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Petitioner, and Respondent. (Florida)

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__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
IN THE CIRCUIT COURT OF THE ________________________JUDICIAL CIRCUIT
IN AND FOR COUNTY, _______________________FLORIDA
Case No.:
Division:
_________________________________,
Petitioner,
and
_________________________________,
Respondent.
SUPPLEMENTAL FINAL JUDGMENT MODIFYING PARENTAL
RESPONSIBILITY, VISITATION, OR PARENTING
PLAN/TIME-SHARING SCHEDULE AND OTHER RELIEF
This cause came before this Court on a Supplemental Petition to Modify Parental Responsibility, Visitation,
or Parenting Plan/Time-Sharing Schedule and Other Relief. The Court, having reviewed the file, having
heard the testimony, and being otherwise fully advised, makes these findings of fact and reaches these
conclusions of law:
SECTION I. FINDINGS
1. The Court has jurisdiction over the subject matter and the parties.
2. The last order establishing or modifying parental responsibility, visitation, a Parenting Plan, or time-
sharing was entered on {date} ________________________.
3. There has been a substantial change in circumstances of the parties since the entry of the last order,
specifically: ________________________________________________________________________
_________________________________________________________________________________.
4. It is in the best interests of the minor child(ren) that the current parental responsibility, visitation,
time-sharing schedule or Parenting Plan be changed because:________________________________
_________________________________________________________________________________.
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment Modifying Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief (02/18)
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
SECTION II. PARENTING PLAN ESTABLISHING PARENTAL RESPONSIBILITY AND TIME-SHARING WITH
DEPENDENT OR MINOR CHILD(REN)
1. Jurisdiction. The Court has jurisdiction to determine parental responsibility, to establish or approve
a Parenting Plan, and time-sharing with regard to the parties’ minor child(ren) listed in paragraph 2
below.
2. The parties’ dependent or minor child(ren) is (are):
Name Birth date
3. Parenting Plan. The parties shall comply with the Parenting Plan which is attached and
incorporated herein as Exhibit ______.
SECTION III. CHILD SUPPORT
1. Modification of Child Support.
{Choose one only}
a. ______The modification of parental responsibility or time-sharing entered above does not
necessitate a modification of child support. The previous order or final judgment establishing or
modifying child support shall remain in effect.
OR
b. ______The Court finds that there is a need for modification of child support and that the
______ Petitioner ______ Respondent, (hereinafter Obligor), has the present ability to pay child
support. The amounts in the Child Support Guidelines Worksheet, Florida Family Law Rules of
Procedure Form 12.902(e), filed by the ______ Petitioner ______ Respondent are correct OR
the Court makes the following findings:
Petitioner’s net monthly income is $_____________, (Child Support Guidelines _____%).
Respondent’s net monthly income is $_____________, (Child Support Guidelines _____%).
Monthly child care costs are $_______________.
Monthly health/dental insurance costs are $_____________.
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment Modifying Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief (02/18)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
2. Amount.
Child support established at the rate of $_____________ per month for the _______children {total
number of parties’ minor or dependent children} shall be paid commencing ____________________
{month, day, year} and terminating _________________________________ {month, day, year}.
Child support shall be paid in the amount of $___________per ____________ {week, month, other}
which is consistent with the Obligor’s current payroll cycle.
Upon the termination of the obligation of child support for one of the parties’ children, child support
in the amount of $_____________for the remaining _______ children {total number of remaining
children} shall be paid commencing___________________________________ {month, day, year}
and terminating_________________________________ {month, day, year}. This child support shall
be paid in the amount of $____________ per ____________ {week, month, other} consistent with
the Obligor’s current payroll cycle.
{Insert schedule for the child support obligation, including the amount, and commencement and
termination dates, for the remaining minor or dependent children, which shall be payable as the
obligation for each child ceases. Please indicate whether the schedule ______appears below or
_____ is attached as part of this form.}
______________________________________________________________________________.
The Obligor shall pay child support until all of the minor or dependent child(ren): reach the age of
18; become emancipated, marry, join the armed services, die, or become self-supporting; or until
further order of the court or agreement of the parties. The child support obligation shall continue
beyond the age of 18 and until high school graduation for any child who is dependent in fact,
between the ages of 18 and 19, and is still in high school, performing in good faith with a reasonable
expectation of graduation before the age of 19.
If the child support ordered deviates from the guidelines by more than 5%, the factual findings
which support that deviation are: ______________________________________________________
3. Retroactive Child Support and/or Arrearages.
{Choose one only}
a. _____There is no child support arrearage at the time of this Supplemental Final Judgment.
OR
b. _____The _____ Petitioner _____ Respondent shall pay to the other party child support in the
amount of:
$_____________ for retroactive child support, as of {date}_________________________________.
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment Modifying Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief (02/18)
___________________________________________________________________________
__________________________________________________________________________________
4.
5.
6.
7.
$_____________ for previously ordered unpaid child support, as of {date}_____________________.
The total of $_______________ in retroactive child support and arrearages shall be paid in the
amount of $_______________, per month payable ______ in accordance with Obligor’s employer’s
payroll cycle, and in any event at least once a month _____ other {explain}
___________________beginning {date} _____________________________ until paid in full including
statutory interest.
Insurance.
[Indicate all that apply]
a. ______Health/Dental Insurance. _____ Petitioner _____ Respondent shall be required to
maintain _____health and/or _____ dental insurance for the parties’ minor child(ren), so long as
reasonable in cost and accessible to the child(ren) . The party providing insurance shall be
required to convey insurance cards demonstrating said coverage to the other party;
OR
______ health and/or ______ dental insurance is not reasonable in cost or accessible to the
child(ren) at this time.
b. _____Reasonable and necessary uninsured medical/dental/prescription drug costs for the
minor child(ren) shall be assessed as follows:
_____ Shared equally by both parents.
_____ Prorated according to the child support guideline percentages.
_____ Other {explain}: ___________________________________________________________
As to these uninsured medical/dental/prescription drug expenses, the party who incurs the
expense shall submit a request for reimbursement to the other party within 30 days, and the
other party, within 30 days of receipt, shall submit the applicable reimbursement for that
expense, according to the schedule of reimbursement set out in this paragraph.
______Life Insurance (to secure payment of support). To secure the child support obligations in this
judgment, ______ Petitioner ______ Respondent ______Each parent shall maintain life insurance,
in an amount of at least $ ________, on his/her life naming the _____ minor child(ren) as
the beneficiary(ies) OR naming _____ Petitioner _____ Respondent or _____ other
{name}_________________________ as Trustee for the minor child(ren), so long as reasonably
available. The obligation to maintain the life insurance shall continue until the youngest child turns
18, becomes emancipated, marries, joins the armed services, dies, or becomes self-supporting.
______IRS Income Tax Exemption(s). The assignment of any tax exemption(s) for the child(ren) shall
be as follows: ______________________________________________________________________
_________________________________________________________________________________.
Further, each party shall execute any and all IRS forms necessary to effectuate the provisions of this
paragraph.
Other provisions relating to child support: ______________________________________________
_________________________________________________________________________________.
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment Modifying Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief (02/18)
______________________________________________________________________________
SECTION IV. METHOD OF PAYMENT
Obligor shall pay court-ordered child support and arrears, if any, as follows:
1. Place of Payment.
a. _____Obligor shall pay court-ordered support directly to either the State Disbursement Unit or
the central depository, as required by statute, along with any fee required by statute.
b. _____Both parties have requested and the court finds that it is in the best interests of the
child(ren) that support payments need not be directed through either the State Disbursement
Unit or the central depository at this time; however, either party may subsequently apply,
pursuant to section 61.13(1)(d)3, Florida Statutes, to require payments through either the State
Disbursement Unit or the central depository.
2. Income Deduction.
a. ______Immediate. Obligor shall pay through income deduction, pursuant to a separate Income
Deduction Order which shall be effective immediately. Obligor is individually responsible for
paying this support obligation until all of said support is deducted from Obligor
’s income. Until
support payments are deducted from Obligor
’s paycheck, Obligor is responsible for making
timely payments directly to the State Disbursement Unit or the Obligee, as previously set forth
in this order.
b. ______Deferred. Income deduction is ordered this day, but it shall not be effective until a
delinquency of $____________, or, if not specified, an amount equal to one month’s obligation
occurs. Income deduction is not being implemented immediately based on the following
findings: Income deduction is not in the best interests of the child(ren) because: {explain}
______________________________________________________________________________,
AND
There is proof of timely payment of a previously ordered obligation without an income
deduction order,
AND
_____ There is an agreement by the Obligor to advise the Title IV-D agency, the clerk of court,
and the Obligee of any change in Payor and/or health insurance OR
_____ there is a signed written agreement providing an alternative arrangement between
the Obligor and the Obligee and, at the option of the IV-D agency, by the IV-D agency in IV-D
cases in which there is an assignment of support rights to the state, reviewed and entered in the
record by the court.
3. Bonus/one-time payments. _____All _________% _____No income paid in the form of a bonus or
other similar one-time payment, up to the amount of any arrearage or the remaining balance
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment Modifying Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief (02/18)
__________________________________________________________________________________
________________________________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_____________________________________________
thereof owed pursuant to this order, shall be forwarded to the Obligee pursuant to the payment
method prescribed above.
4. Other provisions relating to method of payment. ________________________________________
_________________________________________________________________________________.
SECTION V. ATTORNEY’S FEES, COSTS, AND SUIT MONEY
1. _____ Petitioner’s _____ Respondent’s request(s) for attorney’s fees, costs, and suit money is (are)
denied because
_________________________________________________________________________________.
OR
2. _____The Court finds there is a need for and an ability to pay attorney’s fees, costs, and suit money.
_____ Petitioner _____ Respondent is hereby ordered to pay to the other party $____________ in
attorney’s fees, and $____________ in costs. The Court further finds that the attorney’s fees
awarded are based on the reasonable rate of $____________ per hour and ____________
reasonable hours. Other provisions relating to attorney’s fees, costs, and suit money are as follows:
_________________________________________________________________________________.
SECTION VI. OTHER
1. Other Provisions. ___________________________________________________________________
_________________________________________________________________________________.
2. The Court reserves jurisdiction to modify and enforce this Supplemental Final Judgment.
3. Unless specifically modified by this Supplemental Final Judgment, the provisions of all final
judgments or orders in effect remain the same.
DONE AND ORDERED at __________________________, Florida, on _____________________.
CIRCUIT JUDGE
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment Modifying Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief (02/18)
I certify that a copy of this Supplemental Final Judgment Modifying Parental Responsibility, Visitation, or
Parenting Plan/Time-Sharing Schedule was: _____ mailed _____ faxed and mailed _____ e-mailed
_____ hand-delivered to the parties and any entities listed below on
{date}____________________________.
by____________________________________
{Clerk of court or
designee}
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment Modifying Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief (02/18)
_____Petitioner (or his or her attorney)
_____Respondent (or his or her attorney)
_____Central Depository
_____State Disbursement Unit
Other: ________________________
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Completed 25 March 2021

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