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Petitioner, and Respondent. (Florida)

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Florida Supreme Court Approved Family Law Form 12.941(e), Order to Pick-Up Minor Child(ren) (03/15)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
ORDER TO PICK-UP MINOR CHILD(REN)
An Emergency Verified Motion for Child Pick-Up Order has been filed by ____ Petitioner
____ Respondent, alleging facts which under existing law are determined to be sufficient to authorize
taking into custody the minor child(ren) named below. Based on this motion, this Court makes the
following findings, notices, and conclusions:
JURISDICTION
This Court has jurisdiction over issues surrounding the minor child(ren) listed below based on the
following:
{Choose all that apply}
a. ____ This Court exercised and continues to exercise original jurisdiction over the minor children
listed below under the Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA),
specifically, section 61.514, Florida Statutes.
b. ____A certified out-of-state custody decree has been presented to this Court with a request for
full faith and credit recognition and enforcement under the Parental Kidnapping Prevention Act,
28 U.S.C. Section 1738A. This Court has jurisdiction to enforce this decree under the UCCJEA,
specifically sections 61.501-61.542, Florida Statutes.
c. ____ By operation of Florida law governing the custody of or time-sharing with child(ren) born
out of wedlock, this Court has jurisdiction over the child(ren) listed below because this (these)
child(ren) was (were) born in the State of Florida and no prior court action involving the minor
child(ren) has addressed a putative father’s rights to time-sharing or other parental rights. See
sections 742.031 and 744.301, Florida Statutes.
d. ____ Pursuant to the UCCJEA, specifically section 61.516, Florida Statutes, this Court has
jurisdiction to modify a custody decree of another state and has consulted with the Court which
took initial jurisdiction over the minor child(ren) to determine this authority.
e. ____ Other:
Florida Supreme Court Approved Family Law Form 12.941(e), Order to Pick-Up Minor Child(ren) (03/15)
NOTICE OF HEARING
Because this Order to Pick-Up Minor Child(ren) has been issued without prior notice to the non-movant
{name} ________________________________________________________ , all parties involved in
this matter are informed that they are scheduled to appear and testify at a hearing regarding this matter
on {date} , at {time} ,at which time the Court will consider
whether the Court should issue a further order in this case, and whether other things should be ordered,
including who should pay the filing fees and costs. The hearing will be before The Honorable {name}
___________________________________________ at {room name/number, location, address,
city}__________________________________________________________________________, Florida.
If a party does not appear, this order may be continued in force, extended, or dismissed, and/or
additional orders may be issued, including the imposition of court costs.
If you are a person with a disability who needs any accommodation in order
to participate in this proceeding, you are entitled, at no cost to you, to the
provision of certain assistance. Please contact:
__________________________________________________________________
{identify applicable court personnel by name, address, and telephone number}
at least 7 days before your scheduled court appearance, or immediately upon
receiving this notification if the time before the scheduled appearance is less
than 7 days; if you are hearing or voice impaired, call 711.
ORDER
This Court ORDERS AND DIRECTS any and all sheriffs of the State of Florida (or any other authorized law
enforcement officer in this state or in any other state) to immediately take into custody the minor
child(ren) identified below from anyone who has possession and:
1. ____ Place the minor child(ren) in the physical custody of {name} ________________
who ( ) may ( ) may not remove the minor child(ren) from the jurisdiction of this Court.
OR
____ Accompany the minor child(ren) to the undersigned judge, if the minor child(ren) is (are)
picked up during court hours, for immediate hearing on the issue of custody or time-sharing.
It is the intention of this Court that the nonmoving party, minor child(ren), and movant appear
immediately upon service of this order before the undersigned judge, if available, or duty judge
to conduct a hearing as to which party is entitled to lawful custody of the minor child(ren) at
issue. It is not the intention of the court to turn over the child(ren) to the movant on an ex parte
basis. Neither party should be permitted to remove the child(ren) from the jurisdiction of this
Court pending a hearing. If unable to accomplish the above, the sheriff/officer shall take the
child(ren) into custody and place them with the Department of Children and Family Services of
the State of Florida pending an expedited hearing herein.
OR
____ Place the minor child(ren) in the physical custody of {agency} _______________________
Florida Supreme Court Approved Family Law Form 12.941(e), Order to Pick-Up Minor Child(ren) (03/15)
who shall contact the undersigned judge for an expedited hearing. The sheriff/officer shall not
delay the execution of this court order for any reason or permit the situation to arise where the
nonmoving party is allowed to remove the child(ren) from the jurisdiction of this court.
2. NEITHER PARTY OR ANYONE AT THEIR DIRECTION, EXCEPT PURSUANT TO THIS ORDER, MAY
REMOVE THE CHILD(REN) FROM THE JURISDICTION OF THIS COURT PENDING FURTHER
HEARING. SHOULD THE NONMOVING PARTY IN ANY WAY VIOLATE THE MANDATES OF THIS
ORDER IN THE PRESENCE OF THE LAW ENFORCEMENT OFFICER, THIS OFFICER IS TO
IMMEDIATELY ARREST AND INCARCERATE THE OFFENDING PARTY UNTIL SUCH TIME AS THE
OFFENDING PARTY MAY BE BROUGHT BEFORE THIS COURT FOR FURTHER PROCEEDINGS.
All sheriffs of the State for Florida are authorized and ORDERED to serve (and/or execute) and enforce
this order in the daytime or in the nighttime and any day of the week, except as limited by this order
above.
Except as limited by the above, if necessary, the sheriff/officer is authorized to take all reasonable,
necessary, and appropriate measures to effectuate this order. The sheriff/officer shall not delay the
execution of this order for any reason or permit the situation to arise where the child(ren) is (are)
removed from the jurisdiction of this Court before execution of this order.
The minor child(ren) is (are) identified as follows:
Name Sex Birth date Race Physical Description
Current location/address of minor child(ren) or of party believed to have possession of the minor
child(ren):
DONE AND ORDERED on at _______________________, Florida {date} .
CIRCUIT JUDGE
Florida Supreme Court Approved Family Law Form 12.941(e), Order to Pick-Up Minor Child(ren) (03/15)
I certify that a copy of the {name of document(s)} ___________________________________________
was ( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) hand-delivered to the parties listed below on
{date}______________________________.
by _______________________________.
{clerk of the court or designee}
Petitioner (or his or her attorney)
Respondent (or his or her attorney)
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Petitioner, and Respondent. (Florida)

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Completed 10 January 2021

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