48
Page 38 of 46
NOTICE OF INTENTION TO IMPOSE CLAIM ON SECURITY DEPOSIT
To:
Tenant's Name
Address
City, State, Zip Code
Date:
This is a notice of my intention to impose a claim for damage in the amount of $
Upon your security deposit due to
[Damage done to premises or other reason for claiming security deposit]. This notice is sent to
you as required by §83.49(3), Florida Statutes. You are hereby notified that you must object in
writing to this deduction from your security deposit within 15 days from the time you receive
this notice or I will be authorized to deduct my claim from your security deposit. Your objection
must be sent to
[Landlord's address].
Landlord’s Name
Address:
Phone Number:
Approved for use under rule 10-2.1(a) of
the R
ules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name:
Address:
Telephone Number:
Self Service Packet #48 (Page 39 of 46)
Florida Bar Form #12, Notice of Intention To Impose
Claim on Security Deposit, Page 1 of 1
_______________________________
_______________________________
_______________________________________
IN THE COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT,
IN AND FOR PALM BEACH COUNTY, FLORIDA
Case No: ___________________________
Division:
Plaintiff(s)
___________________________
-vs-
Defendant(s)
NOTICE OF VOLUNTARY DISMISSAL
No property having been seized or placed into the custody of the Court, the plaintiff,
______________________________________________________, hereby dismisses this action.
I certify that a copy here of has been furnished to:
by ____mail or by ______hand delivery, this _______day of __________________, 20____.
Signature: _______________________________________
Name [print]: _______________________________________
Address:
City, State, Zip Code: _______________________________________
Telephone:
_______________________________________
Self Service Packet #48 (Page 40 of 46)
Notice of Voluntary Dismissal, Page 1 of 1
=THE==================
15TH
JUDICIAL
CIRCUIT
==============OF
FLOR
I
DA===
ADMINISTRATIVE
OFFICE
OF
THE
COURT
E-SERVICE INSTRUCTIONS FOR SELF REPRESENTED PARTIES
Pursuant to the Florida Rule of Judicial Administration 2.516, self-represented parties involved
in any type of case in any Florida court, may, but are not required to, serve on t he opposing
party's attorney court documents by e-mail.
E-mail Service to/from an Opposing Party: Self-represented parties opting to serve court
docume
nts by e-mail may do so by designating a primary e-mail address (and up to 2 secondary
e-mail addresses) for receiving service in that proceeding. This designation only informs the
other side of your email address. O nce a party has filed an e-mail address designation in a
proceeding, all court documents required or permitted to be served on a party must be served by
e-mail unless the parties otherwise agree or a court orders otherwise.
E-Mail Service from Participating Judges: Self-represented parties who want to receive court
order
s and other court documents from judges who use e-mail service MUST register with the
15th Judicial Circuit's online services system at
www.15thcircuit.com/html/onlineservices.
You
will NOT receive court documents from participating judges unless and until you register with
the 15th Judicial Circuit's online system.
Form of Email: E-mail service is made by attaching a copy of the document to be served in PDF
format to an e-mail. The e-mail’s subject line must state “SERVICE OF COURT DOCUMENT”
in all capital letters, followed by the case number of the relevant proceeding. The body of the e-
mail must identify the: (1) court in which the proceeding is pending; (2) case number; (3) name
of the initial party on each side; (3) title of each document served with that e-mail; (4) sender’s
name; (5) sender’s t elephone number. The e-mail and attachments together may not exceed 5
megabytes in size; e-mails that exceed the size requirement must be divided into separate e-mails
(no one of which may exceed 5 m egabytes) and labeled sequentially in the subject line.
Documents served by e-mail may be signed by "/s/", "/s" or "s/" as long as the document filed
with the Clerk's Office is signed in accordance with the applicable rule of procedure.
Service Dates: S ervice by e-mail is deemed complete on the date it is sent. E-mail service is
tr
eated as service by mail for the computation of time. When, in addition to service by e-mail, the
sender also utilizes another means of service provided for in the Rules of Judicial
Administration, the computation of time will be based on t he method of service that has the
shortest response time.
Filing of Documents: The Rules of Judicial Administration require that all documents be filed
wit
h the court either before service on the opposing party or immediately thereafter. Documents
are deemed filed when they are filed with the clerk of court. If the sender learns that the e-mail
did not reach the address of the person to be served, the sender must immediately send another
copy by e-mail, or serve by a means authorized by subdivision (b)(2) of the Rules of Judicial
Administration.
Instructions for E-Service Registration for Self Represented Litigants, (06/13)
Self Service Packet #48
Page 41 of 46
IN THE CIRCUIT/COUNTY COURT OF THE FIFTEENTH JUDICIAL CIRCUIT
IN AND FOR PALM BEACH COUNTY, FLORIDA
CASE NO.:
Plaintiff/Petitioner
,
v.
Defendant/Respondent.
,
NOTICE OF DESIGNATION OF EMAIL ADDRESS FOR E-SERVICE
I, (full legal name) , designate my e-mail
address(es) below (up to 3 different email address) to opt in E-service in this case.
Primarily Email Address: ____________________________________________________
Secondary Email Address: _________________________________________________
Other Email Address: __
__________________________________________________
1. By completing this form I a
m authorizing the Court, the Clerk of the Fifteenth Judicial
Circuit of Florida and the opposing party to send copies of orders/judgment, notices or
other written communications or pleadings to me through my designated e-mail and NOT
through regular U.S. Mail.
2. I understand that I must keep the clerk's office and the opposing party or parties notified of
my c
urrent mailing and e-mail address(es) and that all future orders/judgment, notices or
other written communications or pleadings in this lawsuit will be served at the email
address(es) provided above.
3. I will ensure the software filters have been removed from my computer, so it does not
inte
rfere with my ability to receive any of the above documents.
I certify that a copy of this document was {check all used}: ( ) e-mailed ( ) mailed ( ) faxed
( ) hand-delivered to the person(s) listed below on {date} .
Other party or his/
her attorney
Name:
Address:
City, State, Zip:
Fax Number:
E-Mail Address(es
):
Dated:
Signature of Party
Self Service Packet #48 (Page 42 of 46)
15th Judicial Circuit Court Approved Local Form, Designation of Email
Address for Self Represented Litigants (1/17), Page 1 of 2
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
This form was comp
leted with the assistance of:
{name of individual}
{name of business}
{street}
{city} , {state} {telephone number}
Self Service Packet #48 (Page 43 of 46)
15th Judicial Circuit Court Approved Local Form, Designation of Email
Address for Self Represented Litigants (1/17), Page 2 of 2
INSTRUCTIONS FOR COMPLETING FINAL DISPOSITION FORM
I.
Case Style. Enter the name of the court, the appropriate case number assigned at the time
of filing of the original complaint or petition, the name of the judge assigned to the case and the
names (last, first, middle initial) of plaintiff(s) and defendant(s).
II.
Amount of Final Judgment. Enter the amount as recorded in the final judgment.
III.
Means of Final Disposition. Place an “x” in the appropriate major category box and in the
appropriate subcategory box, if applicable. The following are the definitions of the
disposition categories.
(A) Dismissed Before Hearing—the case is settled, voluntarily dismissed, or
otherwise disposed of before a hearing is held;
(B) Dismissed Pursuant to Settlement — Before Hearing—the case is voluntarily dismissed
by the plaintiff after a settlement is reached without mediation before a hearing is held;
(C) Dismissal Pursuant to Mediated Settlement — Before Hearing—the case is
volunta
rily dismissed by the plaintiff after a settlement is reached with mediation
before a hearing is held;
(D) Other - Before Hearing—the case is dismissed before hearing in an action that does not
fall into one of the other disposition categories listed on this form;
(E) Dismissed After Hearing—the case is dismissed by a judge, voluntarily
dismissed, or settled after a hearing is held;
(F) Dismissal Pursuant to Settlement—After Hearing—the case is voluntarily dismissed by
the plaintiff after a settlement is reach without mediation after a hearing is held;
(G) Dismissal Pursuant to Mediated Settlement—After Hearing—the case is voluntarily
dismissed by the plaintiff after a settlement is reach with mediation after a hearing is held;
(H) Other—After Hearing—the case is dismissed after hearing in an action that does not fall
into one
of the other disposition categories listed on this form;
(I) Disposed by Default—a defendant chooses not to or fails to contest the plaintiff’s
allegations and a judgment against the defendant is entered by the court;
(J) Disposed by Judge—a judgment or disposition is reached by the judge in a case that is
not dismissed and in which no trial has been held. Includes stipulations by the parties,
conditional judgments, summary judgment after hearing and any matter in which a
judgment is entered excluding cases disposed of by default as in category (I) above;
(K) Disposed by Non-Jury Trial—the case is disposed as a result of a contested trial in which
there is no jury and in which the judge determines both the issues of fact and law in the
Self Service Packet #48
Page 44 of 46
case;
(L) Disposed by Jury Trial—the case is disposed as a result of a jury trial (consider the
beg
inning of a jury trial to be when the jurors and alternates are selected and sworn);
(M) Other—the case is consolidated, submitted to arbitration or mediation, transferred,
or otherw
ise disposed of by other means not listed in categories (A) through (L).
DATE AND ATTORNEY SIGNATURE. Date and sign the final disposition form.
Self Service Packet #48
Page 45 of 46
______________________________
______________________________
FORM 1.998. FINAL DISPOSITION FORM
This form shall be filed by the prevailing party with the Clerk of Court for the purpose of
reporting uniform case data pursuant to Florida Statutes section
25.075. (See instructions on the reverse of the form.)
I. CASE STYLE
IN THE
COUNTY
COURT OF THE FIFTEENTH JUDICIAL CIRCUIT, IN AND FOR
PALM BEACH COUNTY, FLORIDA
________________
Plaintiff(s)
-vs-
Defendant(s)
Case No.
Judge
II. AMOUNT OF FINAL JUDGMENT
Please indicate the amount of the final judgment, rounded to the nearest dollar.
$______________.
III. MEANS OF FINAL DISPOSITION (Place an “x” in one box for major category and
one s
ubcategory, if applicable, only)
□
Dismissed Before Hearing
□
Dismissed Pursuant to Settlement Before Hearing
□
Dismissed Pursuant to Mediated Settlement __Before Hearing
□
Other __ Before Hearing
□
Dismissed After Hearing
□
Dismissed Pursuant to Settlement __ After Hearing
□
Dismissed Pursuant to Mediated Settlement __ After Hearing
□
Other After Hearing __ After Hearing
□
Disposed by Default
□
Disposed by Judge
□
Disposed by Non-jury Trial
□
Disposed by Jury Trial
□
Other
DATE
SIGNATURE OF (ATTORNEY FOR) PREVAILING PARTY
Self Service Packet #48 (Page 46 of 46) Form 1.998, Final Disposition Form, Page 1 of 1
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Joseph Abruzzo Clerk of The Circuit Court & (Clerk of the Circuit Court & Comptroller, Palm Beach County)

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Completed 5 July 2021

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