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KEN BURKE, C.P.A.
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
PINELLAS COUNTY, FLORIDA
www.mypinellasclerk.org
ADOPTION OF A MINOR BY A STEPPARENT
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05/2015
SELF HELP CENTER
The Self Help Centers are the result of a collaborative effort between the Clerk’s Office, the Sixth Judicial Circuit,
the Community Law Program and the Clearwater Bar Association.
The purpose of the Clerk's Legal Self Help Centers is to assisW citizens representing
themselves in court (sometimes referred to as pro se persons) who do NOT have a private attorney.
&itizens who represent themselves in court and do not already have a private attorney representing them, can
now get affordable legal assistance.
OUR SERVICES INCLUDE:
x Schedule an appointment to consult with an attorney for a minimum of $15.00*
(Attorneys may assist with Family Law, Small Claims and Landlord/Tenant matters ONLY.)
x Purchase forms and packets for WKHcivil court actions OLVWHVDERYH
x Have documents notarized
x Make copies
Open Monday through Friday from 8:30 a.m. until 4:30 p.m.:
x
The Clearwater Self Help Center
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Clearwater, FL 33756
Phone: (727) 464-5150
Fax: (727) 453-3423
o Appointments may be scheduled for:HGQHVGD\
Thursday and/or Friday.
o A Spanish interpreter provided by the
Hispanic Outreach Center is availableE\
DSSRLQWPHQWat theClearwater location
x
The St. Petersburg Self Help
Center
The St. Petersburg Judicial Building
545 First Avenue North5RRP
St Petersburg, FL 33701
Phone: (727) 582-7941
Fax: (727) 582-7945
o Appointments may be scheduled for
Monday WednesdayDQGRU)ULGD\
x The North County Branch Self Help Center
29582 U.S. 19 North
Clearwater, FL 33761
Phone: (727) 464-5150
Fax: (727) 453-3423
o Attorney appointments may be scheduled
for Tuesday only at this office.
Self Help Center Now Offering Online Scheduling of attorney consultation appointments for pro se litigants
that do not already have an attorney. To schedule an appointment online using a credit card, please visit
www.mypinellasclerk.org
and click on the SELF HELP CENTER link in the top menu.
*Attorney appointments may only be scheduled for a minimum of 15 minutes to a maximum of one hour. All appointments must be
scheduled in 15-minute increments, i.e., 15, 30, 45 or 60 minutes at a rate of $1 (one dollar) per minute, therefore payments will be $15, $30,
$45 or $60 accordingly.
Attorney consultation fees must be paid when the appointment time is scheduled. Payments must be E\FUHGLWFDUGFDVK check or money
order. Refunds will not be issued for missed appointments.
Ken Burke, CPA
Clerk of the Circuit Court
& Comptroller
Pinellas County, Florida
Administrative Office of the Courts
The Six th Judicial Circuit of Florida
(727)582-7200
CASE PROGRESSION CHECKLIST
JOINT PETITION FOR STEPPARENT ADOPTION
(WITH CONS ENT O R NO TICE BY P ERS ONAL S ERVIC E)
This checklist has been prepared to assist you with the necessary procedure for bringing your case to final hearing.
This checklist lists the minimum requirements and, even though fairly specific, may not be all-inclusive for every
case. It is not intended, and should not be substituted for proper legal advice from an attorney. You should,
however, find that making sure all necessary steps noted below are followed would reduce procedural difficulties
and time delays. IMPORTANT NOTE: If you are unable to obtain the consent of all parties, your case will have
many added complications. It is suggested that you keep a copy of all documents that you file for your reference.
A. Req uired fees:
The Clerk of Court will give you information on f iling fees, if you are unable to pay those fees you may ask
the clerk for an ASSOLFDWLRQIRU,QGLJHQW6WDWXV, if you are requesting that filing fees and sHUYLFH
fees be waived.
Filing fee paid, or fee waiver ($SSOLFDWLRQIRU,QGLJHQW6WDWXVJUDQWHGE\&OHUN&RXUW
B. Petition.
Joint Petition for Adoption by Stepparent – Form 12.981(b)(1). Both the stepparent and his/her spouse (i.e.
the natural parent) must sign this petition. Note: A certified copy of the minor’s original birth certificate
must be filed with the petition.
C. Required forms to be filed with the petition:
Uniform Child Custody Jurisdiction and Enforcement Act Affid avit (UCCJEA) – Form 12.902(d).
Indian Child Welfare Act Affidavit-Form 12.981(a)(5). This form is required in all adoption cases.
Consents:
The process of stepparent adoption is least complicated
when you have obtained th e consent of all
necessary parties. If you are unable to obtain the necessary consent from the other parent, you will need to
have location information on the other party(ies) in the case so they may be served personally with the
petition. If you have no address for another party in the case, you will need additional forms that are not
included in this package to serve notice by constructive service. The law regarding constructive service is
complex and you may wish to consult an attorney regarding that issue.
Note: If the parents were unmarried, there is no father’s name on the birth certificate, the mother was
married to someone other than the father at the time of the child’s birth, or there has not been a court case
for paternity, this could create complications in your case. If you have questions concerning who should
sign these consents and/or which form should be used, you should seek legal advice from an attorney.
Stepparent Adoption: Consent of Adoptee – Form 12.981(a)(2) An adoptee over 12 years old must
sign a consent. In certain circumstances the court can excuse this consent.
Affidavit of Nonpaternity – Form 12.981(a)(3). This form is used when a stepfather is adopting
his wife’s minor child and the mother and father were never married and p aternity has not been
established by a valid acknowledgment or court proceeding.
OR
Six th Judicial Circuit, Courts Information & Resource Cente r 4-2004XSGDWHVE\&OHUN 1 of 4
Stepparent Adoption: Consent and Waiver by Parent – Form 12.981(a)(1). This consent is signed
by the other legal parent of the child.
De ceased parent: If the other parent of the child is deceased, you will need to obtain a certified
death certificate from the agency responsible for issuing those documents in the state where the
death occurred. In Florida, the Department of Vital Statistics issues death certificates. Note: a
search of the Putative Fathery Registry may still be required in this situation.
II. S EA R C H O F TH E P U TA TI V E FA TH ER R EG IS TR Y :
Note: Statute requires a search of the Putative Father Registry maintained by the Florida Office of Vital
Statistics in many adoption cases. If the child was born in another state, you may also be required to search
a similar registry in that state as well as the one in Florida. If you have any questions about whether this step
is necessary in your case, you may need to seek legal advice
.
Gener ally a search of the putative father registry is required when:
x T he mother and father were not married when the child was born.
x The birth father is unknown
x There is no signed consent from the other parent
x The other parent is being served by constructive service.
In this state, the putative father registry is maintained by the Florida Department of Vital Statistics. When
filing a stepparent adoption without an attorney, you must have the Court order the Department of Vital
Statistics to complete the search for you. The Department of Vital statistics charges a small fee for the
search of the registry and a copy of the court’s order must accompany their form requesting the search. The
Department of Vital Statistics, Adoption Division, can be reached at 904-359-6900, ext. 9001 (as of 4-2004)
to obtain their forms and instructions for accomplishing the search.
Motion for Search of the Putative Father Registry – Form 12.981(a)(6).
Order Granting Motion for Search of the Putative Father Registry – Form 12.981(a)(7).
After the Court has signed the order Granting your motion for the search of the Putative Father Registry,
you must obtain a certified copy from the clerk’s office and mail it to Vital Statistics along with their search
form and fee for the search. Vital Statistics will send the results directly to the Pinellas County Clerk of
Court.
Vital Statistics form: Florida Putative Father Registry, Application for Search. Complete this form
and attach the following:
x Check or money order made out to Vital Statistics for the appropriate fee.
x A certified copy of the signed Order Granting Motion for Search of the Putative Father
Registry.
III. S ERVICE OF P RO CESS :
Service of Pro cess by personal servi ce: The following parties to the case must b e served with the above
documents by personal service.
x The legal parent who has not signed a consent.
x Any putative father who previously signed an affid avit of non-paternity but later withdrew it.
x Any putative father located in the search of the putative father registry.
x Any putative father that has signed an affidavit of paternity (acknowledgment) pursuant to section
382.013(2)(c) Florida Statutes, but has not been found to be the father in a paternity proceeding.
Summons: Personal Service on an Individual – Form 12.910(a). Complete one for each party being served.
Process Service Memorandum – Form 12.910(b). Complete one for each party being served.
Sixth Judicial Circuit, Courts Information & Resource Center 4-2004 2 of 4
Six th Judicial Circuit, Courts Information & Resource Cente r 4-2004 3 of 4
Out of S tate Service Information: If service is required on a party residing outside of the state of Florida, the party
who filed the petition must obtain service procedure information including fees, from the local officials responsible
for process service where the other party resides. This information, along with applicable fees (in the form of a
money order), must be provided to the Clerk’s Office. The Clerk’s Office will forward the completed summons and
paperwork to the address you provide for the out of state agency. Most other states will not honor a Florida
Affidavit of Indigence.
Summons returned “ served” and the Original Return of Service has been filed by Clerk in your court file.
You will need a return of service for each party that has been served
. Out of state agencies will often
send the original “ Return of Service” form to you and you will need to file that form in your court file.
You will need a return of service on each party that you had served.
If your summons is returned to the clerk “NOT S ERVED”
Alias summons: Return to the Clerk of Court to request an Alias (2
nd
attempt at service) or Pluries (3
rd
or
more attempt at service) service to be processed by the clerk of court.
Complete Summons: Personal Service on an Individual - Form 12.910(a).
Process Service memorandum–Form 12.910(b).
If you are still unable to serve all of the other party(ies) by personal service, your
case cannot proceed until you have obtained service on all parties in the case.
Constructive service by publication is available for this procedure, however, those
forms are not included in this package. The law regarding constructive service is
complex and you may wish to consult an attorney regarding that issue.
III. PROCEEDING WITH THE CAS E: Contac t the Resource Cent er f or f urther instructions.
Contact the Court’s Information & Resource center at 727-582-7200 to request that your file be reviewed
for readiness for hearing. You will not be given a court date at the time you call.
The Resource Center will take some information from you and will order the file to the proper staff for
review. You will be contacted later with information concerning your court date or problems that may
have been found with your filing.
If you have legal questions, the Resource Center staff may be able to direct you to community legal
resources that may be available for low income individuals.
IV. HEARING ON STEPPARENT ADOPTION:
A. Notice of H earing:
General Notice of Hearing – Form 12.923 must be sent to each party in the case that has not signed a
consent or affidavit of non-paternity. Each party must receive notice of the hearing no less than 5 days in
advance of the court date.
B.
Attendance at the hearing: Both the stepparent adopting the child, and the child’s parent who is married
to the stepparent must appear at the hearing.
Does the child have to come to the hearing?
x Under 12 years old: The attendance of the minor child being adopted is allowed but not required.
x Over 12 years old: The attendance of the minor child being adopted is required.
Six th Judicial Circuit, Courts Information & Resource Cente r 4-2004 4 of 4
C. Also bring with you to the final hearing:
Driver’s License, Florida Identification Card or Voter’s Identification card.
Certified copies of all previous court orders affecting the child(ren ) (custody, visitation, support,
dependency), especially if those orders were entered by a Court in another state or county.
Final Orders: Final Judgment of Stepparent Adoption – Form 12.981(b)(2). Note: you will need to provide
one original and enough copies for all parties in the case.
VI. AFTER THE FINAL HEARING:
After the final hearing you will need to request at least one certified copy of the final order.
The clerk of court will charge a fee for certif ied copies.
The clerk of court routinely seals
files of this nature after ten (10) days from the entry of the final order. After that period, if
you must gain access to a sealed court f ile, it will require a court order to do so.
PLEASE READ THE FO LLOWING CAREFULLY!!!
All adop tion f iles are routinely sealed from p ublic v iew. This means that once the case is
co
mpleted y ou will not be able to access the court file to obtain copies of documents you have
filed or orders that have been entered in the case. YOU M US T ORDER AS MANY
CERTIFIED COPIES AS YOU NEED OF THE FINAL ORDER(S) FROM THE CLERK
OF COURT BEFORE TEN (10) DAYS AFTER ENTRY OF THE FIN AL JUDGMENT
INTO THE COURT FILE. If you do not obtain enough copies and need more later, it will
require a court order to access the f ile to obtain more copies of the f inal ord er(s).
Some agencies that may actually want a certified copy of the judgement for their files are as
f
ollows:
x T
he other parent for purposes of stopping support orders, changin g insurance, etc.
x Schools
x The Social Security Administration
x The Department of Vital Statistics in the State where the child was born – it is especially
important that a copy of the final order is sent to this agency. If this is not done, the child
may have problems later due to a name that doesn’t match the birth certificate, problems with
obtaining a passport, etc.
x Any professional organizations that the child may be a member of
x Any government agencies that may be providing services to the child due to a disability,
s
pecial education, etc.
"If you are a person with a disability who needs any accommodation in order to participate
in a court proceeding, you are entitled, at no cost to you, to the provision of certain
assistance. Within two (2) working days of your receipt of any notice or order requiring
your presence at a hearing, please contact the Human Rights Office, 400 S. Ft. Harrison
Ave., Ste. 300, Clearwater, FL 33756, (727) 464-4062 (V/TDD).”
General Information for Self-Represented Litigants (09/13)
- 1 -
FAMILY LAW FORMS, COMMENTARY, AND INSTRUCTIONS
GENERAL INFORMATION FOR SELF-REPRESENTED LITIGANTS
(09/13)
You should read this General Information thoroughly before taking any other steps to file your case or
represent yourself in court. Most of this information is not repeated in the attached forms. This
information should provide you with an overview of the court system, its participants, and its processes.
It should be useful whether you want to represent yourself in a pending matter or have a better
understanding of the way family court works. This is not intended as a substitute for legal advice from
an attorney. Each case has its own particular set of circumstances, and an attorney may advise you of
what is best for you in your individual situation.
These instructions are not the only place that you can get information about how a family case works.
You may want to look at other books for more help. The Florida Statutes, Florida Family Law Rules of
Procedure, Florida Rules of Civil Procedure, and other legal information or books may be found at the
public library or in a law library at your county courthouse or a law school in your area. If you are filing a
petition for Name Change and/or Adoption, these instructions may not apply.
If the word(s) is printed in bold, this means that the word is being emphasized. Throughout these
instructions, you will also find words printed in bold and underlined. This means that the definitions of
these words may be found in the glossary of common family law terms at the end of this general
information section.
Commentary
1995 Adoption. To help the many people in family law court cases who do not have attorneys
to represent them (pro se litigants), the Florida Supreme Court added these simplified forms and
directions to the Florida Family Law Rules of Procedure. The directions refer to the Florida Family Law
Rules of Procedure or the Florida Rules of Civil Procedure. Many of the forms were adapted from the
forms accompanying the Florida Rules of Civil Procedure. Practitioners should refer to the committee
notes for those forms for rule history.
The forms were adopted by the Court pursuant to Family Law Rules of Procedure, 667 So. 2d
202 (Fla. 1995); In re Petition for Approval of Forms Pursuant to Rule 10-1.1(b) of the Rules Regulating
the Florida Bar—Stepparent Adoption Forms, 613 So. 2d 900 (Fla. 1992); Rules Regulating the Florida
Bar—Approval of Forms, 581 So. 2d 902 (Fla. 1991).
Although the forms are part of these rules, they are not all-inclusive, and additional forms, as
necessary, should be taken from the Florida Rules of Civil Procedure as provided in Florida Family Law
Rules of Procedure. Also, the following notice has been included to strongly encourage individuals to
seek the advice, when needed, of an attorney who is a member in good standing of the Florida Bar.
1997 Amendment. In 1997, the Florida Family Law Forms were completely revised to simplify
and correct the forms. Additionally, the appendices were eliminated, the instructions contained in the
appendices were incorporated into the forms, and the introduction following the Notice to Parties was
created. Minor changes were also made to the Notice to Parties set forth below.
General Information for Self-Represented Litigants (09/13)
- 2 -
NOTICE TO PARTIES WHO ARE NOT REPRESENTED BY AN ATTORNEY WHO IS A
MEMBER IN GOOD STANDING OF THE FLORIDA BAR
If you have questions or concerns about these forms, instructions, commentary, the use of the forms,
or your legal rights, it is strongly recommended that you talk to an attorney. If you do not know an
attorney, you should call the lawyer referral service listed in the yellow pages of the telephone book
under “Attorney.” If you do not have the money to hire an attorney, you should call the legal aid
office in your area.
Because the law does change, the forms and information about them may have become outdated.
You should be aware that changes may have taken place in the law or court rules that would affect
the accuracy of the forms or instructions.
In no event will the Florida Supreme Court, The Florida Bar, or anyone contributing to the production
of these forms or instructions be liable for any direct, indirect, or consequential damages resulting
from their use.
FAMILY LAW PROCEDURES
Communication with the court. Ex parte communication is communication with the judge with only
one party present. Judges are not allowed to engage in ex parte communication except in very limited
circumstances, so, absent specific authorization to the contrary, you should not try to speak with or
write to the judge in your case unless the other party
is present or has been properly notified. If you
have something you need to tell the judge, you must ask for a hearing and give notice to the other
party or file a written statement in the court file and send a copy of the written statement to the
other party.
Filing a case. A case begins with the filing of a petition
. A petition is a written request to the court for
some type of legal action. The person who originally asks for legal action is called the petitioner
and
remains the petitioner throughout the case.
A petition is given to the clerk of the circuit court
, whose office is usually located in the county
courthouse or a branch of the county courthouse. A case number is assigned and an official court file is
opened. Delivering the petition to the clerk’s office is called filing
a case. A filing fee is usually required.
Once a case has been filed, a copy must be given to (served on) the respondent. The person against
whom the original legal action is being requested is called the respondent
, because he or she is
expected to respond to the petition. The respondent remains the respondent throughout the case.
Service
. When one party files a petition, motion, or other pleading, the other party must be “served”
with a copy of the document. This means that the other party is given proper notice of the pending
action(s) and any scheduled hearings. Personal service of the petition and summons on the respondent
by a deputy sheriff or private process server is required in all original petitions and supplemental
petitions, unless constructive service is permitted by law. Personal service may also be required in
other actions by some judges. After initial service of the original or supplemental petition and summons
by a deputy sheriff or private process server, service of most motions and other documents or papers
filed in the case generally may be made by email, regular U.S. mail, or hand delivery. However, service
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by certified mail
is required at other times so you have proof that the other party actually received the
papers. The instructions with each form will advise you of the type of service
required for that form. If
the other party is represented by an attorney, you should serve the attorney and send a copy to the
other party, except for original or supplemental petitions, which must be personally served on the
respondent.
Other than the original or supplemental petitions, any time you file additional pleadings or motions in
your case, you must provide a copy to the other party and include a certificate of service
. Likewise, the
other party must provide you with copies of everything that he or she files. Service of additional
documents is usually completed by U.S. mail. For more information, see the instructions for Certificate
of Service (General), Florida Supreme Court Approved Family Law Form 12.914.
Forms for service of process are included in the Florida Family Law Forms, along with more detailed
instructions and information regarding service. The instructions to those forms should be read carefully
to ensure that you have the other party properly served. If proper service is not obtained, the court
cannot hear your case.
Note: If you absolutely do not know where the other party to your case lives, or if the other party
resides in another state, you may be able to use constructive service
. However, if constructive service is
used, other than granting a divorce, the court may only grant limited relief, which cannot include either
alimony or child support. For more information on constructive service, see Notice of Action for
Dissolution of Marriage (No Child or Financial Support), Florida Supreme Court Approved Family Law
Form 12.913(a)(1), Notice of Action for Family Cases with Minor Child(ren), Florida Supreme Court
Approved Family Law Form 12.913(a)(2), Affidavit of Diligent Search and Inquiry, Florida Family Law
Rules of Procedure Form 12.913(b), and Affidavit of Diligent Search, Florida Family Law Rules of
Procedure Form 12.913(c).. Additionally, if the other party is in the military service of the United States,
additional steps for service may be required. See, for example, Memorandum for Certificate of Military
Service, Florida Supreme Court Approved Family Law Form 12.912(a). In sum, the law regarding
constructive service and service on an individual in the military is very complex and you may wish to
consult an attorney regarding these issues.
Default
... After being served with a petition or counterpetition, the other party has 20 days to file a
response. If a response to a petition is not filed, the petitioner may file a Motion for Default, Florida
Supreme Court Approved Family Law Form 12.922(a), with the clerk. This means that you may proceed
with your case and set a final hearing
, and a judge will make a decision, even if the other party will not
cooperate. For more information, see rule 12.080(c), Florida Family Law Rules of Procedure.
Answer
and Counterpetition... After being served, the respondent has 20 days to file an answer
admitting or denying each of the allegations contained in the petition. In addition to an answer, the
respondent may also file a counterpetition. In a counterpetition, the respondent may request the same
or some other relief or action not requested by the petitioner. If the respondent files a counterpetition,
the petitioner should then file an Answer to Counterpetition, Florida Supreme Court Approved Family
Law Form 12.903(d), and either admit or deny the allegations in the respondent’s counterpetition.
Mandatory disclosure
... Rule 12.285, Florida Family Law Rules of Procedure, requires each party in a
dissolution of marriage
to exchange certain information and documents, and file a Family Law Financial
Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c). Failure to make this required
disclosure within the time required by the Florida Family Law Rules of Procedure may allow the court to
dismiss the case or to refuse to consider the pleadings of the party failing to comply. This requirement
also must be met in other family law cases, except adoptions, simplified dissolutions of marriage,
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enforcement proceedings, contempt proceedings, and proceedings for injunctions for domestic or
repeat violence. The Certificate of Compliance with Mandatory Disclosure, Florida Family Law Rules of
Procedure Form 12.932, lists the documents that must be given to the other party. For more
information see rule 12.285, Florida Family Law Rules of Procedure, and the instructions to the
Certificate of Compliance with Mandatory Disclosure, Florida Family Law Rules of Procedure Form
12.932.
Parenting Plan. If your case involves minor or dependent child(ren), a Parenting Plan shall be approved
or established by the court. Parenting Plan, Florida Supreme Court Approved Family Law Form,
12.995(a), Safety-Focused Parenting Plan, Florida Supreme Court Approved Family Law Form 12.995(b),
or Relocation/Long Distance Parenting Plan, Florida Supreme Court Approved Family Law Form
12.995(c). The Parenting Plan shall be developed and agreed to by the parents and approved by a court.
If the parents cannot agree, or if the agreed Parenting Plan is not approved, the court must establish a
Parenting Plan. The Parenting Plan shall contain a time-sharing schedule and should address the issues
regarding the child(ren)’s education, health care, and physical, social, and emotional well-being.
Setting a hearing
or trial. Generally, the court will have hearings on motions, final hearings on
uncontested
or default cases, and trials on contested cases. Before setting your case for final hearing
or trial, certain requirements such as completing mandatory disclosure and filing certain papers and
having them served on the other party must be met. These requirements vary depending on the type of
case and the procedures in your particular jurisdiction. For further information, you should refer to the
instructions for the type of form you are filing.
Next, you must obtain a hearing or trial date so that the court may consider your request. You should
ask the clerk of court, or family law intake staff
about the local procedure for setting a hearing or trial,
which you should attend. These family law forms contain orders
and final judgments, which the judge
may use. You should ask the clerk of court or family law intake staff if you need to bring one of these
forms with you to the hearing or trial. If so, you should type or print the heading, including the circuit,
county, case number, division, and the parties’ names, and leave the rest blank for the judge to
complete at your hearing or trial.
Below are explanations of symbols or parts of different family law forms...
{specify}, {date}, {name(s)}, {street}, {city}, {state}, {phone}
Throughout these forms, you will find hints such as those above. These tell you what to put in the
blank(s).
ሾ one only] [all that apply]
These show how many choices you should check. Sometimes you may check only one, while other times
you may check several choices. ( ) This also shows an area where you must make a choice. Check the
( ) in front of the choice that applies to you or your case.
IN THE CIRCUIT COURT OF THE (1)
JUDICIAL CIRCUIT,
IN AND FOR (2) COUNTY, FLORIDA
Case No.: (3)
Division: (4)
(5) ,
Petitioner,
and
(6) ,
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Respondent.
Line 1 The clerk of court can tell you the number of your judicial circuit. Type or print it here.
Line 2 Type or print your county name on line (2).
Line 3 If you are filing an initial petition or pleading, the Clerk of the Court will assign a case number
after the case is filed. You should type or print this case number on all papers you file in this
case.
Line 4 The clerk of the court can tell you the name of the division in which your case is being filed, and
you should type or print it here. Divisions vary from court to court. For example, your case may
be filed in the civil division, the family division, or the juvenile division.
Line 5 Type or print the legal name of the person who originally filed the case on line 5. This person is
the petitioner because he/she is the one who filed the original petition.
Line 6 Type or print the other party’s legal name on line 6. The other party is the respondent because
he/she is responding to the petition.
I understand that I am swearing or affirming under oath to the truthfulness of the claims
made in this petition and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
Dated: (1) (2)
Signature of Petitioner
Printed Name: (3)
Address: (4)
City, State, Zip: (5)
Telephone Number: (6)
Fax Number: (7)
Email Address:________________(8)_______________
Some forms require that your signature be witnessed. You must sign the form in the presence of a
notary public
or deputy clerk (employee of the clerk of the court’s office). When signing the form, you
must have a valid photo identification unless the notary knows you personally. You should completely
fill in all lines (1 & 3–8) except 2 with the requested information, if applicable. Line 2, the signature line,
must be signed in the presence of the notary public
or deputy clerk.
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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
clerk.]
Personally known
Produced identification
Type of identification produced
DO NOT SIGN OR FILL IN THIS PART OF ANY FORM. This section of the form is to be completed by the
notary public who is witnessing your signature.
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: {either Petitioner or Respondent; or Husband or Wife}
This form was completed with the assistance of:
{name of individual }________(1)________________________________________________________,
{name of business} _____________(2)____________________________________________________,
{address} (3) ___________________________________________,
{city} (4)______________,{state} (5), {telephone number} _(6)____________________.
This section should be completed by anyone who helps you fill out these forms but is not an attorney
who is a member in good standing of The Florida Bar, which means that he or she is not licensed to
practice law in Florida.
Line 1 The nonlawyer
who helps you should type or print his or her name on line 1.
Lines 2–6 The nonlawyer’s business name, address, (including street, city, state, and telephone
number) should be typed or printed on lines 2–6.
In addition, a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), should
be completed if a nonlawyer assists you. The disclosure is available as a family law form and should be
completed before the nonlawyer helps you. This is to be sure that you understand the role and
limitations of a nonlawyer. You and the nonlawyer should keep a copy of this disclosure for your
records.
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FAMILY LAW GLOSSARY OF COMMON TERMS AND DEFINITIONS
Note: The following definitions are intended to be helpful, BUT they are not intended to constitute
legal advice or address every possible meaning of the term(s) contained in this glossary.
Affidavit - a written statement in which the facts stated are sworn or affirmed to be true.
Alimony-spousal support which may be ordered by the court in a proceeding for dissolution of marriage.
Types of alimony include: bridge-the-gap, durational, rehabilitative, or retroactive and may be either
temporary or permanent. The court may order periodic payments, payment in lump sum, or both. In
determining whether to award alimony, the court must determine whether either party has an actual
need for alimony and whether the other party has the ability to pay. The court must consider the
factors set forth in section 61.08, Florida Statutes, and must make certain written findings. An alimony
award may not leave the paying party with significantly less net income than that of the receiving party
without written findings of exceptional circumstances.
Answer - written response by a respondent that states whether he or she admits (agrees with) or denies
(disagrees with) the allegations in the petition. Any allegations not specifically denied are considered to
be admitted.
Appeal - asking a district court of appeal to review the decision in your case. There are strict procedural
and time requirements for filing an appeal.
Asset - everything owned by you or your spouse, including property, cars, furniture, bank accounts,
jewelry, life insurance policies, businesses, or retirement plans. An asset may be marital or nonmarital,
but that distinction is for the court to determine if you and your spouse do not agree.
Attorney - a person with special education and training in the field of law who is a member in good
standing of The Florida Bar and licensed to practice law in Florida. An attorney is the only person who is
allowed to give you legal advice. An attorney may file your case and represent you in court, or just
advise you of your rights before you file your own case. In addition to advising you of your rights, an
attorney may tell you what to expect and help prepare you for court. In family law matters, you are not
entitled to a court-appointed lawyer, like a public defender in a criminal case. However, legal assistance
is often available for those who are unable to hire a private attorney. You may consult the yellow pages
of the telephone directory for a listing of legal aid or lawyer referral services in your area, or ask your
local clerk of court or family law intake staff what services are available in your area. You may also
obtain information from the Florida Supreme Court’s Internet site located at http://www.flcourts.org.
Bond - money paid to the clerk of court by one party in a case, to be held and paid to an enjoined party
in the event that the first party causes loss or damage of property as a result of wrongfully enjoining the
other party.
Beneficiary Designation-Florida law provides that a beneficiary designation made by or on behalf of a
party providing for the payment or transference of an asset or benefit upon his or her death to the other
spouse is void when the final judgment dissolving or declaring a marriage invalid is signed, unless the
final judgment specifically states otherwise. Federal law and other statutory provisions may also apply.
This includes, but is not limited to, such assets as life insurance policies, annuities, employee benefit
plans, individual retirement accounts, and payable-on-death accounts. Whether or not to continue a
beneficiary designation is a complex area of the law and you may wish to consult with an attorney.
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Bridge-the-Gap Alimony-spousal support which is ordered to assist a party to make the transition from
being married to being single. Bridge-the-Gap alimony is designed to assist a party with legitimate,
identifiable short-time needs; its length cannot exceed two years and it cannot be modified.
Central Depository-the office of the clerk of court that is responsible for collecting and disbursing court
ordered alimony and child support payments. The depository also keeps payment records and files
judgments if support is not paid.
Certificate of Service - a document that must be filed whenever a form you are using does not contain a
statement for you to fill in showing to whom you are sending copies of the form. Florida Supreme Court
Approved Family Law Form 12.914 is the certificate of service form and contains additional instructions.
Certified Copy - a copy of an order or final judgment, certified by the clerk of the circuit court to be an
authentic copy.
Certified Mail - mail which requires the receiving party to sign as proof that they received it.
Child Support - money paid from one parent to the other for the benefit of their dependent or minor
child(ren).
Clerk of the Circuit Court - elected official in whose office papers are filed, a case number is assigned,
and case files are maintained. The clerk’s office usually is located in the county courthouse.
Concurrent Custody-(for the purposes of a petition filed pursuant to chapter 751, Florida Statutes)
means that an eligible extended family member is awarded custodial rights to care for a child or children
concurrently with the child(ren)’s parent or parents.
Constructive Service - notification of the other party by newspaper publication or posting of notice at
designated places when the other party cannot be located for personal service. You may also be able to
use constructive service when the other party lives in another state. Constructive service is also called
“service by publication.” However, when constructive service is used, the relief the Court may grant is
limited; that relief cannot include either alimony or child support. For more information on service, see
the Instructions for Florida Family Law Rules of Procedure Forms 12.910(a) and 12.913(b) and Florida
Supreme Court Approved Family Law Form 12.913(a).
Contested Issues - any or all issues upon which the parties are unable to agree and which must be
resolved by the judge at a hearing or trial.
Contingent Asset - an asset that you may receive or get later, such as income, tax refund, accrued
vacation or sick leave, a bonus, or an inheritance.
Contingent Liability - a liability that you may owe later, such as payments for lawsuits, unpaid taxes, or
debts that you have agreed or guaranteed to pay if someone else does not.
Counterpetition - a written request to the court for legal action, which is filed by a respondent after
being served with a petition.
Custody Order - a judgment or order incorporating a 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. ss. 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.
Default - a failure of a party to respond to the pleading of another party. This failure to respond may
allow the court to decide the case without input from the party who did not appear or respond.
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Delinquent - late.
Dependent Child(ren) - child(ren) who depend on their parent(s) for support either because they are
under the age of 18, have a mental or physical disability that prevents them from supporting
themselves, or are in high school, between the ages of 18 and 19, and performing in good faith with a
reasonable expectation of graduation before the age of 19.
Deputy Clerk - an employee of the office of the clerk of court, which is usually located in the county
courthouse or a branch of the county courthouse.
Dissolution of Marriage - divorce; a court action to end a marriage.
Durational Alimony-spousal support which is ordered to provide economic assistance for a set period of
time following a marriage of short or moderate duration or following a marriage of long duration if there
is no ongoing need for support on a permanent basis. Durational alimony terminates upon the death of
either party or upon remarriage of the party receiving support. It may be modified or terminated, but
cannot exceed the length of a marriage.
Electronic Communication -Contact, other than face-to-face contact, facilitated by tools such as
telephones, electronic mail or email, webcams, video-conferencing equipment, and software or other
wired or wireless technologies, or other means of communication to supplement fact-to face contact
between a parent and that parent’s minor child.
Enjoined - prohibited by the court from doing a specific act.
Ex Parte - communication with the judge by only one party. In order for a judge to speak with either
party, the other party must have been properly notified and have an opportunity to be heard. If you
have something you wish to tell the judge, you should ask for a hearing or file information in the clerk of
court’s office, with certification that a copy was sent to the other party.
Extended Family-(for the purposes of a petition filed pursuant to chapter 751, Florida Statutes) is a
person who is either:
1) A relative of a minor child within the third degree by blood or marriage to the parent; OR
2) The stepparent of a minor child if the stepparent is currently married to the parent of the child
and is not a party in a pending dissolution, separate maintenance, domestic violence, or other
civil or criminal proceeding in any court of competent jurisdiction involving one or both of the
child’s parents as an adverse party.
Family Law Intake Staff - a court’s employee(s) who is (are) available to assist you in filing a family law
case. Family law intake staff are not attorneys and cannot give legal advice. They may only assist you
with filling out the form(s). Your local clerk’s office can tell you if your county has such assistance
available.
Filing - delivering a petition, response, motion, or other pleading in a court case to the clerk of court’s
office.
Filing Fee - an amount of money, set by law, that the petitioner must pay when filing a case. If you
cannot afford to pay the fee, you must file an Application for Determination of Civil Indigent Status, to
ask the clerk to file your case without payment of the fee. This form can be obtained from the clerk’s
office.
Final Hearing - trial in your case.
Financial Affidavit - a sworn statement that contains information regarding your income, expenses,
assets, and liabilities.
Final Judgment - a written document signed by a judge and recorded in the clerk of the circuit court’s
office that contains the judge’s decision in your case.
Guardian ad Litem - a neutral person who may be appointed by the court to evaluate or investigate your
child’s situation, and file a report with the court about what is in the best interests of your child(ren).
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Guardians do not “work for” either party. The guardian may interview the parties, visit their homes,
visit the child(ren)’s school(s) and speak with teachers, or use other resources to make their
recommendation.
Hearing - a legal proceeding before a judge or designated officer (general magistrate or hearing officer)
on a motion.
Health Insurance-coverage under a fee-for-service arrangement, health care maintenance organization,
or preferred provider organization, and other types of coverage available to either parent, under which
medical services could be provided to a minor or dependent child.
Judge - an elected official who is responsible for deciding matters on which you and the other parties in
your case are unable to agree. A judge is a neutral person who is responsible for ensuring that your case
is resolved in a manner which is fair, equitable, and legal. A judge is prohibited by law from giving you
or the other party any legal advice, recommendations, or other assistance, and may not talk to either
party unless both parties are present, represented, or at a properly scheduled hearing.
Judicial Assistant - the judge’s personal staff assistant.
Liabilities - everything owed by you or your spouse, including mortgages, credit cards, or car loans. A
liability may be marital or nonmarital, but that distinction is for the court to determine if you and your
spouse do not agree.
Lump Sum Alimony - money ordered to be paid by one spouse to another in a limited number of
payments, often a single payment.
Mandatory Disclosure - items that must be disclosed by both parties except those exempted from
disclosure by Florida Family Law Rule 12.285.
Marital Asset - generally, anything that you and/or your spouse acquired or received (by gift or
purchase) during the marriage. For example, something you owned before your marriage may be
nonmarital. An asset may only be determined to be marital by agreement of the parties or
determination of the judge.
Marital Liability - generally, any debt that you and/or your spouse incurred during the marriage. A debt
may only be determined to be nonmarital by agreement of the parties or determination of the judge.
Mediator - a person who is trained and certified to assist parties in reaching an agreement before going
to court. Mediators do not take either party’s side and are not allowed to give legal advice. They are
only responsible for helping the parties reach an agreement and putting that agreement into writing. In
some areas, mediation of certain family law cases may be required before going to court.
Modification - a change made by the court in an order or final judgment.
Motion - a request made to the court, other than a petition.
No Contact - a court order directing a party not speak to, call, send mail to, visit, or go near his or her
spouse, ex-spouse, child(ren), or other family member.
Nonlawyer - a person who is not a member in good standing of The Florida Bar.
Nonmarital Asset - generally, anything owned separately by you or your spouse. An asset may only be
determined to be nonmarital by either agreement of the parties or determination of the judge.
Nonmarital Liability - generally, any debt that you or your spouse incurred before your marriage or
since your separation. A debt may only be determined to be nonmarital by either agreement of the
parties or determination of the judge.
Nonparty - a person who is not the petitioner or respondent in a court case.
Notary Public - a person authorized to witness signatures on court-related forms.
Obligee - a person to whom money, such as child support or alimony, is owed.
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Obligor - a person who is ordered by the court to pay money, such as child support or alimony.
Order - a written decision signed by a judge and filed in the clerk of the circuit court’s office, that
contains the judge’s decision on part of your case, usually on a motion.
Original Petition - see Petition
.
Parenting Course - a class that teaches parents how to help their child(ren) cope with divorce and other
family issues.
Parenting Plan – a document created to govern the relationship between the parents relating to the
decisions that must be made regarding the minor child(ren). The Parenting Plan must contain a time-
sharing schedule for the parents and child(ren) and shall address the issues concerning the minor
child(ren). The issues concerning the minor child(ren) may include, but are not limited to, the
child(ren)’s education, health care, and physical, social, and emotional well-being. In creating the Plan,
all circumstances between the parents, including their historic relationship, domestic violence, and
other factors must be taken into consideration. The Parenting Plan must be developed and agreed to by
the parents and approved by the court. If the parents cannot agree to a Parenting Plan, or if the parents
agreed to a plan that is not approved by the court, a Parenting Plan will be established by the court with
or without the use of parenting plan recommendations.
Parenting Plan Recommendation – A nonbinding recommendation concerning one or more elements of
a Parenting Plan made by a court-appointed mental health practitioner or other professional designated
pursuant to either section 61.20 or 61.401, Florida Statutes, or Florida Family Law Rule of Procedure
12.363.
Party - a person involved in a court case, either as a petitioner or respondent.
Paternity Action - A lawsuit used to determine whether a designated individual is the father of a specific
child or children.
Payor - an employer or other person who provides income to an obligor.
Permanent Alimony - spousal support ordered to provide for the needs and necessities of life as they
were established during the marriage for a party who lacks the financial ability to meet his or her needs
and necessities after dissolution of marriage. Permanent alimony is paid at a specified, periodic rate
until: modification by a court order; the death of either party; or the remarriage of the party receiving
alimony, whichever occurs first. Permanent alimony requires consideration of the factors set forth in
section 61.08(2), Florida Statutes, and must include certain written findings by the court.
Personal Service - when a summons and a copy of a petition (or other pleading) that has been filed with
the court are delivered by a deputy sheriff or private process server to the other party. Personal service
is required for all petitions and supplemental petitions.
Petition - a written request to the court for legal action, which begins a court case.
Petitioner - the person who files a petition that begins a court case.
Pleading - a formal written statement of exactly what a party wants the court to do in a lawsuit or court
action.
Pro Se or Self-Represented Litigant - a person who appears in court without the assistance of a lawyer.
Pro Se Coordinator - see Family Law Intake Staff
.
Rehabilitative Alimony - spousal support ordered to be paid for a limited period of time to allow one of
the parties an opportunity to complete a plan of education or training, according to a rehabilitative plan
accepted by the court, so that he or she may better support himself or herself after dissolution of
marriage.
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Relocation- a change in the location of the principal residence of a parent or other person in accordance
with section 61.13001, Florida Statutes.
Respondent - the person who is served with a petition requesting some legal action against him or her.
Scientific Paternity Testing - a medical test to determine who the father of a child is.
Service - the delivery of legal documents to a party. Service must be in accordance with Florida Rule of
Judicial Administration 2.516.
Shared Parental Responsibility - an arrangement under which both parents have full parental rights and
responsibilities for their child(ren), and the parents make major decisions affecting the welfare of the
child(ren) jointly. Shared Parental Responsibility is presumptive in Florida.
Sole Parental Responsibility - a parenting arrangement under which the responsibility for the minor
child(ren) is given to one parent by the court, with or without rights of time-sharing to the other parent.
State Disbursement Unit- the unit established and operated by the Title IV-D agency to provide one
central address for the collection and disbursement of child support payments made in both
Department of Revenue and non-Department of Revenue cases, in which the obligation is paid through
an income deduction order.
Supervised Time-Sharing- a parenting arrangement under which time-sharing between a parent and his
or her child(ren) is supervised by either a friend, family member, or a supervised visitation center.
Supplemental Petition - a petition that may be filed by either party after the judge has made a decision
in a case and a final judgment or order has been entered. For example, a supplemental petition may be
used to request that the court modify the previously entered final judgment or order.
Supportive Relationship-a relationship, defined in section 61.14(1)(b)1, Florida Statutes, existing
between a spouse who receives alimony and a person with whom that spouse resides.
Time-Sharing Schedule – a timetable that must be included in the Parenting Plan that specifies the time,
including overnights and holidays, that a minor child or children will spend with each parent. The time-
sharing schedule shall either be developed and agreed to by the parents of a minor child or children and
is approved by the court, or established by the court if the parents cannot agree, or if their agreed-upon
schedule is not approved by the court.
Trial - the final hearing in a contested case.
Uncontested - any and all issues on which the parties are able to agree and which are part of a marital
settlement agreement.
Administrative Office of the Courts
The Sixth Judicial Circuit of Florida
(727)582-7200
How can I keep my address confidential in a court case if I am in fear
of domestic violence?
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Instructions for Florida Family Law Rules of Procedure Form 12.900(a), Disclosure from Nonlawyer
(11/12)
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.900(a), DISCLOSURE FROM NONLAWYER (11/12)
When should this form be used?
This form must be used when anyone who is not a lawyer in good standing with The Florida Bar
helps you complete any Florida Family Law Form. Attorneys who are licensed to practice in
other states but not Florida, or who have been disbarred or suspended from the practice of law
in Florida, are nonlawyers for the purposes of the Florida Family Law Forms and instructions.
The nonlawyer must complete this form and both of you are to sign it before the nonlawyer
assists you in completing any Family Law Form.
In addition, on any other form with which a nonlawyer helps you, the nonlawyer shall complete
the nonlawyer section located at the bottom of the form unless otherwise specified in the
instructions to the form. This is to protect you and be sure that you are informed in advance of
the nonlawyer’s limitations.
What should I do next?
A copy of this disclosure, signed by both the nonlawyer and the person, must be given to the
person to retain and the nonlawyer must keep a copy in the person’s file. The nonlawyer shall
also keep copies for at least 6 years of all forms given to the person being assisted.
Special Notes
This disclosure form does NOT act as or constitute a waiver, disclaimer, or limitation of liability.
Florida Family Law Rules of Procedure Form 12.900(a), Disclosure From Nonlawyer (11/12)
IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT,
IN AND FOR PINELLAS COUNTY, FLORIDA
Case No.: ________________________
Division: ________________________
_______________________________,
Petitioner,
and
_______________________________,
Respondent.
DISCLOSURE FROM NONLAWYER
{Name} __________________________________________ told me that he/she is a nonlawyer
and may not give legal advice, cannot tell me what my rights or remedies are, cannot tell me how to
testify in court, and cannot represent me in court.
Rule 10-2.1(b) of the Rules Regulating The Florida Bar defines a paralegal as a person who works
under the supervision of a member of The Florida Bar and who performs specifically delegated
substantive legal work for which a member of The Florida Bar is responsible. Only persons who meet the
definition may call themselves paralegals. {Name} ______
, informed me that he/she is not
a paralegal as defined by the rule and cannot call himself/herself a paralegal.
{Name}
, told me that he/she may only type the factual information
provided by me in writing into the blanks on the form. Except for typing, {name} ____
,
may not tell me what to put in the form and may not complete the form for me. However, if using a
form approved by the Supreme Court of Florida, {name} ________________________
,
may ask me factual questions to fill in the blanks on the form and may also tell me how to file the form.
[choose one only]
____ I can read English.
____ I cannot read English, but this disclosure was read to me [fill in both blanks] by
{name} _
in {language} ,which I understand.
Dated:
Signature of Party
Signature of NONLAWYER
Printed Name:
Name of Business:
Address:
Telephone Number:
Instructions for Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related Cases (11/13)
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.900(h), NOTICE OF RELATED CASES (11/13)
When should this form be used?
Florida Rule of Judicial Administration 2.545(d) requires the petitioner in a family law case to file
with the court a notice of related cases, if any. Your circuit may also require this form to be filed
even if there are no related cases. A case is considered related if
x it involves the same parties, children, or issues and is pending when the family law
case is filed; or
x it affects the court’s jurisdiction to proceed; or
x an order in the related case may conflict with an order on the same issues in the
new case; or
x an order in the new case may conflict with an order in the earlier case.
This form is used to provide the required notice to the court.
This form should be typed or printed in black ink. It must be filed with the clerk of the circuit
court with the initial pleading in the family law case.
What should I do next?
A copy of the form must be served on the presiding judges, either the chief judge or the family
law administrative judge, and all parties in the related cases. You should also keep a copy for
your records. Service must be in accordance with 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 Florida Rule of Judicial
Administration 2.545(d).
Special notes . . .
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
Instructions for Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related Cases (11/13)
Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping
you fill out these forms must also 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 Family Law Rules of Procedure Form 12.900(h), Notice of Related Cases (11/13)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR
COUNTY, FLORIDA
Case No.:
Division:
_____________________________,
Petitioner,
and
_____________________________,
Respondent.
NOTICE OF RELATED CASES
1. Petitioner submits this Notice of Related Cases as required by Florida Rule of Judicial Administration
2.545(d). A related case may be an open or closed civil, criminal, guardianship, domestic violence,
juvenile delinquency, juvenile dependency, or domestic relations case. A case is “related” to this
family law case if it involves any of the same parties, children, or issues and it is pending at the time
the party files a family case; if it affects the court’s jurisdiction to proceed; if an order in the related
case may conflict with an order on the same issues in the new case; or if an order in the new case
may conflict with an order in the earlier litigation.
[check one only]
___ There are no related cases.
___ The following are the related cases (add additional pages if necessary):
Related Case No. 1
Case Name(s): _____________________________________________________________________
Petitioner ________________________________________________________________________
Res ponde nt _ _ __ _ ___ __ _ __ _ __ _ ______ ___ _ __ _ __ _ __ _ ____ _ ___ _ _ __ _ ___ __ _ __ _ __ _______ ___ _
Case No.: _________________________________ Division: ________________________________
Type of Proceeding: [check all that apply]
____ Dissolution of Marriage ____ Paternity
____ Custody ____ Adoption
____ Child Support ____ Modification/Enforcement/Contempt Proceedings
____ Juvenile Dependency ____ Juvenile Delinquency
____ Termination of Parental Rights ____ Criminal
____ Domestic/Sexual/Dating/Repeat ____ Mental Health
Violence or Stalking Injunctions ____ Other {specify}___________________________
Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related Cases (11/13)
State where case was decided or is pending: ____ Florida ____ Other: {specify} _________________
Name of Court where case was decided or is pending (
for example, Fifth Circuit Court, Marion
County, Florida): __________________________________________________________________
Title of last Court Order/Judgment (if any): ______________________________________________
Date of Court Order/Judgment (if any): _________________________________________________
Relationship of cases check all that apply]:
____ pending case involves same parties, children, or issues;
____ may affect court’s jurisdiction;
____ order in related case may conflict with an order in this case;
____ order in this case may conflict with previous order in related case.
Statement as to the relationship of the cases: ____________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Related Case No. 2
Case Name(s): _____________________________________________________________________
Petitioner ________________________________________________________________________
Respondent _______________________________________________________________________
Case No.: _________________________________ Division: ________________________________
Type of Proceeding: [check all that apply]
____ Dissolution of Marriage ____ Paternity
____ Custody ____ Adoption
____ Child Support ____ Modification/Enforcement/Contempt Proceedings
____ Juvenile Dependency ____ Juvenile Delinquency
____ Termination of Parental Rights ____ Criminal
____ Domestic/Sexual/Dating/Repeat ____ Mental Health
Violence or Stalking Injunctions ____Other {specify}__________________________
State where case was decided or is pending: ____ Florida ____ Other: {specify} _________________
Name of Court where case was decided or is pending (
for example, Fifth Circuit Court, Marion
County, Florida): __________________________________________________________________
Title of last Court Order/Judgment (if any): ______________________________________________
Date of Court Order/Judgment (if any): _________________________________________________
Relationship of cases check all that apply]:
____ pending case involves same parties, children, or issues;
Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related Cases (11/13)
____ may affect court’s jurisdiction;
____ order in related case may conflict with an order in this case;
____ order in this case may conflict with previous order in related case.
Statement as to the relationship of the cases: ____________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Related Case No. 3
Case Name(s): _____________________________________________________________________
Petitioner ________________________________________________________________________
Res ponde nt _ _ __ _ ___ __ _ __ _ __ _ ______ ___ _ __ _ __ _ __ _ ____ _ ___ _ _ __ _ ___ __ _ __ _ __ _______ ___ _
Case No.: _________________________________ Division: ________________________________
Type of Proceeding: [check all that apply]
____ Dissolution of Marriage ____ Paternity
____ Custody ____ Adoption
____ Child Support ____ Modification/Enforcement/Contempt Proceedings
____ Juvenile Dependency ____ Juvenile Delinquency
____ Termination of Parental Rights ____ Criminal
____ Domestic/Sexual/Dating/Repeat ____ Mental Health
Violence or Stalking Injunctions ____Other {specify} __________________________
State where case was decided or is pending: ____ Florida ____ Other: {specify} _________________
Name of Court where case was decided or is pending (
for example, Fifth Circuit Court, Marion
County, Florida): __________________________________________________________________
Title of last Court Order/Judgment (if any): ______________________________________________
Date of Court Order/Judgment (if any): _________________________________________________
Relationship of cases check all that apply]:
____ pending case involves same parties, children, or issues;
____ may affect court’s jurisdiction;
____ order in related case may conflict with an order in this case;
____ order in this case may conflict with previous order in related case.
Statement as to the relationship of the cases: ____________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2. [check one only]
____ I do not request coordination of litigation in any of the cases listed above.
Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related Cases (11/13)
____ I do request coordination of the following cases: _____________________________________
______________________________________________________________________________
______________________________________________________________________________
3. [check all that apply]
____ Assignment to one judge
____ Coordination of existing cases
will conserve judicial resources and promote an efficient determination of these cases
because:_______________________________________________________________________.
4. The Petitioner acknowledges a continuing duty to inform the court of any cases in this or any other
state that could affect the current proceeding.
Dated: _________________ ________________________________________
Petitioner’s Signature
Printed Name: ______________________________
Address: ________________________________
City, State, Zip: ___________________________
Telephone Number: _______________________
Fax Number: ____________________________
E-mail Address(es):________________________
CERTIFICATE OF SERVICE
I CERTIFY that I delivered a copy of this Notice of Related Cases to the _____________________ County
Sheriff’s Department or a certified process server for service on the Respondent, and [check all used]
( ) e-mailed ( ) mailed ( ) hand delivered, a copy to {name}________________________, who is the
[check all that apply] ( ) judge assigned to new case, ( ) chief judge or family law administrative
judge, ( ) {name}__________________________________ a party to the related case, ( ) {name}
____________________________
, a party to the related case on {date} _________________________.
____________________________________
Signature of Petitioner/Attorney for Petitioner
Printed Name:________________________
Address:____________________________
City, State, Zip:________________________
Telephone Number:____________________
Fax Number:__________________________
E-mail Address(es):______________________
Florida Bar Number:_____________________
Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related Cases (11/13)
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 completed with the assistance of:
{name of individual} ______________________________________________________________,
{name of business}_______________________________________________________________,
{address}______________________________________________________________________,
{city} _______________________{state} __________, {telephone number} ___________________.
Instructions for Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases
(11/13)
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.928, COVER SHEET FOR FAMILY COURT CASES (11/13)
When should this form be used?
The Cover Sheet for Family Court Cases and the information contained in it neither replace nor
supplement the filing and service of pleadings or other documents as required by law. This form
shall be filed by the petitioner/party opening or reopening a case for the use of the clerk of the
circuit court for the purpose of reporting judicial workload data pursuant to Florida Statutes
section 25.075.
This form should be typed or printed in black ink. The petitioner must file
this cover sheet with
the first pleading or motion filed to open or reopen a case in all domestic and juvenile cases.
What should I do next?
Follow these instructions for completing the form:
I. Case Style. Enter the name of the court, the appropriate case number assigned at the time
of filing of the original petition, the name of the judge assigned (if applicable), and the name
(last, first, middle initial) of the petitioner(s) and respondent(s).
II. Type of Action /Proceeding. Place a check beside the proceeding you are initiating. If you are
simultaneously filing more than one type of proceeding against the same opposing party,
such as a modification and an enforcement proceeding, complete a separate cover sheet for
each action being filed.
(A) Initial Action/Petition
(B) Reopening Case. If you check “Reopening Case,” indicate whether you are filing a
modification or supplemental petition or an action for enforcement by placing a check
beside the appropriate action/petition.
1. Modification/Supplemental Petition
2. Motion for Civil Contempt/ Enforcement
3. Other – All reopening actions not involving modification/supplemental petitions or
petition enforcement.
III. Type of Case. Place a check beside the appropriate case. If the case fits more than one
category, select the most definitive. Definitions of the categories are provided below.
(A) Simplified Dissolution of Marriage- petitions for the termination of marriage pursuant to
Florida Family Law Rule of Procedure 12.105.
(B) Dissolution of Marriage - petitions for the termination of marriage pursuant to Chapter
61, Florida Statutes, other than simplified dissolution.
(C) Domestic Violence - all matters relating to injunctions for protection against domestic
violence pursuant to section 741.30, Florida Statutes.
Instructions for Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases
(11/13)
(D) Dating Violence - all matters relating to injunctions for protection against dating
violence pursuant to section 784.046, Florida Statutes.
(E) Repeat Violence - all matters relating to injunctions for protection against repeat
violence pursuant to section 784.046, Florida Statutes.
(F) Sexual Violence - all matters relating to injunctions for protection against sexual
violence pursuant to section 784.046, Florida Statutes.
(G) Stalking-all matters relating to injunctions for protection against stalking pursuant to
section 784.0485, Florida Statutes
(H) Support - IV-D - all matters relating to child or spousal support in which an application
for assistance has been filed with the Department of Revenue, Child Support
Enforcement under Title IV-D, Social Security Act, except for such matters relating to
dissolution of marriage petitions (sections 409.2564, 409.2571, and 409.2597, Florida
Statutes), paternity, or UIFSA.
(I) Support-Non IV-D - all matters relating to child or spousal support in which an
application for assistance has not been filed under Title IV-D, Social Security Act.
(J) UIFSA- IV-D - all matters relating to Chapter 88, Florida Statutes, in which an application
for assistance has been filed under Title IV-D, Social Security Act.
(K) UIFSA - Non IV-D - all matters relating to Chapter 88, Florida Statutes, in which an
application for assistance has not been filed under Title IV-D, Social Security Act.
(L) Other Family Court - all matters involving time-sharing and/or parenting plans relating
to minor child(ren), support unconnected with dissolution of marriage, annulment,
delayed birth certificates pursuant to Florida Statutes section 382.0195, expedited
affirmation of parental status pursuant to Florida Statutes section 742.16, termination
of parental rights proceedings pursuant to Florida Statutes section 63.087, declaratory
judgment actions related to premarital, marital, post-marital agreements, or other
matters not included in the categories above.
(M) Adoption Arising Out Of Chapter 63 - all matters relating to adoption pursuant to
Chapter 63, Florida Statutes, excluding any matters arising out of Chapter 39, Florida
Statutes.
(N) Name Change - all matters relating to name change, pursuant to section 68.07, Florida
Statutes.
(O) Paternity/Disestablishment of Paternity – all matters relating to paternity pursuant to
Chapter 742, Florida Statutes.
(P) Juvenile Delinquency - all matters relating to juvenile delinquency pursuant to Chapter
985, Florida Statutes.
(Q) Petition for Dependency - all matters relating to petitions for dependency.
(R) Shelter Petition – all matters relating to shelter petitions pursuant to Chapter 39, Florida
Statutes.
(S) Termination of Parental Rights Arising Out Of Chapter 39 – all matters relating to
termination of parental rights pursuant to Chapter 39, Florida Statutes.
(T) Adoption Arising Out Of Chapter 39 – all matters relating to adoption pursuant to
Chapter 39, Florida Statutes.
(U) CINS/FINS – all matters relating to children in need of services (and families in need of
services) pursuant to Chapter 984, Florida Statutes.
Instructions for Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases
(11/13)
ATTORNEY OR PARTY SIGNATURE. Sign the Cover Sheet for Family Court Cases. Print legibly the
name of the person signing the Cover Sheet for Family Court Cases. Attorneys must include a
Florida Bar number. Insert the date the Cover Sheet for Family Court Cases is signed. Signature is
a certification that filer has provided accurate information on the Cover Sheet for Family Court
Cases.
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 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 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.
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. For further information, see Rule 12.100, Florida Family
Law Rules of Procedure.
Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases (11/13)
COVER SHEET FOR FAMILY COURT CASES
I. Case Style
IN THE CIRCUIT COURT OF THE ______
JUDICIAL CIRCUIT,
IN AND FOR __________________
COUNTY, FLORIDA
Case No.: ________________
Judge: __________________
_____________________________
Petitioner
and
_____________________________
Respondent
II. Type of Action/Proceeding. Place a check beside the proceeding you are initiating. If you are
simultaneously filing more than one type of proceeding against the same opposing party,
such as a modification and an enforcement proceeding, complete a separate cover sheet for
each action being filed. If you are reopening a case, choose one of the three options below
it.
(A) ____ Initial Action/Petition
(B) ____ Reopening Case
1. ____ Modification/Supplemental Petition
2. ____ Motion for Civil Contempt/Enforcement
3. ____ Other
III. Type of Case. If the case fits more than one type of case, select the most definitive.
(A) ____ Simplified Dissolution of Marriage
(B) ____ Dissolution of Marriage
(C) ____ Domestic Violence
(D) ____ Dating Violence
(E) ____ Repeat Violence
(F) ____ Sexual Violence
(G) ____ Stalking
(H) ____ Support IV-D (Department of Revenue, Child Support Enforcement)
(I) ____ Support Non-IV-D (not Department of Revenue, Child Support Enforcement)
(J) ____ UIFSA IV-D (Department of Revenue, Child Support Enforcement)
(K) ____ UIFSA Non-IV-D (not Department of Revenue, Child Support Enforcement)
(L) ____ Other Family Court
(M) ____ Adoption Arising Out Of Chapter 63
(N) ____ Name Change
Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases (11/13)
(O) ____ Paternity/Disestablishment of Paternity
(P) ____ Juvenile Delinquency
(Q) ____ Petition for Dependency
(R) ____ Shelter Petition
(S) ____ Termination of Parental Rights Arising Out Of Chapter 39
(T) ____ Adoption Arising Out Of Chapter 39
(U) ____ CINS/FINS
IV. Rule of Judicial Administration 2.545(d) requires that a Notice of Related Cases Form, Family
Law Form 12.900(h), be filed with the initial pleading/petition by the filing attorney or self-
represented litigant in order to notify the court of related cases. Is Form 12.900(h) being
filed with this Cover Sheet for Family Court Cases and initial pleading/petition?
____ No, to the best of my knowledge, no related cases exist.
____ Yes, all related cases are listed on Family Law Form 12.900(h).
ATTORNEY OR PARTY SIGNATURE
I CERTIFY that the information I have provided in this cover sheet is accurate to the best
of my knowledge and belief.
Signature_______________________________________
_ FL Bar No.: _____________________
Attorney or party (Bar number,if attorney)
_______________________________________
_ __________________________
(Type or print name) (E-mail Address(es))
____________________________
Date
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 completed with the assistance of:
{name of individual}____________________________________________________________,
{name of business} ______________________________________________________________,
{address}______________________________________________________________________,
{city}_________________________, {state}______ , {telephone number }__________________.
Instructions for Florida Supreme Court Approved Family Law Form 12.981(b)(1), Joint Petition for
Adoption by Stepparent (11/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.981(b)(1),
JOINT PETITION FOR ADOPTION BY STEPPARENT (11/15)
When should this form be used?
This form should be used when a stepparent is adopting his or her spouse’s child. Both the stepparent
and his or her spouse must sign this petition. You must attach all necessary consents or
acknowledgments that apply to your case, as listed under the Special Notes section below. Florida
Statutes require that consent to adoption be obtained from:
x The mother of the minor.
x The father of the minor if:
1. The minor was conceived or born while the father was married to the mother;
2. The minor is his child by adoption;
3. The minor has been established by a court proceeding to be his child;
4. He has filed an affidavit of paternity pursuant to section 382.013(2)(c) Florida Statutes;
or
5. In the case of an unmarried biological father, he has acknowledged in writing, signed in
the presence of a competent witness, that he is the father of the minor, has filed such
acknowledgment with the Office of Vital Statistics of the Department of Health within
the required timeframes, and has complied with the requirements of section 63.062(2),
Florida Statutes.
Determining whether someone’s consent is required, or when consent may not be required is a
complicated issue and you may wish to consult an attorney. For more information about consenting to
adoption, you should refer to Chapter 63, Florida Statutes, and sections 63.062-63.082 in particular.
This form should be typed or printed in black ink. The name to be given to the child(ren) after the
adoption should be used in the heading of the petition. The stepparent is the petitioner, because he or
she is the one who is asking the court for legal action. After completing this form, you and your spouse
must sign it before a notary public or deputy clerk. You should then file the original and 1 copy with the
clerk of the circuit court in the county where the minor resides unless the court changes the venue.
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 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 have the written consent of the other birth parent and the child, if
Instructions for Florida Supreme Court Approved Family Law Form 12.981(b)(1), Joint Petition for
Adoption by Stepparent (11/15)
applicable. The court may choose not to require consent to an adoption in some circumstances. For
more information about situations where consent may not be required, see section 63.064, Florida
Statutes. If you are attempting to proceed without the consent of the other birth parent, you may wish
to consult with an attorney. Section 63.054, Florida Statutes, requires that in each adoption proceeding,
the Florida Putative Father Registry be searched. You will need an order from the judge to do this,
which you can request by filing a Motion for Search of the Putative Father Registry, Florida Supreme
Court Approved Family Law Form 12.981(a)(6).
When you have filed all of the required forms and met the requirements as outlined above, you are ready
to set a hearing on your petition. You should check with the clerk of court, family law intake staff or
the judicial assistant to set a final hearing. If all persons required to consent have consented and the
consents/affidavits of nonpaternity have been filed with the court, the hearing may be held immediately.
If not, notice of the hearing must be given as provided by the Rules of Civil Procedure. See Form 1.902,
Florida Rules of Civil Procedure. If you know where the other birth parent lives, you should use personal
service. If you absolutely do not know where he or she lives, you may use constructive service. In order
to use constructive service you will need to complete and submit to the court Stepparent Adoption:
Affidavit of Diligent Search, Florida Supreme Court Approved Family Law Form 12.981(a)(4). For more
information about personal and constructive service, you should refer to the “General Instructions for
Self-Represented Litigants” found at the beginning of these forms and the instructions to Florida Family
Law Rules of Procedure Forms 12.910(a) and 12.913(b) and Florida Supreme Court Approved Family Law
Form 12.913(a). However, the law regarding constructive service is very complex and you may wish to
consult an attorney regarding that issue.
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. See Chapter 63, Florida Statutes, and Florida Family Law Rule 12.200(a)(2) for
further information.
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.
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.
Instructions for Florida Supreme Court Approved Family Law Form 12.981(b)(1), Joint Petition for
Adoption by Stepparent (11/15)
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.
Special notes...
With this petition you must file the following:
x Consent form executed by the birth parent, Stepparent Adoption: Consent and Waiver by Parent,
Florida Supreme Court Approved Family Law Form 12.981(a)(1) or Stepparent Adoption: Affidavit
of Nonpaternity, Florida Supreme Court Approved Family Law Form 12.981(a)(3).
x If any person whose consent is required is deceased, a certified copy of the death certificate must
be attached to this Petition.
x Consent form executed by the minor child(ren), if the child(ren) is/are over 12 years of age,
Stepparent Adoption: Consent of Adoptee, Florida Supreme Court Approved Family Law Form
12.981(a)(2). The court can excuse filing of this form under certain circumstances.
x Certified copy of the child(ren)’s birth certificate.
x Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit, Florida Supreme
Court Approved Family Law Form 12.902(d).
x If applicable, Stepparent Adoption: Motion for Search of the Putative Father Registry, Florida
Supreme Court Approved Family Law Form 12.981(a)(6).
These family law forms contain a Final Judgment of Stepparent Adoption, Florida Supreme Court
Approved Family Law Form 12.981(b)(2), which the judge may use. You should check with the clerk,
family law intake staff, or judicial assistant to see if you need to bring a final judgment form with you to
the hearing. If so, you should type or print the heading, including the circuit, county case number,
division, and the child(ren)’s names, and leave the rest blank for the judge to complete at your hearing.
You should decide how many certified copies of the final judgment you will need and be prepared to
obtain them after the hearing. There is a charge for certified copies, and the clerk can tell you how
much. The file will be sealed after the final hearing, and then it will take an order from a judge to open
the file and obtain a copy of the final judgment.
AN ADOPTIVE STEPPARENT WILL CONTINUE TO HAVE PARENTAL RIGHTS, INCLUDING CUSTODY AND
TIME-SHARING, WHERE APPROPRIATE, IN THE EVENT OF A LATER DISSOLUTION OF MARRIAGE, AND
MAY BE LIABLE FOR CHILD SUPPORT IN THE EVENT OF A LATER DISSOLUTION OF MARRIAGE. YOU
COULD BE LIABLE IN LITIGATION FOR THE ACTIONS OF THE ADOPTEE(S). THIS ADOPTION MAY ALSO
AFFECT THE ADOPTEE’S INHERITANCE.
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
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 12.981(b)(1), Joint Petition for Adoption by
Stepparent
(11/15)
IN THE CIRCUIT COURT OF THE __________________ JUDICIAL CIRCUIT,
IN AND FOR __________________ COUNTY, FLORIDA
Case No.: _______________________
Division: _______________________
IN THE MATTER OF THE ADOPTION OF
_________________________________________,
{use name to be given to the minor child} Adoptee.
JOINT PETITION FOR ADOPTION BY STEPPARENT
Petitioner, {full legal name} ______________________________________, being sworn, joined by the
above-named child(ren)’s _____ mother _____ father, {full legal name} __________________________,
being sworn, files this joint petition for adoption of the above-named minor child(ren), under chapter
63, Florida Statutes.
1. This is an action for adoption of a minor child(ren) by his or her (their) stepparent.
2. I desire to adopt the following child(ren):
Name to be given to child(ren) Birth date Birthplace
a. __________________________________________________________________________
b. __________________________________________________________________________
c. __________________________________________________________________________
d. __________________________________________________________________________
e. __________________________________________________________________________
f. __________________________________________________________________________
A certified copy of the birth certificate(s) is/are attached.
3. The child(ren) has (have) resided with me since {date} __________________________________.
I wish to adopt the child(ren) because I would like to legally establish the parent-child
relationship already existing between the child(ren) and me. Since the above date, I have been
able to provide adequately for the material needs of the child(ren) and am able to continue
doing so in the future, as well as to provide for the child(ren)’s mental and emotional well-being.
Other reasons I wish to adopt the children are:
____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. I am ______________ years old, and have resided at {street address}, _____________________
{city} _____________________ {county} __________ {state} _______ for _____________ years.
5. I married the _____ father or _____ mother of the child(ren) on {date} ___________________,
in {city} _____________________ {county} __________ {state} _______. The following are the
Florida Supreme Court Approved Family Law Form 12.981(b)(1), Joint Petition for Adoption by
Stepparent
(11/15)
dates and places of my dissolutions of marriage, if any:
Date Place
a. _ ________________________________ _______________________________________
b. ____________________________________________ __________________________
6. A completed Uniform Child Custody Jurisdiction and Enforcement Act Affidavit (UCCJEA),
Florida Supreme Court Approved Family Law Form 12.902(d), is filed with this petition.
7. A description and estimate of the value of any property of the adoptee(s) is as follows:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
8. Consent by the adoptee(s):
_____ is attached for: Name(s) ____________________________________________________
_____ is not required because the adoptee(s) is/are not 12 years of age: Name(s) ____________
_____ was excused by the court for: Name(s) _________________________________________
9. The following person(s) is/are required to consent and the consent form or affidavit of
nonpaternity is/are attached _______________________________________________________
10. The following person(s) whose consent is required has not consented. The facts/circumstances
that excuse the lack of consent and would justify termination of this person’s parental rights
are:
Name Address Facts/circumstances
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
11. A copy of this Petition was served on all known persons whose consent is required but did not
waive notice, as well as on all persons whose consent is required but did not provide consent.
Proof of service is attached.
{Indicate if applicable}:
_____ A search of the Putative Father Registry maintained by the Office of Vital Statistics of
the Department of Health has been requested, and if granted, the certificate from the State
Registrar will be filed in this action.
WHEREFORE, I request that this Court terminate the parental rights of __________________________,
{name of parent whose rights are sought to be terminated}, enter a Final Judgment of Adoption of the
Minor Child(ren) by Petitioner Stepparent and, as requested, change the name of the adoptee(s).
Florida Supreme Court Approved Family Law Form 12.981(b)(1), Joint Petition for Adoption by
Stepparent
(11/15)
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
petition and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated: ____________________ _______________________________________
Signature of Party
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
clerk.}
_____ Personally known
_____ Produced identification
Type of identification produced _________________________
Florida Supreme Court Approved Family Law Form 12.981(b)(1), Joint Petition for Adoption by
Stepparent
(11/15)
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
petition and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated: ____________________ _______________________________________
Signature of Party
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
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:
[fill in all blanks] This form was prepared for the: ( ) parent ( ) stepparent ( ) both .
This form was completed with the assistance of:
{name of individual} ___________________________________________________________________,
{name of business} ____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} ____________________, {state} _____, {zip code} __________, {telephone number} ____________.
Instructions for Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction
and Enforcement Act (UCCJEA) Affidavit (02/18)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.902(d)
UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT
(UCCJEA) AFFIDAVIT
(02/18)
When should this form be used?
This form should be used in any case involving parental responsibility for, custody of, or time-sharing or
visitation with, any minor child(ren). This affidavit is required even if the parental responsibility for,
custody of, or time-sharing or visitation with, the minor child(ren) is not in dispute.
This form should be typed or printed in black ink. After completing this form, you should sign the form
before a notary public or deputy clerk. You should then file it with the clerk of the circuit court in the
county where the petition was filed and keep a copy for your records.
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?
A copy of this form must be mailed, e-mailed, or hand delivered to the other party in your case, if it is
not served on him or her with your initial papers.
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
Instructions for Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction
and Enforcement Act (UCCJEA) Affidavit (02/18)
A-Z Topical Index.
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 sections 61.501-61.542, Florida Statutes.
Special notes...
With this form, you must also file a Notice of Confidential Information within Court Filing, Florida Rules
of Judicial Administration Appendix to Rule 2.420 Form.
Effective October 1, 2008, terms such as custodial parent, noncustodial parent, primary residential
parent, secondary residential parent, and visitation were removed from Chapter 61, Florida Statutes;
however, because the UCCJEA uses the terms, custody and visitation, they are included in this form.
Parents must develop a Parenting Plan that includes, among other things, their time-sharing schedule
with the minor child(ren). If the parents cannot agree, a parenting plan will be established by the Court.
If you are the petitioner in an injunction for protection against domestic violence case and you have filed
a Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form
12.980(h), you should write confidential in any space on this form that would require you to write the
address where you are currently living.
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
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(d), Uniform Child Custody Jurisdiction and Enforcement
Act (UCCJEA) Affidavit (02/18)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT
(UCCJEA) AFFIDAVIT
I, {full legal name} ____________, being sworn, certify that the following
statements are true:
1. The number of minor child(ren) subject to this proceeding is . The name, place of
birth, birth date, and sex of each child; the present address, periods of residence, and places
where each child has lived within the past five (5) years; and the name, present address, and
relationship to the child of each person with whom the child has lived during that time are:
THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # 1 :
Child’s Full Legal Name:
Place of Birth: Date of Birth: Sex:
Child’s Residence for the past 5 years:
Dates
(From/To)
Address (including city and
state) where child lived
Name and present address of
person child lived with
Relationship
to child
/present*
____/____
____/____
____/____
Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement
Act (UCCJEA) Affidavit (02/18)
____/____
____/____
* If you are the petitioner in an injunction for protection against domestic violence case and you have
filed a Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form
12.980(h), you should write confidential in any space on this form that would require you to enter the
address where you are currently living.
THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # :
Child’s Full Legal Name:
Place of Birth: Date of Birth: Sex:
Child’s Residence for the past 5 years:
Dates
(From/To)
Address (including city and
state) where child lived
Name and present address of
person child lived with
Relationship
to child
/present
____/____
____/____
____/____
____/____
____/____
THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # :
Child’s Full Legal Name:
Place of Birth: Date of Birth: Sex:
Child’s Residence for the past 5 years:
Dates
(From/To)
Address (including city and
state) where child lived
Name and present address of
person child lived with
Relationship
to child
/present
Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement
Act (UCCJEA) Affidavit (02/18)
____/____
____/____
____/____
____/____
____/____
2. Participation in custody or time-sharing proceeding(s):
[Choose only one]
______ I HAVE NOT participated as a party, witness, or in any capacity in any other litigation or
custody proceeding in this or any other state, jurisdiction, or country, concerning parental
responsibility for, custody of, or time-sharing or visitation with a child subject to this
proceeding.
______ I HAVE participated as a party, witness, or in any capacity in any other litigation or
custody proceeding in this or another state, jurisdiction, or country, concerning parental
responsibility for, custody of, or time-sharing or visitation with a child subject to this proceeding.
Explain:
a. Name of each child:
b. Type of proceeding:
c. Court and state:
d. Date of court order or judgment (if any):
3. Information about custody or time-sharing proceeding(s):
[Choose only one]
______ I HAVE NO INFORMATION of any parental responsibility, custody, time-sharing, or
visitation proceeding pending in a court of this or any other state, jurisdiction, or country
concerning a child subject to this proceeding.
______ I HAVE THE FOLLOWING INFORMATION concerning a parental responsibility, custody,
time-sharing, or visitation proceeding pending in a court of this or another state concerning a
child subject to this proceeding, other than set out in item 2. Explain:
a. Name of each child involved in said litigation:
b. Type of proceeding:
c. Court and state:
d. Date of court order or judgment (if any):
e. Case Number: _______________________________________________________________
Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement
Act (UCCJEA) Affidavit (02/18)
4. Persons not a party to this proceeding:
[Choose only one]
______ I DO NOT KNOW OF ANY PERSON in this or any other state, jurisdiction, or country, who
is not a party to this proceeding and who has physical custody or claims to have parental
responsibility for, custody of, or time-sharing or visitation with respect to any child subject to
this proceeding.
______ I KNOW THAT THE FOLLOWING NAMED PERSON(S), not a party to this proceeding, has
(have) physical custody or claim(s) to have parental responsibility for, custody of, , or time-
sharing or visitation with respect to any child subject to this proceeding:
a. Name and address of person:
_____ has physical custody
_____ claims parental responsibility or custody rights
_____ claims time-sharing or visitation
Name of each child:
Relationship to child, if any:________________________________________________________
b. Name and address of person:
_____ has physical custody
_____ claims parental responsibility or custody rights
_____ claims time-sharing or visitation
Name of each child:
Relationship to child, if any:________________________________________________________
c. Name and address of person:
_____ has physical custody
_____ claims parental responsibility or custody rights
_____claims time-sharing or visitation
Name of each child:
Relationship to child, if any:________________________________________________________
5. Knowledge of prior child support proceedings:
[Choose only one]
_____ The child(ren) described in this affidavit are NOT subject to existing child support
order(s) in this or any other state, jurisdiction, or country..
_____ The child(ren) described in this affidavit are subject to the following existing child
support order(s):
a. Name of each child: ______________________________________________________
b. Type of proceeding: ______________________________________________________
c. Court and address: _______________________________________________________
d. Date of court order/judgment (if any): ___________________________________________
Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement
Act (UCCJEA) Affidavit (02/18)
e. Amount of child support ordered to be paid and by whom:
6. I acknowledge that I have a continuing duty to advise this Court of any parental responsibility,
custody, time-sharing or visitation , child support, or guardianship proceeding (including
dissolution of marriage, separate maintenance, child neglect, or dependency) concerning the
child(ren) in this state or any other state about which information is obtained during this
proceeding.
7. A completed Notice of Confidential Information within Court Filing, Florida Rules of Judicial
Administration Appendix to Rule 2.420 Form, is filed with this Affidavit.
I certify that a copy of this document was ( ) e-served ( ) mailed ( ) faxed and mailed
( ) hand delivered to the person(s) listed below on {date} .
Other party or his/her attorney:
Name:
Address:
City, State, Zip: ______
Fax Number:
Designated E-mail Address(es):____________________
_____________________________________________
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
affidavit and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated: ______________________
Signature of Party
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
Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement
Act (UCCJEA) Affidavit (02/18)
__________________________________________________
[Print, type, or stamp commissioned name of notary or 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:
[fill in all blanks] This form was prepared for the {choose only one} _____ Petitioner _____ Respondent
This form was completed with the assistance of:
{name of individual} _________________________________________________________________,
{name of business} ____________________________________________________________________,
{address} ____________________________________________,
{city} _____________,{state} ___, {zip code}____________,{telephone number}________________.
Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(5), Indian Child Welfare Act
Affidavit (11/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.981(a)(5),
INDIAN CHILD WELFARE ACT AFFIDAVIT (11/15)
When should this form be used?
This form should be used in cases involving stepparent adoption of a child. This affidavit is required.
This form should be typed or printed in black ink. After completing this form, you should sign the form
before a notary public or deputy clerk. You should then file the original with the clerk of the circuit
court in the county where the petition was filed and keep a copy for your records.
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 pleading 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?
A copy of this form must be mailed, e-mailed, or hand delivered to the other party in your case, if it is not
served on him or her with your initial papers.
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.
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
Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(5), Indian Child Welfare Act
Affidavit (11/15)
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.
Special notes...
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
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 12.981(a)(5), Indian Child Welfare Act Affidavit
(11/15)
IN THE CIRCUIT COURT OF THE __________________ JUDICIAL CIRCUIT,
IN AND FOR _________________________ COUNTY, FLORIDA
Case No.: ____________________
Division: _____________________
IN THE MATTER OF THE ADOPTION OF
______________________________________________,
{use name to be given to the minor child(ren)} Adoptee(s).
INDIAN CHILD WELFARE ACT AFFIDAVIT
I, {full legal name} ___________________________________, being sworn, certify that the following
statements are true:
Upon information and belief the child ____________________________________ {name} subject to
this proceeding: {choose one only}
1. _____ is not an Indian child. The Indian Child Welfare Act does not apply to this proceeding.
2. _____ is an Indian child within the meaning of the Indian Child Welfare Act of 1978 (25 U.S.C.
Section 1901 et seq.).
I certify that a copy of this document was ( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) hand-
delivered to the person(s) listed below on {date} ____________________.
Other party or his/her attorney:
Name: __________________________________
Address: _________________________________
City, State, Zip: ____________________________
Fax Number: ______________________________
Designated E-mail Address(es): _______________
_________________________________________
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
affidavit and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated: ____________________ _______________________________________
Signature of Party
Printed Name: ___________________________
Address: _______________________________
City, State, Zip: __________________________
Telephone Number: ______________________
Fax Number: ____________________________
Designated E-mail Address(es): _____________
_______________________________________
Florida Supreme Court Approved Family Law Form 12.981(a)(5), Indian Child Welfare Act Affidavit
(11/15)
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
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:
[fill in all blanks] This form was prepared for the: {choose only one} ( ) Petitioner ( ) Respondent
This form was completed with the assistance of:
{name of individual} ___________________________________________________________________,
{name of business} ____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} ____________________, {state} _____, {zip code} __________, {telephone number} ____________.
Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(3), Affidavit of Nonpaternity (03/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.981(a)(3),
AFFIDAVIT OF NONPATERNITY (03/15)
When should this form be used?
This form should be used when a stepfather is adopting his wife’s minor child and the mother and father of
the minor child(ren) were never married and paternity has not been established by a valid acknowledgment
or court order. This Affidavit of Nonpaternity may be used instead of a consent form. This Affidavit may be
executed before the birth of the minor child. The person signing the affidavit waives notice to all court
proceedings after the date it is signed. After signing this affidavit, it may only be withdrawn if the court finds
the affidavit was obtained by fraud or duress.
This form should be typed or printed in black ink. This form must be signed before a notary public or deputy
clerk and two witnesses other than the notary or clerk. You should then file the original of this form with the
Joint Petition for Stepparent Adoption, Florida Supreme Court Approved Family Law Form 12.981(b)(1).
IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of Judicial Administration now require that petitions, pleadings, and documents be filed
electronically except in certain circumstances. Self-represented litigants may file petitions or other
pleadings 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.
Special Notes
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 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 12.981(a)(3), Affidavit of Nonpaternity (03/15)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR __ COUNTY, FLORIDA
Case No.:
Division:
IN THE MATTER OF THE ADOPTION OF
___________________________________________,
{use name to of the minor child(ren)}
Adoptee(s)
AFFIDAVIT OF NONPATERNITY
I, {full legal name} , have personal knowledge of the facts
stated in this affidavit and certify that the following statements are true:
1. I have been told that {name} has a child. I do not wish to
and shall not establish or claim paternity for this child, whose name is ___________________
and whose date of birth is_____________________________.
2. The child referenced in this affidavit was not conceived or born while the birth mother was
married to me. I AM NOT MARRIED TO THE BIRTH MOTHER, nor do I intend to marry the birth
mother.
3. The child has not been established to be my child in any court proceeding and I have not adopted
this child.
4. I have no interest in assuming the responsibilities of parenthood for this child. I have not
acknowledged and will not acknowledge in writing that I am the father of this child or will not
institute court proceedings to establish the child as mine.
5. I do not object to any decision or arrangements the birth mother makes regarding this child,
including adoption.
6. I understand my right to choose a person who does not have an employment, professional, or
personal relationship with the adoption entity or the prospective adoptive parents to be present
when this affidavit is executed and to sign it as a witness. The witness I selected is {full legal name}
.
7. I am executing this affidavit freely and voluntarily and I understand that it can only be withdrawn if
the court finds it was executed by fraud or duress.
I WAIVE NOTICE OF ANY AND ALL PROCEEDINGS TO TERMINATE PARENTAL RIGHTS OR FINALIZE AN
ADOPTION UNDER CHAPTER 63, FLORIDA STATUTES.
Florida Supreme Court Approved Family Law Form 12.981(a)(3), Affidavit of Nonpaternity (03/15)
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
affidavit and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Signature
Printed Name: __________________________________
Address: _______________________________________
City, State, Zip: _________________________________
Designated E-mail Address(es):_____________________
_________________________________________
Signature of Witness
Printed Name:
Business Address:
Home Address:
Driver’s License or
State ID Card No.:
Signature of Witness
Printed Name:
Business Address:
Home Address:
Driver’s License or
State ID Card No.:
STATE OF FLORIDA
COUNTY OF
Sworn to or affirmed and signed before me on {date
} .
NOTARY PUBLIC or DEPUTY CLERK
[Print, type, or stamp commissioned name of notary or
deputy 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:
[fill in all blanks] This form was prepared for the: {choose only one} ( ) parent or ( ) stepparent
This form was completed with the assistance of:
{name of individual}_________________________________________________________________,
{name of business} ___________________________________________________________________,
{address} ___________________________________________________________________________,
{city} ________________, {state} ____, {zip code}_________{telephone number} ________________.
.
Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(1), Stepparent Adoption:
Consent and Waiver by Parent (11/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.981(a)(1)
STEPPARENT ADOPTION: CONSENT AND WAIVER BY PARENT (11/15)
When should this form be used?
This form is to be completed and signed by the parent who is giving up all rights to, custody of, and
time-sharing with the minor child to be adopted. This consent shall not be executed before the birth of
the minor child. For more information about consenting to adoption, you should refer to Chapter 63,
Florida Statutes, and sections 63.062 - 63.082, Florida Statutes, in particular.
This form should be typed or printed in black ink. It must be signed in the presence of a notary public or
deputy clerk and two witnesses other than the notary or clerk. You should file this form with the Joint
Petition for Adoption by Stepparent, Florida Supreme Court Approved Family Law Form 12.981(b)(1).
After completing this form, you should hand deliver a copy or duplicate original to the parent giving
consent and have them sign the original saying they received a copy. Then you should file the original
with the clerk of the circuit court in the county where the Joint Petition for Adoption by Stepparent,
Florida Supreme Court Approved Family Law Form 12.981(b)(1) is filed and keep a copy for your records.
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.
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.
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
Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(1), Stepparent Adoption:
Consent and Waiver by Parent (11/15)
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.
Special notes...
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 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
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 12.981(a)(1), Stepparent Adoption: Consent and
Waiver by Parent (11/15)
IN THE CIRCUIT COURT OF THE ___________________________ JUDICIAL CIRCUIT,
IN AND FOR __________________ COUNTY, FLORIDA
Case No.: ________________________________
Division: _________________________________
IN THE MATTER OF THE ADOPTION OF
{use name to be given to minor child(ren)} Adoptee(s).
CONSENT AND WAIVER BY PARENT
1. I, {full legal name} ________________________________________________, am the {Choose only
one} _____ father or _____ mother of the minor child(ren) subject to this consent who is/are:
Child’s Current Name Gender Birth date Birthplace
{city, county, state}
a. ______________________________________________________________________________
b. ______________________________________________________________________________
c. ______________________________________________________________________________
d. ______________________________________________________________________________
e. ______________________________________________________________________________
f. ______________________________________________________________________________
2. I relinquish all rights to, custody of, and time sharing with this (these) minor child(ren), {name(s)},
_____________________________________________________________________________________
with full knowledge of the legal effect of the stepparent adoption and consent to the adoption by the
child(ren)’s stepparent whose name is: {Choose only one}
_____ {name} _________________________________________
_____ not required for my granting of this consent.
3. I understand my legal rights as a parent and I understand that I do not have to sign this consent and
release of my parental rights. I acknowledge that this consent is being given knowingly, freely, and
voluntarily. I further acknowledge that my consent is not given under fraud or duress. I understand
that there is a “grace period” in Florida during which I may revoke my consent. If the child to be
adopted is older than 6 months at the time of consent, this grace period is for 3 days or until the
child has been placed with the prospective adoptive parents, whichever is later. I understand that, in
signing this consent, I am permanently and forever giving up all my parental rights to and interest in
this (these) minor child(ren) and that this consent may only be withdrawn if the Court finds it was
obtained by fraud or duress. I voluntarily, permanently relinquish all my parental rights to this
(these) minor child(ren).
Florida Supreme Court Approved Family Law Form 12.981(a)(1), Stepparent Adoption: Consent and
Waiver by Parent (11/15)
4. I consent, release, and give up permanently, of my own free will, my parental rights to this (these)
minor child(ren), for the purpose of stepparent adoption.
5. I waive any further notice of the stepparent adoption proceeding.
6. I understand that pursuant to Chapter 63, Florida Statutes, “an action or proceeding of any kind to
vacate, set aside, or otherwise nullify a judgment of adoption or an underlying judgment
terminating parental rights on any ground may not be filed more than 1 year after entry of the
judgment terminating parental rights.”
7. I understand I have the right to choose a person who does not have an employment, professional, or
personal relationship with the adoption entity or the prospective adoptive parents to be present
when this affidavit is executed and to sign it as a witness. The witness I selected is: {full legal name}
__________________________________________________________________________________
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
consent and waiver and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
Dated: _____________________ Signature of Parent: ______________________
Printed Name: ___________________________
Address: _______________________________
City, State, Zip: __________________________
Telephone Number: ______________________
Fax Number: ____________________________
Designated E-mail Address(es) ______________
_______________________________________
Signature of Witness: ______________________ Signature of Witness: _____________________
Printed Name: ____________________________ Printed Name: __________________________
Business Address: _________________________ Business Address: _______________________
Home Address: ___________________________ Home Address: _________________________
Driver’s License No.: _______________________ Driver’s License No.: _____________________
State ID Card No.: _________________________ State ID Card No.: _______________________
Florida Supreme Court Approved Family Law Form 12.981(a)(1), Stepparent Adoption: Consent and
Waiver by Parent (11/15)
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 ________________________________
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} ( ) Mother ( ) Father. This form
was completed with the assistance of:
{name of individual} ____________________________________________________________________,
{name of business} _____________________________________________________________________,
{address} _____________________________________________________________________________,
{city} _________________,{state} _____, {zip code} _________ {telephone number} _________________.
Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(2), Stepparent Adoption:
Consent of Adoptee (03/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.981(a)(2),
STEPPARENT ADOPTION: CONSENT OF ADOPTEE (03/15)
When should this form be used?
This form must be completed and signed by the person being adopted, the adoptee, if he or she is over 12
years of age, unless the court, in the best interest of the minor excuses the minor’s consent. It must be
signed in the presence of a notary public or deputy clerk and two witnesses other than the notary public or
deputy clerk.
This form should be typed or printed in black ink. After completing this form, you should file the original
with the clerk of the circuit court in the county where the Joint Petition for Adoption by Stepparent, Florida
Supreme Court Approved Family Law Form 12.981(b)(1) is filed and keep a copy for your records.
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.
Special notes...
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 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 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 12.981(a)(2), Stepparent Adoption: Consent of Adoptee (03/15)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
IN THE MATTER OF THE ADOPTION OF
_________________________________________
{use name to be given to the child(ren)} Adoptee(s).
CONSENT OF ADOPTEE
1. I, {full legal name} , being over the age of 12,
consent to my adoption by {name} , to be his/her legal
child and heir at law.
2. I have been told of my right to choose a person who does not have an employment,
professional, or personal relationship with the adoption entity or prospective adoptive parents
to be present when this affidavit is executed and to sign it as a witness. The witness I selected is:
{full legal name} .
3. {Choose only one]
( ) I consent to my name being legally changed to {specify} .
( ) I do not consent to a name change.
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
consent and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated:
Signature of Adoptee
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
Designated E-mail Address(es): ____________________
_______________________________________________
Florida Supreme Court Approved Family Law Form 12.981(a)(2), Stepparent Adoption: Consent of
Adoptee (03/15)
______________________________________
Signature of Witness
Printed Name: _________________________
Business Address: _______________________
Home Address:_________________________
Driver’s License No.: _____________________
State ID Card No.: _______________________
______________________________________
Signature of Witness
Printed Name: _________________________
Business Address: _______________________
Home Address:______________________
Driver’s License No.: _____________________
State ID Card No.: _______________________
STATE OF FLORIDA
COUNTY OF __________________________
Sworn to or affirmed and signed before me on
{date}
.
_________________________________________
NOTARY PUBLIC or DEPUTY CLERK
{Print, type, or stamp commissioned name of notary or
deputy 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:
[fill in all blanks] This form was prepared for the {choose only one} ( ) adoptee ( ) stepparent
This form was completed with the assistance of:
{name of individual}___________________________________________________________________,
{name of business} _____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} ________________, {state} ______,{zip code}_________ {telephone number} __________________.
.
Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(6), Motion for Search of Putative
Father Registry (11/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.981(a)(6),
MOTION FOR SEARCH OF THE PUTATIVE FATHER REGISTRY (11/15)
When should this form be used?
This form should be used when a stepparent is adopting his or her spouse’s child. Section 63.054,
Florida Statutes, requires that a search of Florida’s Putative Father Registry be conducted in every
adoption proceeding. The Office of Vital Statistics of the Department of Health has an application
available called Florida Putative Father Registry - Application for Search which should be completed and
attached to this form. The Office of Vital Statistics is allowed to charge for searching the registry. You
may wish to contact that office in advance to find out what amount and method of payment will be
accepted.
This form should be typed or printed in black ink. The name to be given to the adoptee after the
adoption should be used in the heading of the petition. The stepparent is the petitioner, because he or
she is the one who is asking the court for legal action. You must have your signature witnessed by a
notary public or deputy clerk.
After completing this form, you should file the original with the clerk of the circuit court in the county
where you have filed the Joint Petition for Adoption by Stepparent, Florida Supreme Court Approved
Family Law Form 12.981(b)(1) and keep a copy for your records. These family law forms contain an
Order Granting Motion for Search of Putative Father Registry, Florida Supreme Court Approved Family
Law Form 12.981(a)(7), which the judge may use. You should check with the clerk, family law intake
staff or judicial assistant to see if you need to provide this form order to the judge with your motion. If
so, you should type or print the heading, including the circuit, county, case number, division, and the
child(ren)’s name, and leave the rest blank for the judge to complete.
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?
If the judge grants your motion, you will need to take the order, your completed application, and any fee
to the Office of Vital Statistics. That office will conduct the search and file the results with the clerk of
court. You may call the clerk’s office to determine when the results have been filed in order to set a final
hearing.
Where can I look for more information?
Before proceeding, you should read General Information for Self-Represented Litigants found at the
Instructions for Florida Supreme Court Approved Family Law Form 12.981(a)(6), Motion for Search of Putative
Father Registry (11/15)
beginning of these forms. See Chapter 63, Florida Statutes, and Florida Family Law Rule 12.200(a)(2) for
further information.
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.
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.
Special notes...
THIS ADOPTION MAY AFFECT THE ADOPTEE’S INHERITANCE.
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
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 12.981(a)(6), Motion for Search of Putative Father Registry
(11/15)
IN THE CIRCUIT COURT OF THE __________________ JUDICIAL CIRCUIT,
IN AND FOR __________________ COUNTY, FLORIDA
Case No.: _______________________
Division: _______________________
IN THE MATTER OF THE ADOPTION OF
_________________________________________,
{use name to be given to the minor child} Adoptee.
MOTION FOR SEARCH OF THE PUTATIVE FATHER REGISTRY
Petitioner, {full legal name} ______________________________________, files this Motion for Search
of the Putative Father Registry, pursuant to Chapter 63, Florida Statutes, and states:
1. This is an action for adoption of a minor by the child’s stepparent, who is the Petitioner. .
2. Section 63.054, Florida Statutes, requires that in every adoption, a search of the Putative Father
Registry maintained by the Department of Health, Office of Vital Statistics be conducted. Section
63.0541, Florida Statutes, makes information maintained by the Registry confidential and exempt
from public disclosure, except that it may be disclosed to adoption entities, registrant unmarried
biological fathers, and the court, upon issuance of a court order concerning a petitioner acting
pro se.
3. The Florida Putative Father Registry - Application for Search is completed and attached to this
Motion.
WHEREFORE, I request that this Court enter an Order Granting Motion for Search of the Putative Father
Registry.
Florida Supreme Court Approved Family Law Form 12.981(a)(6), Motion for Search of Putative Father Registry
(11/15)
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
motion and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated: ____________________ _______________________________________
Signature of Party
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
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:
[fill in all blanks] This form was prepared for the petitioner.
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 12.981(a)(7), Order Granting Motion for Search of Putative
Father Registry(03/15)
IN THE CIRCUIT COURT OF THE ________________JUDICIAL CIRCUIT,
IN AND FOR ____________________________COUNTY, FLORIDA
Case No.:____________________________
Division: ____________________________
IN THE MATTER OF THE ADOPTION OF
___________________ ,
{use name to be given to the minor child} Adoptee.
ORDER GRANTING MOTION FOR SEARCH OF
THE PUTATIVE FATHER REGISTRY
Upon consideration of Petitioner’s Motion for Search of the Putative Father Registry, this Court finds:
1. This is an action for adoption of a minor by the child’s stepparent, Petitioner, who is proceeding
pro se.
2. Section 63.054, Florida Statutes, requires that in every adoption, a search of the Putative Father
Registry maintained by the Department of Health, Office of Vital Statistics be conducted. Section
63.0541, Florida Statutes, makes information maintained by the Registry confidential and
exempt, except that it may be disclosed to adoption entities, registrant unmarried biological
fathers, the birth mother, and the court, upon issuance of a court order concerning a petitioner
acting pro se.
NOW, THEREFORE, IT IS ORDERED THAT:
1. The Office of Vital Statistics, Department of Health shall conduct a search of the Putative Father
Registry upon receipt of a completed application and payment of any authorized fee.
2. The State Registrar shall issue a certificate indicating the results of such search which shall be
filed in this proceeding by transmitting the certificate to the clerk of court.
DONE and ORDERED on: ____________________in __________________________, Florida.
______________________________________
Circuit Judge
Florida Supreme Court Approved Family Law Form 12.981(a)(7), Order Granting Motion for Search of Putative
Father Registry(03/15)
I certify that a copy of the {name of document(s)} _____________________________________________
was ( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) hand-delivered to the parties and to any other
persons or entities listed below on {date} ___________________________________________.
__________________________________________
By: Clerk of Court, Designee, or Judicial Assistant
Petitioner (or his or her attorney)
Other: ______________________
State Registrar, Office of Vital Statistics
Instructions for Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an
Individual (03/17)
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM
12.910(a)
SUMMONS: PERSONAL SERVICE ON AN INDIVIDUAL
(03/17)
When should this form be used?
This form should be used to obtain personal service on the other party when you begin your lawsuit.
Service is required for all documents filed in your case. Service means giving a copy of the required papers
to the other party using the procedure that the law requires. Generally, there are two ways to make
service: (1) personal service, or (2) service by email, mail, or hand delivery. A third method for service is
called constructive service; however, the relief a court may grant may be limited in a case where
constructive service has been used.
The law requires that certain documents be served by personal service if personal service is possible.
Personal service means that a summons (this form) and a copy of the forms you are filing with the court
that must be personally served are delivered by a deputy sheriff or private process server
a. directly to the other party, or
b. to someone over the age of fifteen with whom the other party lives.
Personal service is required for all petitions, including petitions for modification. You cannot serve these
papers on the other party yourself or by mail or hand delivery. Personal service must be made by the
sheriff’s department in the county where the other party lives or works or by a private process server
certified in the county where the other party lives or works.
In many counties, there are private process servers who, for a fee, will personally serve the summons and
other documents that require personal service. You should look under process servers in the yellow pages
of the telephone book for a list of private process servers in your area. You may use a private process
server to serve any paper required to be personally served in a family law case except a petition for
injunction for protection against domestic or repeat violence.
How do I start?
When you begin your lawsuit, you need to complete this form (summons) and a Process Service
Memorandum, Florida Supreme Court Approved Family Law Form 12.910(b). The forms should be typed
or printed legibly in black ink. Next, you will need to take these forms and, if you have not already done
so, file your petition with the clerk of the circuit court in the county where you live. You should keep a
copy of the forms for your records. The clerk will sign the summons, and then the summons, a copy of the
papers to be served, and the process service memorandum must be delivered to the appropriate sheriff’s
office or to a private process server for service on the other party.
IF THE OTHER PARTY LIVES IN THE COUNTY WHERE SUIT IS FILED: Ask the clerk in your county about any
local procedures regarding service. Generally, if the other party lives in the county in which you are filing
suit and you want the sheriff’s department to serve the papers, you will file the summons along with a
Instructions for Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an
Individual (03/17)
Process Service Memorandum, Florida Supreme Court Approved Family Law Form 12.910(b), with the
clerk and the clerk will forward those papers to the sheriff for service. Make sure that you attach a copy
of the papers you want personally served to the summons. You may also need to provide the sheriff with
a stamped envelope addressed to you. This will allow the sheriff to send the proof of service to you, after
the sheriff serves your papers on the other party. However, in some counties the sheriff may send the
proof of service directly to the clerk. If you are instructed to supply a self-addressed, stamped envelope
and you receive the proof of service, you should file the proof of service with the clerk after you receive
it from the sheriff. Also, you will need to find out how much the sheriff charges to serve the papers.
Personal checks are not accepted. You should attach to the summons a cashier’s check or money order
made payable to the sheriff, and either give it to the clerk for delivery to the sheriff or send all of the
paperwork and the fee to the sheriff yourself. The clerk will tell you which procedure to use. The costs for
service may be waived if you are indigent.
If you want a private process server to serve the other party, you should still bring the summons to the
clerk’s office and have the clerk sign it for you. You should deliver the summons, along with the copy of
your initial petition and any other papers to be served, and a Process Service Memorandum, Florida
Supreme Court Approved Family Law Form 12.910(b), to the private process server. The private process
server will charge you a fee for serving the papers. After service is complete, proof of service by the
private process server must be filed with the clerk. You should discuss how this will occur with the private
process server.
IF THE OTHER PARTY LIVES IN ANOTHER COUNTY: If the other party lives in another county, service needs
to be made by a sheriff in the county where the other party lives or by a private process server certified
in the county where the other party lives. Make sure that you attach a copy of the papers you want
personally served to the summons as well as the Process Service Memorandum, Florida Supreme Court
Approved Family Law Form 12.910(b). If you want the sheriff to serve the papers, the clerk may send your
papers to that sheriff’s office for you, or you may have to send the papers yourself. The clerk will tell you
which procedure to use. Either way, you will need to provide the sheriff with a stamped envelope
addressed to you. This will allow the sheriff to send the proof of service to you, after the sheriff serves
your papers on the other party. You should file the proof of service with the clerk after you receive it from
the sheriff. Also, you will need to find out how much the sheriff charges to serve the papers. Personal
checks are not accepted. You should attach to the summons a cashier’s check or money order made
payable to the sheriff, and either give it to the clerk for delivery to the sheriff or send all of the paperwork
and the fee to the sheriff yourself. The clerk will tell you which procedure to use. The costs for service
may be waived if you are indigent.
If you want a private process server to serve the other party, you should still bring the summons to the
clerk’s office where the clerk will sign it for you. You should deliver the summons, along with the copy of
your initial petition and any other papers to be served, and a Process Service Memorandum, Florida
Supreme Court Approved Family Law Form 12.910(b), to the private process server. The private process
server will charge you a fee for serving the papers. After service is complete, proof of service by the
private process server must be filed with the clerk. You should discuss how this will occur with the private
process server.
IF THE OTHER PARTY CANNOT BE LOCATED OR DOES NOT LIVE IN FLORIDA: If, after you have made a
diligent effort to locate the other party, you absolutely cannot locate the other party, you may serve the
other party by publication. Service by publication is also known as constructive service. You may also be
able to use constructive service if the other party does not live in Florida. However, Florida courts have
only limited jurisdiction over a party who is served by constructive service and may have only limited
Instructions for Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an
Individual (03/17)
jurisdiction over a party living outside of Florida regardless of whether that party is served by
constructive or personal service; that is, the judge’s power to order the other party to do certain things
may be limited. For example, the judge may be able to grant your request for a divorce, but the judge
may not be able to address issues such as child support, spousal support (alimony), or division of property
or debts.
Regardless of the type of service used, if the other party once lived in Florida but is living outside of Florida
now, you should include in your petition a statement regarding the length of time the party lived in Florida,
if any, and when. For example: “Respondent last lived in Florida from {date} to
{date} .”
This area of the law is very complex and you may need to consult with an attorney regarding the proper
type of service to be used in your case if the other party does not live in Florida or cannot be located.
What happens when the papers are served on the other party?
The date and hour of service are written on the original summons and on all copies of it by the person
making the service. The person who delivers the summons and copies of the petition must file a proof of
service with the clerk or provide a proof of service to you for filing with the court. It is your responsibility
to make sure the proof of service has been returned to the clerk and placed in your case file.
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. For further information regarding service of process, see chapters 48 and 49,
Florida Statutes, and Florida Family Law Rule of Procedure 12.070, as well as the instructions for Notice
of Action for Dissolution of Marriage (No Child or Financial Support), Florida Supreme Court Approved
Family Law Form 12.913(a)(1), Notice of Action for Family Cases with Minor Child(ren), Florida Supreme
Court Approved Family Law Form 12.913(a)(2), Affidavit of Diligent Service and Inquiry, Florida Family
Law Rules of Procedure Form 12.913(b), and Affidavit of Diligent Search, Florida Family Law Rules of
Procedure Form 12.913(c).
Special notes
If you have been unable to obtain proper service on the other party within 120 days after filing your
lawsuit, the court will dismiss your lawsuit against the other party unless you can show the court a good
reason why service was not made within 120 days. For this reason, if you had the local sheriff serve the
papers, you should check with the clerk every couple of weeks after completing the service papers to see
if service has been completed. You may need to supply the sheriff with a new or better address. If you
had a private process server or a sheriff in another county serve the papers, you should be in contact with
that person or sheriff until you receive proof of service from that person or sheriff. You should then file
the proof of service with the clerk immediately.
If the other party fails to respond, i.e., fails to file a written response with the court, within 20 days after
the service of the summons, you are entitled to request a default. See the instructions to Motion for
Default, Florida Supreme Court Approved Family Law Form 12.922 (a), and Default, Florida Supreme Court
Approved Family Law Form 12.922(b), for further information. You will need to file an Affidavit of Military
Service, Florida Supreme Court Approved Family Law Form 12.912(b), before a default may be granted.
Instructions for Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an
Individual (03/17)
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 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 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 Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an Individual (03/17)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
SUMMONS: PERSONAL SERVICE ON AN INDIVIDUAL
ORDEN DE COMPARECENCIA: SERVICIO PERSONAL EN UN INDIVIDUO
CITATION: L’ASSIGNATION PERSONAL SUR UN INDIVIDUEL
TO/PARA/A: {enter other party’s full legal name} ,
{address (including city and state)/location for service} .
IMPORTANT
A lawsuit has been filed against you. You have 20 calendar days after this summons is served on you to
file a written response to the attached complaint/petition with the clerk of this circuit court, located at:
{street address} _______________________________________________________________________.
A phone call will not protect you. Your written response, including the case number given above and the
names of the parties, must be filed if you want the Court to hear your side of the case.
If you do not file your written response on time, you may lose the case, and your wages, money, and
property may be taken thereafter without further warning from the Court. There are other legal
requirements. You may want to call an attorney right away. If you do not know an attorney, you may call
an attorney referral service or a legal aid office (listed in the phone book).
If you choose to file a written response yourself, at the same time you file your written response to the
Court, you must also serve a copy of your written response on the party serving this summons at:
{Name and address of party serving summons}
.
If the party serving summons has designated email address(es) for service or is represented by an
attorney, you may designate email address(es) for service by or on you. Service must be in accordance
with Florida Rule of Judicial Administration 2.516.
Copies of all court documents in this case, including orders, are available at the Clerk of the Circuit
Court’s office. You may review these documents, upon request.
You must keep the Clerk of the Circuit Court’s office notified of your current address. (You may file
Designation of Current Mailing and Email Address, Florida Supreme Court Approved Family Law Form
Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an Individual (03/17)
12.915.) Future papers in this lawsuit will be mailed to the address on record at the clerk’s office.
WARNING: Rule 12.285, Florida Family Law Rules of Procedure, requires certain automatic disclosure
of documents and information. Failure to comply can result in sanctions, including dismissal or striking
of pleadings.
IMPORTANTE
Usted ha sido demandado legalmente. Tiene veinte (20) dias, contados a partir del recibo de esta
notificacion, para contestar la demanda adjunta, por escrito, y presentarla ante este tribunal. Localizado
en: . Una llamada telefonica no lo protegera. Si usted desea
que el tribunal considere su defensa, debe presentar su respuesta por escrito, incluyendo el numero del
caso y los nombres de las partes interesadas. Si usted no contesta la demanda a tiempo, pudiese perder
el caso y podria ser despojado de sus ingresos y propiedades, o privado de sus derechos, sin previo aviso
del tribunal. Existen otros requisitos legales. Si lo desea, usted puede consultar a un abogado
inmediatamente. Si no conoce a un abogado, puede llamar a una de las oficinas de asistencia legal que
aparecen en la guia telefonica.
Si desea responder a la demanda por su cuenta, al mismo tiempo en que presente su respuesta ante el
tribunal, usted debe enviar por correo o entregar una copia de su respuesta a la persona denominada
abajo.
Si usted elige presentar personalmente una respuesta por escrito, en el mismo momento que usted
presente su respuesta por escrito al Tribunal, usted debe enviar por correo o llevar una copia de su
respuesta por escrito a la parte entregando esta orden de comparencencia a:
Nombre y direccion de la parte que entrega la orden de comparencencia:
.
Copias de todos los documentos judiciales de este caso, incluyendo las ordenes, estan disponibles en la
oficina del Secretario de Juzgado del Circuito [Clerk of the Circuit Court’s office]. Estos documentos
pueden ser revisados a su solicitud.
Usted debe de manener informada a la oficina del Secretario de Juzgado del Circuito de su direccion
actual. (Usted puede presentar el Formulario: Ley de Familia de la Florida 12.915, Florida Supreme
Court Approved Family Law Form 12.915, [Designation of Current Mailing and Email Address].) Los
papelos que se presenten en el futuro en esta demanda judicial seran env ados por correo a la direccion
que este registrada en la oficina del Secretario.
ADVERTENCIA: Regla 12.285 (Rule 12.285), de las Reglas de Procedimiento de Ley de Familia de la
Florida [Florida Family Law Rules of Procedure], requiere cierta revelacion automatica de documentos
e informacion. El incumplimient, puede resultar en sanciones, incluyendo la desestimacion o anulacion
de los alegatos.
IMPORTANT
Des poursuites judiciaries ont ete entreprises contre vous. Vous avez 20 jours consecutifs a partir de la
date de l’assignation de cette citation pour deposer une reponse ecrite a la plainte ci-jointe aupres de ce
tribunal. Qui se trouve a: {L’Adresse} . Un simple coup de telephone est
insuffisant pour vous proteger; vous etes obliges de deposer votre reponse ecrite, avec mention du
numero de dossier ci-dessus et du nom des parties nommees ici, si vous souhaitez que le tribunal entende
Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an Individual (03/17)
votre cause. Si vous ne deposez pas votre reponse ecrite dans le delai requis, vous risquez de perdre la
cause ainsi que votre salaire, votre argent, et vos biens peuvent etre saisis par la suite, sans aucun preavis
ulterieur du tribunal. Il y a d’autres obligations juridiques et vous pouvez requerir les services immediats
d’un avocat. Si vous ne connaissez pas d’avocat, vous pourriez telephoner a un service de reference
d’avocats ou a un bureau d’assistance juridique (figurant a l’annuaire de telephones).
Si vous choisissez de deposer vous-meme une reponse ecrite, il vous faudra egalement, en meme temps
que cette formalite, faire parvenir ou expedier une copie au carbone ou une photocopie de votre reponse
ecrite a la partie qui vous depose cette citation.
Nom et adresse de la partie qui depose cette citation:
Les photocopies de tous les documents tribunals de cette cause, y compris des arrets, sont disponible
au bureau du greffier. Vous pouvez revue ces documents, sur demande.
Il faut aviser le greffier de votre adresse actuelle. (Vous pouvez deposer Florida Supreme Court
Approved Family Law Form 12.915, Designation of Current Mailing and Email Address.) Les documents
de l’avenir de ce proces seront envoyer a l’adresse que vous donnez au bureau du greffier.
ATTENTION: La regle 12.285, des regles de procedure du droit de la famille de la Floride exige que l’on
remette certains renseignements et certains documents a la partie adverse. Tout refus de les fournir
pourra donner lieu a des sanctions, y compris le rejet ou la suppression d’un ou de plusieurs actes de
procedure.
THE STATE OF FLORIDA
TO EACH SHERIFF OF THE STATE: You are commanded to serve this summons and a copy of the complaint
in this lawsuit on the above-named person.
DATED:
CLERK OF THE CIRCUIT COURT
(SEAL)
By:
Deputy Clerk
Instructions for Florida Supreme Court Approved Family Law Form 12.910(b), Process Service Memorandum
(11/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.910(b),
PROCESS SERVICE MEMORANDUM (11/15)
When should this form be used?
You should use this form to give the sheriff’s department (or private process server) instructions for
serving the other party in your case with the Summons: Personal Service on an Individual, Florida Family
Law Rules of Procedure Form 12.910(a), and other papers to be served. On this form you can tell the
sheriff’s department the best times to find the person at work and/or at home. You can also include a
map to the other person’s home or work place to help the sheriff find the person and deliver the
summons. Do not forget to attach to the summons a copy of your initial petition and any other papers
you want personally served on the other party.
This form should be typed or printed in black ink. After completing this form, you should file the original
with the clerk of the circuit court in the county where your petition was filed and attach a copy to the
Summons: Personal Service on an Individual, Florida Family Law Rules of Procedure Form 12.910(a).
You should also keep a copy for your records.
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.
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. You should read the instructions for Summons: Personal Service on an
Individual, Florida Family Law Rules of Procedure Form 12.910(a), for additional information.
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.
SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT
Instructions for Florida Supreme Court Approved Family Law Form 12.910(b), Process Service Memorandum
(11/15)
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.
Special notes...
If you fear that disclosing your address would put you in danger because you are the victim of sexual
battery, aggravated child abuse, stalking, aggravated stalking, harassment, aggravated battery, or
domestic violence, you should complete a Request for Confidential Filing of Address, Florida Supreme
Court Approved Family Law Form 12.980(h), file it with the clerk, and write confidential in the space
provided on the petition.
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 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 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 12.910(b), Process Service Memorandum (11/15)
IN THE CIRCUIT COURT OF THE _______________________ JUDICIAL CIRCUIT,
IN AND FOR ________________________ COUNTY, FLORIDA
Case No.: ___________________________ ___
Division:
__________________________________________________________________________________ ________
__________________________________,
Petitioner,
and
__________________________________,
Respondent,
PROCESS SERVICE MEMORANDUM
TO: _____ Sheriff of ________________________ County, Florida; _____________________ Division
_____ Private process server: ______________________________________________________
Please serve the {name of document(s)} ______________________________________________________
_____________________________________________________________________________________
in the above-styled cause upon:
Party: {full legal name} __________________________________________________________________
Address or location for service: ___________________________________________________________
_____________________________________________________________________________________
Work Address: _________________________________________________________________________
_____________________________________________________________________________________
If the party to be served owns, has, and/or is known to have guns or other weapons, describe what type
of weapon(s): _________________________________________________________________________
SPECIAL INSTRUCTIONS: _________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Dated: ______________________ _______________________________________
Signature of Party
*Printed Name: __________________________
*Address: ______________________________
*City, State, Zip: __________________________
*Telephone Number: ______________________
*Fax Number: ___________________________
*Designated E-mail Address(es) _____________
_______________________________________
Florida Supreme Court Approved Family Law Form 12.910(b), Process Service Memorandum (11/15)
* Please see the Special Notes section in the instructions to this form regarding Florida Supreme Court
Approved Family Law Form 12.980(h), Request for Confidential Filing of Address, which may be used if
you need to keep your addresses or telephone numbers confidential for safety reasons.
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 Petitioner. This form was completed with the assistance
of:
{name of individual} ____________________________________________________________________,
{name of business} _____________________________________________________________________,
{address} ____________________________________________________________________________,
{city}_______________, {state} ____, {zip code} __________, {telephone number} ___________________
Instructions for Florida Supreme Court Approved Family Law Form 12.923, Notice of Hearing
(General) (11/15)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
FORM 12.923,
NOTICE OF HEARING (GENERAL) (11/15)
When should this form be used?
Anytime you have set a hearing before a judge, you must send notice of the hearing to the other party.
IMPORTANT: If your hearing has been set before a general magistrate, you should use Notice of Hearing
Before General Magistrate, Florida Family Law Rules of Procedure Form 12.920(c). If your hearing has
been set before a child support enforcement hearing officer, you should use Notice of Hearing (Child
Support Hearing Officer), Florida Supreme Court Approved Family Law Form 12.921.
This form should be typed or printed in black ink. After completing this form, you should file the original
with the clerk of the circuit court in the county where your case was filed and keep a copy for your records.
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?
A copy of this form must be mailed, e-mailed, or hand delivered to the other party in your case. If a
default has been entered, you must still send this form to the other party to notify the other party of the
final 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.
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.
Instructions for Florida Supreme Court Approved Family Law Form 12.923, Notice of Hearing
(General) (11/15)
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. For further information on serving notices of hearing, see rule 1.090(d), Florida
Civil Rules of Procedure.
Special notes...
To set a hearing date and time, you will usually have to make a good-faith effort to coordinate a mutually
convenient date and time for you, the other parties in the case, and the judge, except in certain emergency
situations. Some circuits may have additional procedural requirements that you must follow when you
notify the court and other parties of your scheduled hearing. Therefore, before you complete this form,
you should contact the clerk’s office, family law intake staff, or judicial assistant for information regarding
the proper procedure to follow.
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 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 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 12.923, Notice of Hearing (General) (11/15)
IN THE CIRCUIT COURT OF THE _______________________ JUDICIAL CIRCUIT,
IN AND FOR ________________________ COUNTY, FLORIDA
Case No.: ___________________________ ___
Division:
__________________________________________________________________________________ ________
__________________________________,
Petitioner,
and
__________________________________,
Respondent,
NOTICE OF HEARING (GENERAL)
[fill in all blanks]
TO: {name of other party}:
There will be a hearing before Judge {name} ,
on {date} _____ at {time} _____ m., in Room _____ of the __ ___
County Courthouse, on the following issues:
.
______ hour(s)/ _____ minutes have been reserved for this hearing.
This part is to be filled out by the court or to be filled in with information you obtained from the court:
If you are a person with a disability who needs any accommodation in order to participate in this
proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact:
{identify applicable court personnel by name, address, and telephone number} at least 7 days before
your scheduled court appearance, or immediately upon receiving this notification if the time before
the scheduled appearance is less than 7 days; if you are hearing or voice impaired, call 711.
If you are represented by an attorney or plan to retain an attorney for this matter, you should notify the
attorney of this hearing.
If this matter is resolved, the moving party shall contact the judge’s office to cancel this hearing.
Florida Supreme Court Approved Family Law Form 12.923, Notice of Hearing (General) (11/15)
I certify that a copy of this document was ( ) 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: _________________________________
Designated E-mail Address(es): __________________
____________________________________________
_______
Signature of Party
Printed Name: _________________________________
Address: ______________________________________
City, State, Zip: _________________________________
Fax Number: ___________________________________
Designated E-mail Address(es): ____________________
_____________________________________________
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 completed with the assistance of:
{name of individual} ____________________________________________________________________,
{name of business} _____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} ______________, {state} _____, {zip code} ___________, {telephone number} ________________
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
IN THE MATTER OF THE ADOPTION OF
________________________________________,
{use name to be given to child(ren)} Adoptee(s).
FINAL JUDGMENT OF STEPPARENT ADOPTION
Upon consideration of the Joint Petition for Adoption by Stepparent and the evidence presented, the
Court finds that:
1. The Court has subject matter jurisdiction over the Joint Petition for Adoption by Stepparent.
2. The Court has jurisdiction over the minor child(ren) subject to the Joint Petition for Adoption by
Stepparent.
3. Petitioner desires the permanent responsibility of a parent in this adoption.
4. There is no pending litigation regarding the child(ren) in Florida or in any other state, nor is
there any other person not a party to these proceedings who has or claims to have physical
custody or rights to the minor child(ren).
5. The consent of the birth _____mother _____ father who is not married to Petitioner is:
{Choose only one}
_____ Attached to the petition
_____ Not required because he or she is deceased. A certified copy of the death certificate is
attached.
_____ Waived because:
[Indicate all that apply]
_____ The parent has deserted the child without means of identification or has abandoned the
child.
_____ The parent’s rights have been terminated by a court of competent jurisdiction.
_____ The parent has been declared incompetent and restoration of competency is medically
improbable.
_____ The legal guardian or lawful custodian of the adoptee(s), other than the birth parent,
who has failed to respond in writing to a request for consent for a period of 60 days or
the Court has examined the written reasons for withholding consent and has found the
withholding of consent to be unreasonable.
_____ Other: ____________________________________________________________.
6. The best interests of the child(ren) will be promoted by this adoption.
Florida Supreme Court Approved Family Law Form 12.981(b)(2), Final Judgment of Stepparent Adoption
(03/15)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________
_____________________________________________
7. The minor child(ren) is (are) suitable for adoption by Petitioner.
NOW, THEREFORE, IT IS ORDERED that:
1. The minor child(ren) subject to the Petition is (are) declared to be the legal child(ren) of
Petitioner,_______________________________________________________ {name}
2. The minor child(ren) shall be the child(ren) and legal heir(s) at law of Petitioner,
_______________________________________________________________, {name}
and shall be entitled to all rights and privileges, and subject to all obligations, of
child(ren) born of Petitioner.
3. All legal relations between the adoptee(s) and the parent whose rights are being terminated and
between the adoptee(s) and the relatives of that parent are terminated by this adoption, as are
all parental rights and responsibilities of that birth parent.
4. This Final Judgment of Adoption creates a relationship between the adoptee(s) and Petitioner
and all relatives of Petitioner that would have existed if the adoptee(s) was (were) a blood
descendant of the Petitioner, born within wedlock, entitled to all rights and privileges thereof,
and subject to all obligations of a child being born to Petitioner.
5. The minor child(ren) shall hereafter be known as {full legal name(s)}:
DONE AND ORDERED at _____________________________, Florida on ___________________.
CIRCUIT JUDGE
I certify that a copy of {name of document(s)} ____________________________________________was
( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) hand-delivered to the parties and any persons
or entities listed below on {date} _________________________________.
By: Clerk of Court, Designee, or Judicial Assistant
Petitioners (or their attorney)
Other: ____________________________
Florida Supreme Court Approved Family Law Form 12.981(b)(2), Final Judgment of Stepparent Adoption
(03/15)
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.999
FINAL DISPOSITION FORM
(03/17)
When should this form be used?
This form is filed by the petitioner or respondent for the use of the clerk of the court for the purpose of
reporting judicial workload data under section 25.075, Florida Statutes. When your case is completed, the
petitioner or respondent must complete this form and file it with the clerk.
What should I do next?
This form must be typed or printed in black ink. After completing and signing this form, you should then file it
and keep a copy for your records.
A copy of this form must be e-mailed, mailed, or hand delivered to the other party(ies) in your case.
Instructions for completing this form
I. Case Style. Enter the name of the court, the case number assigned at the time of the filing of the
petition, counterpetition, or motion, the name of the judge assigned, and the names of the petitioner and
respondent.
II. Means of Final Disposition. Place an “x” on the appropriate line before the major category and the
appropriate subcategory, if applicable. The following are the definitions of the disposition categories.
A. Dismissed Before Hearing or Trial. The case is settled, voluntarily dismissed, or otherwise
disposed of before a hearing or trial is held.
B. Dismissed Under Settlement, Before Hearing or Trial. Before hearing or trial, the case is
voluntarily dismissed by the petitioner, respondent, or movant after a settlement.
C. Dismissal Under Mediated Settlement, Before Hearing or Trial. The case is voluntarily dismissed
by the petitioner or respondent after a settlement is reached with mediation before a hearing
or trial is held.
D. Other, Before Hearing or Trial. The case is dismissed before a hearing or trial in an action that
does not fall into one of the other disposition categories on this form.
E. Dismissal Before Hearing or Trial. The case is dismissed by a judge voluntarily after a hearing or
trial is held.
Instructions for Florida Family Law Rules of Procedure Form 12.999, Final Disposition Form (03/17)
F. Dismissed Under a Settlement, After Hearing or Trial. The case is voluntarily dismissed by the
petitioner, respondent, or movant after a settlement is reached without mediation after a
hearing or trial is held.
G. Dismissal Under a Mediated Settlement, After Hearing or Trial. The case is voluntarily dismissed
by the petitioner, respondent, or movant after a settlement is reached with mediation after a
hearing or trial.
H. Other, After Hearing or Trial. The case is dismissed after hearing in an action that does not fall
into the categories listed on this form.
I. Disposed by Default. A respondent chooses not to or fails to contest the petitioner’s allegations
and a judgment against the respondent 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 manner in which a judgment is entered,
excluding cases disposed of by default as in category I. above.
K. Disposed by Nonjury 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 the law in the case.
L. Disposed by Jury Trial. Any part of the case is disposed as a result of a jury trial (considered the
beginning of a jury trial to be when the jurors and alternates are selected and sworn).
M. Other. The case is consolidated, submitted to mediation or arbitration, transferred, or
otherwise disposed of by any other means not listed in categories (A) to (L).
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.
Instructions for Florida Family Law Rules of Procedure Form 12.999, Final Disposition Form (03/17)
FINAL DISPOSITION FORM
I. Case Style
{Name of Court} __________________________________
{Petitioner} {Case number}
{Judge} _________________________
{Respondent}
II. Means of Final Disposition
Place an “x” on the line for the major category and one subcategory, f applicable only.
Dismissed before hearing/trial
Dismissed pursuant to settlement, before hearing or trial
Dismissed under a mediated settlement before hearing or trial
Other, before hearing or trial
Dismissed after hearing or trial
_ Dismissed pursuant to a settlement, after hearing or trial
_ Dismissed pursuant to a mediated settlement, after hearing or trial
_ Other after hearing or trial
Disposed by default
Disposed by judge
Disposed by nonjury trial
Disposed by jury trial
Other {specify} .
Date: ________________________
Signature of Attorney or Party
Printed Name:
Address:
City, State, Zip:
Telephone Number:
E-mail address(es):
Fax number:
Florida Family Law Rules of Procedure Form 12.999, Final Disposition Form (03/17)
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 completed with the assistance of:
{name of individual} ____________________________________________________________________
{name of business} _____________________________________________________________________
{address} ,
{city} , {state} _________, {telephone number} .
Florida Family Law Rules of Procedure Form 12.999, Final Disposition Form (03/17)
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KEN BURKE, C.P.A. www.mypinellasclerk.org (Pinellas County Clerk of the Circuit Court and Comptroller)

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Completed 10 February 2021

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