Fill - Free fillable KEN BURKE, C.P.A. www.mypinellasclerk.org (Pinellas County Clerk of the Circuit Court and Comptroller) PDF form

3DFNDJHF

3$&.$*()((

REQUEST FOR CHANGE OF NAME

FAMILY

3OHDVHFRQWDFWWKH&OHUN¶V2IILFHDWRUYLVLWXVRQOLQHDW

ZZZP\SLQHOODVFOHUNRUJIRUDGGLWLRQDOLQIRUPDWLRQ



KEN BURKE, C.P.A.

CLERK OF THE CIRCUIT COURT AND COMPTROLLER

PINELLAS COUNTY, FLORIDA

www.mypinellasclerk.org



REQUEST FOR CHANGE OF NAME

MINOR CHILD(REN)



),/,1*)((  



6800216,668$1&()(( SHUVXPPRQV



&23,(65(48,5('   2ULJLQDOVWRWKH&OHUN

 VHWRIFRSLHVIRUVHUYLFH

 VHWRIFRSLHVIRU\RXUUHFRUGV



$'',7,21$/&2676   SHU$FNQRZOHGJHPHQW

 ,I\RXGRQRWKDYH\RXUVLJQDWXUH

 QRWDUL]HGLQWKHUHTXLUHGVSDFHV

 EHIRUHILOLQJWKH'HSXW\&OHUN

FDQGRWKLVIRU\RX3OHDVH'2127

6,*1XQWLOD1RWDU\RU'HSXW\

&OHUNLQVWUXFWV\RXWRGRVR



6(59,&()((<RXPXVWFRQWDFWDSULYDWHSURFHVV

<RXPXVWSURYLGHDSUHDGGUHVVHG VHUYHURUSHUVRQVDOORZHGWRGR

VWDPSHGHQYHORSHWRPDLODOORI VHUYLFHLQWKHFRXQW\ZKHUHVHUYLFHLV

\RXULVVXHGVXPPRQVDQGRU  WREHGRQHWRREWDLQWKHLUVHUYLFHIHHV

FRSLHVIRUVHUYLFH,IDVXIILFLHQW <RXFDQJHWDOLVWRIORFDOSURFHVV

HQYHORSHDQGSRVWDJHLVQRW  VHUYHUVIURPWKHVKHULIIE\DFFHVVLQJD

SURYLGHG\RXUVXPPRQVZLOOQRW OLQNWKURXJKRXUZHEVLWHDW

EHUHWXUQHGRUPDLOHG   ZZZ0\3LQHOODV&OHUNRUJ





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

The 1HZ&RXUWKRXVH

3 &RXUW6WUHHW,5RRP

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 theClearwater 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

NAME CHANGE

(Effective 10/1/2009)



FINGERPRINT / STATE AND NATIONAL CRIMINAL HISTORY RECORDS CHECK REQUIREMENT

(IIHFWLYH 2FWREHU   6HFWLRQ  )ORULGD 6WDWXWHV ZDV FKDQJHG SHUWDLQLQJ WR QDPH FKDQJH

FDVHV WR UHTXLUH WKDW before a court conducts a hearing RQ D QDPH FKDQJH SHWLWLRQ WKH SHWLWLRQHU

DQGRUDQ\DGXOWFKDQJLQJWKHLUQDPHPXVWKDYHILQJHUSULQWVVXEPLWWHGIRUDVWDWHDQGQDWLRQDOFULPLQDO

KLVWRU\UHFRUGVFKHFNexceptLIDIRUPHUQDPHLVEHLQJUHVWRUHG,WDOVRSURYLGHVWKDW



x )LQJHUSULQWV RI WKH SHWLWLRQHUV DUH WR EH WDNHQ LQ D PDQQHU DSSURYHG E\ WKH

'HSDUWPHQW RI /DZ (QIRUFHPHQW DQG VKDOO EH VHQW electronically WR WKH

GHSDUWPHQWIRUVWDWHSURFHVVLQJIRUDFULPLQDOKLVWRU\UHFRUGVFKHFN

x 7KH GHSDUWPHQW VKDOO VXEPLW WKH ILQJHUSULQWV WR WKH )HGHUDO %XUHDX RI

,QYHVWLJDWLRQIRUQDWLRQDOSURFHVVLQJ

x 7KHGHSDUWPHQWVKDOOVXEPLWWKHUHVXOWVRIWKHVWDWHDQGQDWLRQDOUHFRUGVFKHFN

WRWKH&OHUNRIWKH&RXUW $WXUQDURXQGWLPHDIWHUVXEPLVVLRQLVHVWLPDWHG DW

KRXUVE\)'/(

x <RX PD\ YHULI\ UHFHLSW RI WKH 5HFRUGV &KHFN E\ JRLQJ WR

ZZZP\SLQHOODVFOHUNRUJ

 DQG FOLFN RQ 6($5&+ 5(&25'6 WR YLHZ &LYLO6PDOO

&ODLPVGRFNHWHQWULHVRQOLQH

x 2QFH WKLV LV OLVWHG RQ WKH GRFNHW WKH SHWLWLRQHU FDQ FRQWDFW WKH )DPLO\ /DZ

5HVRXUFH&HQWHUDWWRUHTXHVWDKHDULQJ

x 7KH&RXUWVKDOOFRQVLGHUWKHUHVXOWVLQUHYLHZLQJWKHLQIRUPDWLRQFRQWDLQHGLQWKH

SHWLWLRQDQGHYDOXDWLQJZKHWKHUWRJUDQWWKHSHWLWLRQ



7KH FRVWV RU IHHV IRU SURFHVVLQJ ILQJHUSULQWV DQG FRQGXFWLQJ WKH VWDWH DQG QDWLRQDO FULPLQDO KLVWRU\

UHFRUGV FKHFN IRU WKH QDPH FKDQJH IHH PXVW EH SDLG E\ WKH SHWLWLRQHU GLUHFWO\ WR WKH ILQJHUSULQWLQJ

DJHQF\



Pinellas Clerk 2ULJLQDWLQJ $JHQF\ ,GHQWLILFDWLRQ 1XPEHU ORI

must be provided to the electronic fingerprint provider7KLV

ZLOO LQVXUH WKDW )'/( UHWXUQV WKH UHSRUW WR WKH 3LQHOODV &OHUN¶V

2IILFH



Pinellas ORI # FL924030Z

ELECTRONIC LIVE SCAN FINGERPRINT PROVIDER IN PINELLAS COUNTY

Pinellas County Sheriff Technical Services

$),6'LYLVLRQ 

WK$YHQXH1RUWK

&OHDUZDWHU)/ 



0RQGD\)ULGD\$0WR30 



&RQWDFW3LQHOODV&OHUNRI&RXUWIRUDGGLWLRQDOSURYLGHUVRUDFFHVVZZZP\SLQHOODVFOHUNRUJ

ORRNIRU

1$0(&+$1*(XQGHU),1'$6(59,&(IRUDFRPSOHWHOLVWRI/LYH6FDQODZHQIRUFHPHQWDQGSULYDWH

SURYLGHUV

6L[WK-XGLFLDO&LUFXLW&RXUWV,QIRUPDWLRQ5HVRXUFH&HQWHU8SGDWHG RI

Administrative Office of the Courts

The Sixth Judicial Circuit of Florida

(727)582-7200

CASE PROGRESSION CHECKLIST

ORIGINAL PETITIONS (Except Dissolution of Marriage)

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. I

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.

I. INITIAL FILING:

A.

P

PETITION for (check one).

 Petition for Support Unconnected with Dissolution of Marriage With Dependent or Minor Child(ren)

Form 12.904(a).

 Petition for Support Unconnected With Dissolution of Marriage With No Dependent or Minor Child(ren)

Form 12.904(b).

 Petition to Determine Paternity and for Related Relief - Form 12.983(a).

 Petition for Change of Name (Adult)/Order - Form 12.982(a).

 Petition for Change of Name (Minor Child)/Order - Form 12.982(c).

 Petition for Change of Name (Family) - Form 12.982(f).

 Other local form original petition: __________________________________________________________

B. Required forms filed with initial petition:

 UCCJEA Affidavit - Form 12.902(d), is required in most matters involving children, including request for

the name change of a minor child. T

This form is not required if your petition only covers alimony.

 Child Support Guideline Worksheet – Form 12.902(e), if your original petition is for paternity, or support

unconnected with dissolution of marriage with children, the matter of child support is normally

addressed. (If you do not know the other party’s income, you may file this worksheet after his or her

financial affidavit has been served to you.). T

This form is not required if your original petition only covers

alimony, or name change.

 Financial Affidavit - Form 12.902(b) or 12.902(c) (according to your income-see instructions on form).

This form is not required if your petition only covers change of name, or grandparent visitation.

 Non-military Affidavit - Form 12.912(b). T

This form is required only for obtaining a default on petitions

that have been personally or construc

tively served, not required with any joint form.

 Corroborating Witness Affidavit - Form 12.902(i) or photocopy of Florida Drivers License, Florida

Identification Card, or Voters I.D. I

Issue date of copied document must be at least six months before

date case is filed with Clerk of Cou

rt.

 Summons: Personal Service on an Individual – Form 12.910(a). N

Not required if both parties have

signed and filed a joint petition, if the other party has signed a

consent, or in an adult name change

case.

6L[WK-XGLFLDO&LUFXLW&RXUWV,QIRUPDWLRQ5HVRXUFH&HQWHU8SGDWHGXSGDWHVE\&OHUN  RI

 Process Service Memorandum - Form 12.910(b). If filing for grandparent visitation, b

both

natural or

adopted parents must be individually personally served with the petition. This is true even if your son or

daughter resides with you.

Service is not required in the following situations:

a) if both parties have signed and filed a joint

petition.

b) when filing an Adult Name Change.

c) when filing a minor name change case if the other

parent has signed a consent.

Out of State 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. M

Most other states will not honor a Florida $SSOLFDWRQIRU,QGLJHQW6WDWXV.

OR:

 Consent for Change of Name (Minor Child(ren)) – Form 12.982(d). Signed by other parent and

notarized.

 

For Name Change Only.

Fingerprints are to be taken by a law enforcement agencyHOHFWURQLFDOO\.

C. Required fees.

 Filing fee paid or fee waiver (ASSOLFDWRQRI,QGLJHQW6WDWXV) granted by &OHUNCourt.

 Fees IRUVHUYLFHVKRXOGEHSDLGGLUHFWO\WRD3URFHVV6HUYHU

D. Required class

 Completion of approved Parent Education and Family Stabilization Course. N

Note:

If one party resides in

another Florida county or out of state, the party must receive court approval to take the class available

in their area of residence. T

This class is only required for parties filing an original paternity action, or, if

the court has spe

cifically ordered you to take this class.

If both parties have signed and filed a joint petition, or, if you are filing for an Adult Name Change,

you may skip Section II entitled, “Service of Process.” The remaining sections still apply.

E. Optional Forms.

 Motion for Referral to General Magistrate - Form 12.920(a) (A General Magistrate is an Attorney

appointed by the Chief Judge to take testimony and make recommendations to a judge. The primary

purpose of having a General Magistrate hear family law matters is to reduce the cost of litigation and

speed up cases.)

 Order of Referral to General Magistrate - Form 12.920(b).

II. SERVICE OF PROCESS:

A. Personal Service.

 Summons returned “served” and the Original Return of Service has been filed by Clerk in your court file. If

you are filing grandparent visitation you need this document on each parent.

6L[WK-XGLFLDO&LUFXLW&RXUWV,QIRUPDWLRQ5HVRXUFH&HQWHU8SGDWHG RI

 After 20 days have passed from the day Respondent was served, check to see whether Respondent(s)

filed an answer or a

any

paper within the 20 day period. If yes, you may check this item. (

(If both checked,

skip to Section IV; if no answer filed, go to “B”)

If your summons is returned to the clerk “NOT SERVED”

1. A

Alias summons:

Return to the Clerk of Court to request an A

Alias

(2

nd

attempt at service) or P

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 the other party

2.

. Con

structive Service

: is only to be used after you have completed an actual diligent search for the

other party and have been unable to locate them.

 Constructive service is also known as “service by publication.” You will need a “Notice of Action”

appropriate to your case. The supreme court forms do not contain a notice of action for any type of

action except divorce, you will need to locate the appropriate form in a law library or have the

assistance of an attorney to prepare the proper document. The document must be posted or

published for 32 days before you can proceed further with your case.

 Affidavit of Diligent Search and Inquiry 12.913(b).

Constructive service is not available for all procedures. If constructive service is used, the court may grant

only limited relief. In all cases it is best to have your petition person

ally served. Th

is is a complicated area

of the Law and you may wish to consult with an attorney before using constru

ctive service.

If proper service is not obtained, the court cannot hear your case.

B. Default.

 Respondent failed to answer or file any paper after service.

 Motion for Default filed with Clerk - Form 12.922(a) (no sooner than 25 days after date of service.) a

and

 Default entered by Clerk.

Note:

If the other party has filed a

anything in the case

the clerk will not be able

to process the default. This is also true if the other party is a member of the military service. If the clerk

is unable to process your default, you will need to file a motion for the “court to enter the default” send

a copy to the other party and set a hearing on your motion. If you are filing a grandparent visitation case

you will complete this section for each parent that didn’t respond in writing.

Only now is the case potentially ready for setting for trial/final hearing.

III. FINANCIAL DISCLOSURE:

If your petition involves financial issues such as property, child support or alimony, each party has a right to the

production of certain documents during the discovery phase of the case. See Fla. Fam. L. R. P. 12.285. (

(This

section does not apply to name change, grandparent visitation, or stepparent adoption cases.)

 Certificate of Compliance with Mandatory Disclosure - Form 12.932. The actual documents (tax returns,

pay stubs etc.) should not be filed in the court file. The documents should be provided to the other party

and this affidavit should be filed with the Clerk to notify the court that the listed documents have been

provided to the other party. You may be required to bring these documents with you to the hearing.

6L[WK-XGLFLDO&LUFXLW&RXUWV,QIRUPDWLRQ5HVRXUFH&HQWHU8SGDWHGRI

N

Note:

If the other party refuses to provide you with their financial information, a motion to compel can be

filed with the court requesting the court to order the other party to provide you their financial

information.

O

OR:

 Waiver of Mandatory Disclosure documents signed by both parties. This means that both parties agree

NOT to exchange these documents, however, the requirement to file financial affidavits cannot be

waived.

IV. SETTING A HEARING:

 After an answer is filed or a Default has been entered, contact the following office to set your hearing. If

the other party filed a counterpetition you are required to respond to their counterpetition. If the other

party filed a motion to dismiss your petition, a hearing must be set (by either party) to address the

motion to dismiss before you can set a final hearing. Pending motions may also prevent your final

hearing from being set as they must sometimes be addressed before a final hearing.

 Call the resource center at 727-582-7200 to request final hearing. Your court records will be viewed for

completeness and you will either be given a court calendar date or you will be given further instructions

for setting your final hearing.

Depending upon which Judge your case is assigned to, you may be required to prepare the Notice of

Hearing – please be sure that you have completed the c

certificate of service

section on the bottom of the

form. There is one notice of hearing in your package, if you need more they can be obtained from the

clerk of court for a fee or downloaded from

www.jud6.org

(Representing yourself in court section) for

free. You will need the free acrobat reader (available from www.adobe.com

) software installed on your

computer to access the forms on our web page.

Distribute as follows:

1) Original filed with Clerk’s Office

2) Copy to other party or their attorney (must be received 5 days prior

to the hearing

date).

3) Copy maint

ained fo

r your

use (option

a

l).

If you do

not p

roperly complete th

is step, your hearing cou

l

d be delayed.

NOTE:

IF

YOU

ARE INVOLVE

D IN

OTH

E

R

CAS

E

S,

SUCH

AS

AN

ACTIVE DEPENDENCY

CASE,

YOUR

CASE

COULD B

E

REFE

RRED

TO A UNIFIED FAMILY COURT JUDGE FOR HEARING. IF THIS IS YOUR SITUATION,

PROCEDURES FOR SETTING

A HEARING WILL BE SLIGHTLY DIFFERENT. PLEASE CONTACT THE

RESOURCE CENTER AT THE ABOVE PHONE NUMBER F

OR ASSISTANCE.

V. FINAL HEARING:

A. Make arrangements for child care if applicable. Children not allowed to attend without prior Ord

er, per Fla. Fam.

L. R. P. 12.403.

B. Bring to final hearing:



Stamped ($.60), pre-addressed legal size (9.5” business size) envelopes for each

party, one for each if before Judge, two for each if before General Master.

 Driver’s License, Florida Identification Card or Voter’s Identification card.

 C

Certified copies

of all previous court orders affecting children (custody, visitation, support, dependency),

or other matters in your case (Alimony, distribution of assets/liabilities) especially if those orders were

entered by a Court in another state or county.

6L[WK-XGLFLDO&LUFXLW&RXUWV,QIRUPDWLRQ5HVRXUFH&HQWHU8SGDWHG   RI

 Pay stubs (from past 3 months), certified copies of other support orders that you are required to pay,

documentation of assets and liabilities.

 Completed child support guideline worksheet, if your case includes custody or child support - Form

12.902(e).

 If your petition involves child support (or custody) then a “Memorandum to Clerk” will need to be

completed. Please bring address information for yourself and the other party to the hearing.

 Income Deduction Order and 2 copies, if case involves support.

 Final Disposition Form (obtain from Clerk).



Other possible documents you may need.

If one of the other parties in the case is deceased you may

need a certified death certificate

to prove that fact. If your petition in any way concerns real property

(such as a house or piece of land) you may need the legal description of that piece of property at your

hearing.

VI. AFTER THE FINAL HEARING:

When can I expect my final paperwork to arrive?

If your hearing was before a general magistrate and both parties

appeared. for the final hearing, you will be asked at the end of the hearing if you wish to waive the objection period. If

you both agreed to waive the objection period, the general magistrate’s office prepares the order and sends it directly to

the judge. If both parties did not appear, or one party does not waive their opportunity to file objections, then you will first

receive a copy of the magistrate’s findings and recommendations in the mail shortly after the hearing. After 15 days, if

there is no objection, the findings and recommended order will be forwarded to the judge’s office for signature.

How do I get the support taken out of the other party’s paycheck?

Unless the other party is self-employed, income

deduction orders are usually entered in cases where support has been ordered. If your hearing was before the general

magistrate, your order is not final until you receive the “order confirming findings and recommendations of general

magistrate” in the mail after your hearing. Once you have received this order, it is generally your responsibility to contact

the clerk of court to obtain a “certified” copy of your income deduction order. It is then your responsibility to mail the

certified income deduction order to the employer. It is suggested that you use certified mail so you have proof that it was

received by the employer. If the other party changes jobs frequently, you may need to follow this procedure every time

they change jobs. The income deduction order is not made out to a specific job, it should be accepted by any employer

(note: this should include employers in other states). The income deduction order makes the employer a party to the

case.

The FLSDU:

The State of Florida Disbursement Unit handles all income deducted support payments for the State of

Florida. Their toll free automated number is 877-769-0251.

"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., 5

th

Floor, 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

General Information for Self-Represented Litigants (09/13)

- 3 -

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,

General Information for Self-Represented Litigants (09/13)

- 4 -

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) ,

General Information for Self-Represented Litigants (09/13)

- 5 -

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.

General Information for Self-Represented Litigants (09/13)

- 6 -

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.

General Information for Self-Represented Litigants (09/13)

- 7 -

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.

General Information for Self-Represented Litigants (09/13)

- 8 -

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.

General Information for Self-Represented Litigants (09/13)

- 9 -

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).

General Information for Self-Represented Litigants (09/13)

- 10 -

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.

General Information for Self-Represented Litigants (09/13)

- 11 -

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.

General Information for Self-Represented Litigants (09/13)

- 12 -

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.

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 12.982(f), Petition for Change of Name (Family)

(02/18)

INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW

FORM 12.982(f)

PETITION FOR CHANGE OF NAME (FAMILY)

(02/18)

When should this form be used?

This form should be used when the parents are married and the family wants the court to change its

name. This form is not to be used in connection with a dissolution of marriage, paternity, or adoption

action. If you want a change of name because of a dissolution of marriage, paternity, or adoption action

that is not yet final, the change of name should be requested as part of that case.

This form should be typed or printed in black ink and must be signed before a notary public or deputy

clerk. You should file the original with the clerk of the circuit court in the county where you live and keep

a copy for your records. The petition should only be completed for one adult. If you wish to change the

name(s) of another adult and/or any child(ren), you should complete and file with the clerk of court the

attached Adult and Child Supplemental Form(s) for Petition for Change of Name (Family) for each

additional family member. Be sure that the bottom of each page of each supplemental form is initialed.

What should I do next?

Unless you are seeking to restore a former name, each adult petitioner must have fingerprints

submitted for a state and national criminal history records check. The fingerprints must be taken in a

manner approved by the Department of Law Enforcement and must be submitted to the Department for

a state and national criminal history records check. You may not request a hearing on the petition until

the clerk of court has received the results of your criminal history records check. The clerk of court can

instruct you on the process for having the fingerprints taken and submitted, including information on law

enforcement agencies or service providers authorized to submit finger prints electronically to the

Department of Law Enforcement. The process may take several weeks and you will have to pay for the

cost of processing the fingerprints and conducting the state and national criminal history records check.

Please note that the state and national criminal records check must indicate whether you have

registered as either a sexual predator or a sexual offender and you must also indicate on this petition

whether you have ever been required to register as a sexual predator under section 775.21, Florida

Statutes, or as a sexual offender under section 943.0435, Florida Statutes.

If any of the children for whom you are requesting this change of name are not the legal children of both

adults filing this petition, you must obtain the consent of the legal parent(s). A parent not named as a

petitioner in this action may consent by submitting a Consent for Change of Name (Minor Child(ren)),

Florida Supreme Court Approved Family Law Form 12.982(d).

If the other parent does not consent to the change of name, you may still have a hearing on the petition

if you have properly notified the other parent about your petition and the hearing. If you know where he

Instructions for Florida Supreme Court Approved Family Law Form 12.982(f), Petition for Change of Name (Family)

(02/18)

or she lives, you must use personal service. If you absolutely do not know where he or she lives, you may

use constructive service. 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). The law on constructive service is very complex

and you may wish to consult an attorney regarding constructive service.

Next, you must obtain a final hearing date for the court to consider your request. If you are seeking to

restore a former name, the final hearing on the petition MAY be held immediately after the petition is

filed. The final hearing on any other petition for a name change may be held immediately after the clerk

of court receives the results of your criminal history records check. You should ask the clerk of court,

family law intake staff, or judicial assistant about the local procedure for setting a hearing. You may be

required to attend the hearing. Included in these forms is a Final Judgment of Change of Name (Family),

Florida Supreme Court Approved Family Law Form 12.982(g), which may be used when a judge grants a

change of name for a family. If you attend the hearing, you should take the final judgment form with you.

You should complete the top part of this form, including the circuit, county, case number, division, the

name(s) of the petitioner(s) and leave the rest blank for the judge to complete. It should be typed or

printed in black ink.

If the judge grants your petition, he or she will sign this order. This officially changes your family’s name.

The clerk can provide you with certified copies of the signed order. There will be charges for the certified

copies, and the clerk can tell you the amount of the charges.

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 section 68.07, Florida Statutes.

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

Florida Supreme Court Approved Family Law Form 12.982(f), Form for Petition for Change of Name (Family)

(02/18)

10. Profession

[Choose one only]

____I am not in a profession.

____I am in a profession. My profession is: .

I have practiced this profession:

Dates (to/from) Place and address

___________________________________________________________________________

____________________________________________________________________________

_____________________________________________________________________________

(____ Please indicate here if you are continuing these facts on an attached page.)

11. Education

I have graduated from the following school(s):

Degree Date of

Received Graduation School

(____ Please indicate here if you are continuing these facts on an attached page.).

12. Criminal History

[Indicate all that apply]

_____ I have never been arrested for or charged with, pled guilty or nolo contendere to, or have

been found to have committed a criminal offense, regardless of adjudication.

_____ I have a criminal history. In the past I have been arrested for or charged with, pled guilty

or nolo contendere to, or been found to have committed a criminal offense, regardless of

adjudication. The details of my criminal history are:

Date City/State Event (arrest, charge, plea, or adjudication)

(_____ Please indicate here if you are continuing these facts on an attached page.)

I _____ have ____have not ever been required to register as a sexual predator under section

775.21, Florida Statutes.

I _____ have ______have not ever been required to register as a sexual offender under section

943.0435, Florida Statutes.

Florida Supreme Court Approved Family Law Form 12.982(f), Form for Petition for Change of Name (Family)

(02/18)

13. Bankruptcy

[Choose one only]

____ I have never been adjudicated bankrupt.

____ I was adjudicated bankrupt on {date} , in {city} ,

{county} , {state} .

(____ Please indicate here if you have had additional bankruptcies, and explain on an attached

page.)

14. Creditor’s Judgments

[Choose one only]

____I have never had a money judgment entered against me by a creditor.

____The following creditor(s)’ money judgment(s) have been entered against me:

Date Amount Creditor Court entering judgment and case number {date} if Paid

____

(____ Please indicate here if these facts are continued on an attached page.)

15. Fingerprints and Criminal History Records Check

Unless I am seeking to restore a former name, a copy of my fingerprints has been taken in a

manner approved by the Department of Law Enforcement and submitted for a state and national

criminal history records check. I understand that I cannot request a hearing on my Petition until

the Clerk of Court receives the results of the criminal history records check.

16. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner

invade the property rights of others, whether partnership, patent, goodwill, privacy, trademark,

or otherwise.

17. My civil rights have never been suspended, or, if my civil rights have been suspended, they

have been fully restored.

Florida Supreme Court Approved Family Law Form 12.982(f), Form for Petition for Change of Name (Family)

(02/18)

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 Petitioner

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(s).

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 12.982(f), Supplemental Form for Petition for Change of Name

(Family) (02/18)

ADULT SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (FAMILY) Case No.: ___________

THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER______________________________:

_____ PARENT _____ GUARDIAN

1. My complete present name is:

.

I request that my name be changed to:

.

2. I live in County, Florida, at {street address}

.

3. I was born on {date} , in {city} , {county} ,

{state} , {country} .

4. My parents’ full legal names are:

a. {full legal name} _________________________________ and.

b. {full legal name} .

c. {If applicable} My parents’ maiden name(s) is/are: _____________________ and

_________________________________________.

5. I have lived in the following places since birth:

Dates (to/from) Address

/

(____ Please indicate here if you are continuing these facts on an attached page.)

6. Family

[Indicate all that apply]

_____ I am not married.

_____I am married. My spouse’s full legal name is: .

_____ I do not have child(ren).

_____The name(s), age(s), and address(es) of my child(ren) are as follows (all children, including

those over 18, must be listed):

Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name

(Family) (02/18)

Name {last, first, middle initial} Age Address, City, State

(____ Please indicate here if you are continuing these facts on an attached page.)

7. Former Names

[Indicate all that apply]

____My name has never been changed by a court.

____My name previously was changed by court order from______________________________

to on {date}

by {court, city, and state} .

A copy of the court order is attached.

____My name previously was changed by marriage from _______________________________

to on {date}

in {city, county, and state} .

A copy of the marriage certificate is attached.

____I have never been known or called by any other name.

____I have been known or called by the following other name(s): {list name(s) and explain where

you were known or called by such name(s)} _____________________________________

8. Occupation

My occupation is: .

I am employed at: {company and address}

.

During the past 5 years, I have had the following jobs:

Dates (to/from) Employer and employer’s address

/

(____ Please indicate here if you are continuing these facts on an attached page.)

9. Business

[Indicate all that apply]

PETITIONER # , continued

Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name

(Family) (02/18)

____ I do not own and operate a business.

____ I own and operate a business. The name of the business is: .

The street address is: .

My position with the business is: .

I have been involved with the business since: {date} .

10. Profession

[Indicate all that apply]

____I am not in a profession.

____I am in a profession. My profession is: .

I have practiced this profession:

Dates (to/from) Place and address

/

(___ Please indicate here if you are continuing these facts on an attached page.)

11. Education

I have graduated from the following school(s):

Degree Date of

Received Graduation School

(___ Please indicate here if you are continuing these facts on an attached page.)

12. Criminal History

[Indicate all that apply]

____I have never been arrested for or charged with, pled guilty or nolo contendere to, or been

found to have committed a criminal offense, regardless of adjudication.

____I have a criminal history. In the past I have been arrested for or charged with, pled guilty or

nolo contendere to, or been found to have committed a criminal offense, regardless of

adjudication. The details of my criminal history are:

Date City/State Event (arrest, charge, plea, or adjudication)

(_____ Please indicate here if you are continuing these facts on an attached page.)

I _____ have ____have not ever been required to register as a sexual predator under section

775.21, Florida Statutes.

Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name

(Family) (02/18)

I _____ have ______have not ever been required to register as a sexual offender under section

943.0435, Florida Statutes.

13. Bankruptcy

[Choose one only]

____I have never been adjudicated bankrupt.

____I was adjudicated bankrupt on {date} , in {city} ,

{county} , {state} .

(___ Please indicate here if you have had additional bankruptcies, and explain on an attached

page.)

14. Creditor’s Judgments

[Choose one only]

____I have never had a money judgment entered against me by a creditor.

____The following creditor(s)’ money judgment(s) have been entered against me:

Date Amount Creditor Court entering judgment and case number {date} if

Paid

___

(____ Please indicate here if these facts are continued on an attached page.)

15. Unless I am seeking to restore a former name, a copy of my fingerprints has been taken in a

manner approved by the Department of Law Enforcement and submitted for a state and national

criminal history records check. I understand that I cannot request a hearing on my Petition until

the Clerk of Court receives the results of the criminal history records check.

16. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner

invade the property rights of others, whether partnership, patent, good will, privacy, trademark,

or otherwise.

17. My civil rights have never been suspended, or, if my civil rights have been suspended, they have

been fully restored.

Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name

(Family) (02/18)

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 Petitioner

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(s).

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 12.982(f), Supplemental Form for Petition for Change

of Name (Family) (02/18)

CHILD SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (FAMILY)

Case No.:

THE FOLLOWING INFORMATION IS TRUE ABOUT MINOR CHILD # :

1. The minor child’s complete present name is:

I/We request that minor child’s name be changed to:

2. The minor child lives in County, Florida, at {street address}

.

3. The minor child was born on , in {city, county, state, country}

.

4. The minor child’s parents’ full legal names are:

a. _______________________________________________________ and.

b. _______________________________________________________.

c. {If applicable} The minor child’s parents’ maiden name(s) is/are:_________

_______________and _____________________________.

5. The minor child has lived in the following places since birth:

Dates (to/from) Address

/

(____ Please indicate here if continuing these facts on an attached page.)

6. [Choose one only]

_____The minor child is not married

_____The minor child is married to: {full legal name} .

[Choose one only]

____The minor child has no children.

____The minor child is the parent of the following child(ren):

Name {last, first, middle initial} Date of Birth

_____________________________________________________________________

______________________________________________________________________

Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change

of Name (Family) (02/18)

__________________________________________________________________________

(______Please indicate here if you are continuing these facts on an attached page.)

7. Former Names

[Indicate all that apply]

_____The minor child’s name has never been changed by court order.

_____The minor child’s name previously was changed by court order from __________

to on {date} __________________

{court, city, and state} .

A copy of the court order is attached.

____ The minor child’s name previously was changed by marriage from ______________

to on {date} __________,

in {city, county, and state} .

A copy of the marriage certificate is attached.

____The minor child has never been known or called by any other name.

____ The minor child has been known or called by the following other name(s): {list

name(s) and explain where child was known or called by such name(s)} _________

____________________________________________________________________

____________________________________________________________________.

8. The minor child is not employed in an occupation or profession, does not own and

operate a business, and has received no educational degrees. If the minor child has a job,

explain: _________________________________________________________________

________________________________________________________________________

9. Criminal History

[Indicate all that apply]

____ The minor child has never been arrested for or charged with, pled guilty or nolo

contendere to, or been found to have committed a criminal offense, regardless of

adjudication.

____ The minor child has a criminal history. In the past, the minor child was arrested for

or charged with, pled guilty or nolo contendere to, or been found to have committed

a criminal offense, regardless of adjudication. The details of the criminal history are:

Date City/State Event (arrest, charge, plea, or adjudication)

(_____ Please indicate here if you are continuing these facts on an attached page.)

_____ The minor child _____ has _____has not ever been required to register as a sexual

predator under section 775.21, Florida Statutes.

_____ The minor child _____has _____has not ever been required to register as a sexual

Instructions for Florida Supreme Court Approved Family Law Form 12.982(d), Consent for Change of Name (Minor

Child(ren))(02/18)

INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW

FORM 12.982(d),

CONSENT FOR CHANGE OF NAME (MINOR CHILD(REN))

(02/18)

When should this form be used?

This form should be used when one parent consents to the other parent’s petition to change the name of

their minor child(ren). A parent who is not a petitioner in the case but is consenting to the change of

name should complete this form and sign it in front of a notary public or deputy clerk.

This form should be typed or printed in black ink. After this form is signed and notarized, you should file

it with the clerk of the circuit court in the county where the petition was filed and keep a copy for your

records. This form should be attached to the Petition for Change of Name (Minor Child(ren)), Florida

Supreme Court Approved Family Law Form 12.982(c), if obtained prior to the filing of the petition.

Otherwise, it may be filed separately after it has been completed.

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. For further information see section 68.07, Florida Statutes, and the instructions

for Petition for Change of Name (Minor Child(ren)), Florida Supreme Court Approved Family Law Form

12.982(c), or Petition for Change of Name (Family), Florida Supreme Court Approved Family Law Form

12.982(f).

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 12.982(d), Consent for Change of Name (Minor Child(ren))

(02/18)

IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,

IN AND FOR COUNTY, FLORIDA

Case No.:

Division:

IN RE: THE NAME CHANGE OF

___________________,

Petitioner.

CONSENT FOR CHANGE OF NAME (MINOR CHILD(REN))

I, {full legal name} , being sworn, certify that the

following information is true:

I am the birth or legal parent of the minor child(ren) named in this case, and I give consent for the following

name changes:

Minor child(ren)’s complete present name(s):

(1)

(2)

(3)

(4)

(5)

(6)

Minor child(ren)’s name(s) to be changed to:

(1)

(2)

(3)

(4)

(5)

(6)

Florida Supreme Court Approved Family Law Form 12.982(d), Consent for Change of Name (Minor Child(ren))

(02/18)

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 Consenting Parent

Printed Name:

Address:

City, State, Zip:

Telephone Number:

Fax Number:

Designated E-mail Address(es): ____________________

_____________________________________________

STATE OF FLORIDA

COUNTY OF

Sworn to or affirmed and signed before me on by .

NOTARY PUBLIC or DEPUTY CLERK

{Print, type, or stamp commissioned name of notary or

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 one} _____ Petitioner _____Consenting Parent

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 Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an

Individual (09/12)

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM

12.910(a), SUMMONS: PERSONAL SERVICE ON AN INDIVIDUAL (09/12)

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 e-mail, 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

x directly to the other party, or

x 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

Instructions for Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an

Individual (09/12)

only limited jurisdiction over a party who is served by constructive service and may have only limited

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 rule 1.070, Florida Rules of Civil Procedure, 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

Instructions for Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an

Individual (09/12)

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.

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 (09/12)

IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT,

IN AND FOR PINELLAS 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 e-mail address(es) for service or is represented by an

attorney, you may designate e-mail 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.

Florida Family Law Rules of Procedure Form 12.910(a), Summons: Personal Service on an Individual (09/12)

You must keep the Clerk of the Circuit Court’s office notified of your current address. (You may file

Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form

12.915.) Future papers in this lawsuit will be served at 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 E-mail

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

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.