Supreme Court of Florida.
Robyn L. Vines, Chair, Family Law Rules Committee, Fort Lauderdale, FL, Raymond T. McNeal, Past Chair, Family Law Rules Committee, Ocala, FL, and John F. Harkness, Jr., Executive Director, The Florida Bar, Tallahassee, FL, for Petitioner.
Thomas J. Mato, Chief Counsel, Florida Department of Revenue Child Support Enforcement Program, Tallahassee, FL, Responding with comments.
PER CURIAM.
We have for consideration the regular-cycle report of proposed rule amendments filed by the Florida Bar's Family Law Rules Committee. We have jurisdiction. See art. V, § 2(a), Fla. Const.
The Family Law Rules Committee submitted its regular-cycle report recommending various amendments to the Florida Family Law Rules of Procedure and family law forms. The committee proposed amendments to rules 12.015, Family Law Forms; 12.040, Attorneys; 12.310, Depositions Upon Oral Examination; 12.400, Confidentiality of Records and Proceedings; 12.410, Subpoena; 12.490, General Magistrates; 12.610, Injunctions for Domestic, Repeat, Dating, and Sexual Violence; 12.650, Override of Family Violence *408 Indicator; and 12.750, Family Self-Help Programs. The committee also proposes new forms 12.900(g), Agreement Limiting Representation, and 12.900(h), Notice of Related Cases, as well as amendments to forms 12.930(c), Standard Family Law Interrogatories for Modification Proceedings, 12.982(c), Petition for Change of Name (Minor Children), and 12.982(f), Petition for Change of Name (Family). The proposals were published for comment in The Florida Bar News on March 1, 2008. The Florida Department of Revenue filed a comment with regard to the proposed amendment to rule 12.040 and proposed new form 12.900(h) and a request for oral argument. Oral argument was heard in this matter on June 10, 2008.
After consideration of the committee's report, the comments filed, and the parties' presentations at oral argument, we adopt the amendments to the Florida Family Law Rules as proposed by the committee with one exception. In 2003, the Court adopted Florida Family Law Rule 12.040, Attorneys, in Amendments to the Rules Regulating the Florida Bar & the Family Law Rules of Procedure (Unbundled Legal Services), 860 So. 2d 394 (Fla.2003). The main purpose of rule 12.040 is to provide the appropriate procedure to allow a litigant in a family law case to retain an attorney for limited representation. The rule requires an attorney who is providing such representation to file a notice of limited appearance, the purpose of which is to provide notice to the court and to opposing parties of the limited scope of the attorney's representation of the litigant. After adopting the rule, the Court requested that the committee clarify whether the rule applied to attorneys for the Department of Revenue. In its report in this case, the committee responded that it intended that the rule apply to attorneys for the Department when the Department is involved in Title IV-D proceedings to determine paternity or establish, enforce, or modify an obligation of support or whenever the Department intervenes in a non-IV-D proceeding. In addition, the committee proposed adding new subdivision (c)(2) to the rule to provide:
(2) An attorney for the IV-D child support enforcement agency who appears in a family law matter governed by these rules, whether in an initial proceeding or in any subsequent modification or enforcement action in the proceeding, shall file a notice [of limited appearance] in compliance with subdivisions (c)(1) and (e) which shall also state: whether the recipient of IV-D services is a party to the case; any limits on the legal services being performed for the recipient of IV-D services; any limits on the issues that may be addressed by the attorney during the proceeding.
The Department of Revenue filed a comment objecting to this proposed amendment. While the Department does not object to the committee's determination that rule 12.040 applies to its attorneys under the stated circumstances, the Department's position is that the attorney represents only the IV-D agency and not the recipient of the IV-D services and thus, the notice of limited representation filed by the attorney should clarify the attorney's representation of the IV-D agency only and the limited issues the attorney is authorized to address in representing the IV-D agency as a party in the proceeding. In light of its position, the Department has proposed alternative language for new subdivision (c)(2) as follows:
An attorney for the State's Title IV-D child support enforcement agency who appears in a family law matter governed by these rules shall file a notice informing the recipient of Title IV-D *409 services and other parties to the case that the IV-D attorney represents only the Title IV-D agency and not the recipient of IV-D services. The notice must state that the IV-D attorney may only address issues concerning determination of paternity, and establishment, modification, and enforcement of support obligations. The notice may be incorporated into a pleading, motion, or other paper filed with the court when the attorney first appears.
We adopt this alternative language as proposed by the Department of Revenue.
As noted, other amendments to the Family Law Rules are adopted as proposed by the committee. A committee note is added to rules 12.310, Depositions Upon Oral Examination, and 12.410, Subpoena, to draw attention to the requirements of rule 12.407, Testimony and Attendance of Minor Child, which requires court approval before a child is deposed or is subpoenaed to appear at a hearing. Subdivision (f) of rule 12.490, General Magistrates, is amended to clarify that exceptions to a general magistrate's report should be "filed" within 10 days of service of the report. Similarly, subdivision (g) of rule 12.492, Special Magistrates, is amended to clarify that exceptions to a special magistrate's report must be "filed" within ten days of service of the report, and that cross-exceptions be filed within five days of the "filing" of the exceptions.
Along with the rule amendments discussed above, two new forms are adopted, forms 12.900(g), Agreement Limiting Representation, and 12.900(h), Notice of Related Cases. Form 12.900(g) is a retainer agreement for unbundled legal services and is intended to be used as a "rider" or supplemental agreement, in addition to a standard attorney-client fee agreement. New form 12.900(h) is for use in complying with Florida Rule of Judicial Administration 2.545(d), which requires the petitioner in a family law case to file with the court a notice of related cases.[1]
Several existing forms are also amended. Item 4.d.(4) of form 12.903(c), Standard Family Law Interrogatories for Modification Proceedings, is amended to request the "present" value of the party's interest in a pension. The instructions to and the introductory portion of form 12.982(c), Petition for Change of Name (Minor Children), are amended to require that the petitioner's, not the child's, fingerprints be attached to the petition. Similarly, the instructions to and the introductory portion of form 12.982(f), Petition for Change of Name (Family), are amended to require that each adult family member's fingerprints be attached to the petition.[2]
The Florida Family Law Rules of Procedure are hereby amended as set forth in the appendix to this opinion. New language is indicated by underscoring; deletions are indicated by struck-through type. The committee notes are offered for explanation only and are not adopted as an official part of the rules. The amended *410 family law forms are set forth fully engrossed and ready for use. The amendments shall become effective January 1, 2009, at 12:01 a.m.
It is so ordered.
QUINCE, C.J., and WELLS, ANSTEAD, PARIENTE, and LEWIS, JJ., concur.
QUINCE, C.J., specially concurs with an opinion.
CANADY and POLSTON, JJ., did not participate.
QUINCE, C.J., specially concurring.
While I agree with the majority concerning the adoption of the changes to the rules and the forms, I write to urge the Legislature to clear up the ambiguity in section 68.07, Florida Statutes (2007), concerning petitions for change of name. Subsection (2) of the statute requires a set of the petitioner's fingerprints. In the case of a change of name for a minor child, the petitioner is one or both of the child's parents. Thus, the statute is being interpreted to require a set of the fingerprints of the parent or parents.
However, it seems that the intent of the statute is to require the fingerprints of the person whose name will be changed. Such intent is understandable because it is a way to track and identify in the future the person who has changed her or his name. However, if the fingerprints of the parents are given in a petition to change the name of a minor child, the intent is undermined because one would not be able to track and identify the person whose name was actually changed. Thus, I believe the statute should clearly indicate that the child's fingerprints must be attached to the petition when the change of name is sought for a child.
(a) Forms Adopted as Rules. The forms listed in this rule shall be adopted by the rulemaking process in Fla. R. Jud. Admin. 2.1302.140. The Family Law Rules Committee of The Florida Bar shall propose amendments to these forms and any associated instructions. These forms shall be designated "Florida Family Law Rules of Procedure Forms." Forms coming under this provision are:
(1) 12.900(a), Disclosure From Nonlawyer;
(2) 12.900(b), Notice of Limited Appearance;
(3) 12.900(c), Consent to Limited Appearance by Attorney;
(4) 12.900(d), Termination of Limited Appearance;
(5) 12.900(e), Acknowledgment of Assistance by Attorney;
(6) 12.900(f), Signature Block for Attorney Making Limited Appearance;
(7) 12.900(g), Agreement Limiting Representation;
(8) 12.900(h), Notice of Related Cases;
(79) 12.901(a), Petition for Simplified Dissolution of Marriage;
(810) 12.902(b), Family Law Financial Affidavit (Short Form);
(911) 12.902(c), Family Law Financial Affidavit;
(1012) 12.902(e), Child Support Guidelines Worksheet;
(1113) 12.902(f)(3), Marital Settlement Agreement for Simplified Dissolution of Marriage;
(1214) 12.910(a), Summons: Personal Service on an Individual;
*411 (1315) 12.913(b), Affidavit of Diligent Search and Inquiry;
(16) 12.913(c), Affidavit of Diligent Search;
(1417) 12.920(a), Motion for Referral to General Magistrate;
(1518) 12.920(b), Order of Referral to General Magistrate;
(1619) 12.920(c), Notice of Hearing Before General Magistrate;
(1720) 12.930(a), Notice of Service of Standard Family Law Interrogatories;
(1821) 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings;
(1922) 12.930(c), Standard Family Law Interrogatories for Modification Proceedings;
(2023) 12.932, Certificate of Compliance with Mandatory Disclosure; and
(2124) 12.990(a), Final Judgment of Simplified Dissolution of Marriage.
(b) Other Family Law Forms. All additional Supreme Court approved forms shall be adopted by opinion of the Supreme Court of Florida and outside of the rulemaking procedures required by rule 2.1302.140. These forms shall be designated "Florida Supreme Court Approved Family Law Forms."
2000 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 simplified forms and directions to the Florida Family Law Rules of Procedure when adopting the rules in 1995. These forms initially had been adopted by the Court in In re Family Law Rules of Procedure, 663 So. 2d 1049 (Fla.1995); In re Petition for Approval of Forms Pursuant to Rule 10-1.1(b) of the Rules Regulating the Florida BarStepparent Adoption Forms, 613 So. 2d 900 (Fla. 1992), and Rules Regulating The Florida BarApproval of Forms, 581 So. 2d 902 (Fla.1991).
In 1997, in an effort to fulfill the spirit of the Court's directives to simplify the process of litigation in family law matters, the Family Court Steering Committee completely revised the existing forms and added new forms and instructions. The rules and forms then constituted more than 500 pages.
This rule was adopted in recognition that the forms would require continuous updating and that the rulemaking process was too cumbersome for such an undertaking.
(a)-(b) [No Change]
(c) Scope of Representation.
(1) If an attorney appears of record for a particular limited proceeding or matter, as provided by this rule, that attorney shall be deemed "of record" for only that particular proceeding or matter. Any notice of limited appearance filed shall include the name, address, and telephone number of the attorney and the name, address, and telephone number of the party. At the conclusion of such proceeding or matter, the attorney's role terminates without the necessity of leave of court, upon the attorney filing a notice of completion of limited appearance. The notice, which shall be titled "Termination of Limited Appearance," shall include the names and last known addresses of the person(s) represented by the withdrawing attorney.
(2) An attorney for the State's Title IV-D child support enforcement agency who appears in a family law matter governed by these rules shall file a notice informing the recipient of Title IV-D services and other parties to the case that the *412 IV-D attorney represents only the Title IV-D agency and not the recipient of IV-D services. The notice must state that the IV-D attorney may only address issues concerning determination of paternity, and establishment, modification, and enforcement of support obligations. The notice may be incorporated into a pleading, motion, or other paper filed with the court when the attorney first appears.
(d) Preparation of Pleadings or Other Documents. A party who files a pleading or other document of record pro se with the assistance of an attorney shall certify that the party has received assistance from an attorney in the preparation of the pleading or other document. The name, address, and telephone number of the party shall appear on all pleadings or other documents filed with the court.
(e)-(f) [No Change]
[No Change]
2008 Amendment. The provisions of Fla. R. Civ. P. 1.310(b)(8) do not alter the requirements of Rule 12.407 that a court order must be obtained before deposing a minor child.
(a) Closure of Proceedings or Records. Closure of court proceedings or sealing of records may be ordered by the court only as provided by Florida Rule of Judicial Administration 2.0512.420.
(b) [No Change]
(c) Conditional Sealing of Financial Information.
(1) [No Change]
(2) Notice of conditional sealing shall be as required by Florida Rule of Judicial Administration 2.051(c)(9)(D)2.420(d).
(3) [No Change]
[No Change]
[No Change]
2008 Amendment. The provisions of Fla. R. Civ. P. 1.410(h) do not alter the requirements of Rule 12.407 that a court order must be obtained before a minor child may be subpoenaed to appear at a hearing.
(a)-(c) [No Change]
(d) Hearings.
(1) [No Change]
(2) The general magistrate shall take testimony and establish a record which may be by electronic means as provided by Florida Rule of Judicial Administration 2.0702.535(g)(3) or by a court reporter. The parties may not waive this requirement.
(3) The general magistrate shall have authority to examine under oath the parties and all witnesses upon all matters contained in the reference, to require production of all books, papers, writings, vouchers, and other documents applicable to it, and to examine on oath orally all witnesses produced by the parties. The general magistrate may take all actions concerning evidence that can be taken by the circuit court and in the same manner. The general magistrate shall have the same powers as a circuit judge to utilize communications equipment as defined and regulated by Florida Rule of Judicial Administration 2.0712.530.
*413 (4)-(5) [No Change]
(e) [No Change]
(f) Filing Report; Notice; Exceptions. The general magistrate shall file the report and recommendations and serve copies on all parties. The parties may servefile exceptions to the report within 10 days from the time it is served on them. Any party may file cross-exceptions within 5 days from the service of the exceptions, provided, however, that the filing of cross-exceptions shall not delay the hearing on the exceptions unless good cause is shown. If no exceptions are filed within that period, the court shall take appropriate action on the report. If exceptions are filed, they shall be heard on reasonable notice by either party or the court.
(g) [No Change]
(a)-(d) [No Change]
(e) General Powers and Duties. The support enforcement hearing officer shall be empowered to issue process, administer oaths, require the production of documents, and conduct hearings for the purpose of taking evidence. A support enforcement hearing officer does not have the authority to hear contested paternity cases. Upon the receipt of a support proceeding, the support enforcement hearing officer shall:
(1) [No Change]
(2) take testimony and establish a record, which record may be by electronic means as provided by Florida Rule of Judicial Administration 2.0702.535(g)(3);
(3)-(4) [No Change]
(f)-(h) [No Change]
(a) Special Magistrates. The court may appoint members of The Florida Bar as special magistrates for any particular service required by the court in a family law matter other than those involving domestic, repeat, dating, and sexual violence. The special magistrates shall be governed by all the provisions of law and rules relating to general magistrates except as otherwise provided by this rule. Additionally, they shall not be required to make oath or give bond unless specifically required by the order appointing them. Upon a showing that the appointment is advisable, a person other than a member of The Florida Bar may be appointed.
(b)-(f) [No Change]
(g) Filing Report; Notice; Exceptions. The special magistrate shall file the report and recommendations and serve copies on the parties. The parties may servefile exceptions to the report within 10 days from the time it is served on them. If no exceptions are filed within that period, the court shall take appropriate action on the report. Any party may file cross-exceptions within 5 days from the service-filing of the exceptions, provided, however, that the filing of cross-exceptions shall not delay the hearing on the exceptions unless good cause is shown. If exceptions are filed, they shall be heard on reasonable notice by either party. The party seeking *414 to have exceptions heard shall be responsible for the preparation of the transcript of proceedings before the special magistrate.
(h) [No Change]
(a) [No Change]
(b) Petitions.
(1) [No Change]
(2) Service of Petitions.
(A) [No Change]
(B) Repeat Violence, Dating Violence, and Sexual Violence. Personal service by a law enforcement agency is required. The clerk of the court shall furnish a copy of the petition for an injunction for protection against repeat violence, dating violence, or sexual violence, temporary injunction (if one has been entered), and notice of hearing to the appropriate sheriff or law enforcement agency of the county where the respondent resides or can be found for expeditious service of process.
(C) [No Change]
(3) [No Change]
(4) Forms.
(A) [No Change]
(B) Confidential Filing of Address. A petitioner's address may be furnished to the court in a confidential filing separate from a petition or other form if, for safety reasons, a petitioner believes that the address should be concealed. The ultimate determination of a need for confidentiality must be made by the court as provided in Florida Rule of Judicial Administration 2.0512.420.
(c) [No Change]
(a)-(e) [No Change]
(f) Review of Information by the Court. The court shall conduct an in-camera examination of the contents of the sealed envelope from the Federal Parent Locator Service.
(1) [No Change]
(2) If the information from the sealed envelope includes an address for the respondent or the respondent's employer, the court shall issue an order to show cause to the respondent, the department, the Florida Department of Law Enforcement (FDLE), and the state entity that placed the family violence indicator on the record. The order to show cause shall
(A)-(F) [No Change]
(3) [No Change]
(g) [No Change]
(h) Hearing on Order to Show Cause.
(1) [No Change]
(2) Notwithstanding the provisions of Florida Rule of Judicial Administration 2.0712.530, the court may conduct a hearing on the order to show cause by means of communications equipment without consent of the parties and without a limitation on the time of the hearing. The communications equipment shall be configured to *415 ensure that the location of the respondent is not disclosed.
(i) [No Change]
(a)-(k) [No Change]
(l) Records. All records made or received in connection with the official business of a self-help program are judicial records and access to such records shall be governed by Florida Rule of Judicial Administration 2.0512.420.
(m) [No Change]
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.900(g), AGREEMENT LIMITING REPRESENTATION (01/09)
This form should be used as a "rider" or supplemental agreement, in addition to an Attorney-Client fee agreement, between the attorney and client when the attorney is making a limited appearance under Rules Regulating Florida Bar 4-1.2(c), 4-4.2(b), and 4-4.3(b) and Florida Family Law Rule of Procedure 12.040. A limited appearance means the attorney is not handling the whole case for the client, but is only being retained to do a specific part of the case.
See Rules Reg. Fla. Bar 4-1.2(c), 4-4.2(b), and 4-4.3(b) and Fla.Fam.L.R.P. 12.040.
(This agreement is supplemental to the Attorney-Client fee agreement and is limited to addressing the consequences of Limited Legal Representation by an attorney in Florida)
TO THE CLIENT: THIS IS A LEGALLY BINDING CONTRACT. PLEASE READ IT CAREFULLY AND MAKE CERTAIN THAT YOU UNDERSTAND ALL OF THE TERMS AND CONDITIONS. YOU MAY TAKE THIS CONTRACT HOME WITH YOU, REVIEW IT WITH ANOTHER ATTORNEY IF YOU WISH, AND ASK ANY QUESTIONS YOU MAY HAVE BEFORE SIGNING.
EMPLOYMENT OF AN ATTORNEY FOR LIMITED REPRESENTATION REQUIRES THAT THE ATTORNEY AND CLIENT CAREFULLY AND THOROUGHLY REVIEW THE DUTIES AND RESPONSIBILITIES EACH WILL ASSUME. ANY LIMITED REPRESENTATION AGREEMENT SHOULD DESCRIBE, IN DETAIL, THE ATTORNEY'S DUTIES IN THE CLIENT'S INDIVIDUAL CASE.
1. SERVICES/LIMITED SCOPE OF REPRESENTATION: Client, {name} _____________, employs Attorney, {name} ________________ to provide representation only in the limited matter(s) described as follows: ________ ____________________________ ____________________________
2. COMPLIANCE WITH CHAPTER 4 OF THE RULES REGULATING *416 THE FLORIDA BAR: Although legal assistance is limited, an attorney-client relationship exists, and the client is entitled to the standards of professional responsibility established by Chapter 4 of the Rules Regulating the Florida Bar, including confidentiality, competence, and diligence.
3. COMPLIANCE WITH FLORIDA FAMILY LAW RULE OF PROCEDURE 12.040: An Attorney hired to provide limited representation in court must comply with Florida Family Law Rule of Procedure 12.040, as follows:
a. The attorney will file with the court a Notice of Limited Appearance, Florida Family Law Rules of Procedure Form 12.900(b), signed by the client, specifically limiting the attorney's appearance to the particular proceeding or matter in which the attorney appears.
b. If the attorney seeks to withdraw from representation before the conclusion of a limited appearance, the attorney must:
(1) File a motion with the court setting forth the reasons and serve that motion on the client and interested persons, and
(2) Obtain approval of the court.
c. At the conclusion of the proceeding or matter, the attorney's role terminates without the necessity of leave of court, on the attorney filing Termination of Limited Appearance, Florida Family Law Rules of Procedure Form 12.900(d). The notice shall include the names and last known addresses of the person(s) represented by the withdrawing attorney.
d. THE CLIENT IS ADVISED THAT ANY OBJECTION TO THE ATTORNEY'S "TERMINATION OF LIMITED APPEARANCE" MUST BE MADE IN WRITING BY THE CLIENT BY PROVIDING THE JUDGE, THE ATTORNEY, AND EACH OTHER INTERESTED PERSON (OR THEIR ATTORNEY) A COPY AND FILING THE ORIGINAL WITH THE CLERK OF COURT.
4. ADDITIONAL SERVICES/REPRESENTATION: The attorney and client may later determine that the attorney should provide additional limited services or assume full representation. The attorney may decline to provide additional services.
a. If the attorney agrees to provide additional services, those additional services should be specifically listed in an amendment to this agreement, signed and dated by both the attorney and the client.
b. If the attorney and client agree that the attorney shall serve as the client's attorney of record on all matters related to handling the client's case, the client and the attorney should indicate that agreement in an amendment to this agreement, signed and dated by both the attorney and the client.
c. In either case, additional compliance with the notice requirement of Rule 12.040 will be required by the attorney.
d. THE ATTORNEY AND THE CLIENT SHOULD NOT RELY ON VERBAL DISCUSSIONS OR VERBAL AGREEMENTS WHEN CHANGING THE TERMS OF THE ATTORNEY'S RESPONSIBILITY FOR REPRESENTATION.
5. ATTORNEYS' FEES AND COURT COSTS: The attorney and the client have made a separate agreement *417 in writing as to payment of attorneys' fees and all costs associated with the case and the attorney's representation.
BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT YOU HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL OF THE FOREGOING TERMS, AND YOU INTEND TO BE LEGALLY BOUND BY THEM.
______________________ _____________________ Attorney Client Name: Name: ______________________ _____________________ Address: Address: ______________________ _____________________ City, State, Zip City, State, Zip ______________________ _____________________ Telephone Number: Telephone Number: ______________________ _____________________ Florida Bar Number: ______________________ Date: Date: ______________________ _____________________I HAVE BEEN PROVIDED A FULLY EXECUTED COPY OF THIS AGREEMENT LIMITING REPRESENTATION
______________________ ClientINSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW RULES OF PROCEDURE FORM 12.900(h), NOTICE OF RELATED CASES (01/09)
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
it involves the same parties, children, or issues and is pending when the family law case is filed; or
it affects the court's jurisdiction to proceed; or
an order in the related case may conflict with an order on the same issues in the new case; or
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.
A copy of the form must be served on the presiding judges and either the chief judge or the family law administrative judge. You should also keep a copy for your records.
See Florida Rule of Judicial Administration 2.545(d).
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 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.
IN THE CIRCUIT COURT OF THE __________________ JUDICIAL CIRCUIT, IN AND FOR ______________ COUNTY, FLORIDA *418 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. [√ 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 _______________________________________________________________________________ Respondent _______________________________________________________________________________ Case No.: _________________________________ Division: ____________________________________ Type of Proceeding: [√ 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 ____ Other {specify} _________ ____ Violence Injunctions ____ Mental Health 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 [√ 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: ________________________________ _______________________________________________________________________________ *419 Related Case No. 2 Case Name(s): ____________________________________________________________________ Petitioner: ______________________________________________________________________ Respondent: ______________________________________________________________________ Case No.: _________________________________ Division: ____________________________ Type of Proceeding: [√ 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 ____ Other {specify} ______________ ____ Violence Injunctions ____ Mental Health 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 [√ 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. 3 Case Name(s): ____________________________________________________________________ Petitioner: ______________________________________________________________________ Respondent: ______________________________________________________________________ Case No.: _____________________________________ Division: ________________________ Type of Proceeding: [√ 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 ____ Other {specify} _____________ ____ Violence Injunctions ____ Mental Health 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 [√ all that apply]: *420 ____ 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. [√ one only] ____ I do not request coordination of litigation in any of the cases listed above. ____ I do request coordination of the following cases: ______________ _______________________________________________________________________________ _______________________________________________________________________________ 3. [√ 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: ___________________________ 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 [√ one only] ( ) mailed ( ) hand delivered a copy to ( ) {name} __________, who is the [√ 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} ___________. ___________________________________ Petitioner/Attorney for Petitioner IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] I, {full legal name and trade name of nonlawyer} _________________________, a nonlawyer, located at {street} _____________, {city} ___________, {state} _________, {phone} ________, helped {name} ______, who is the Petitioner, fill out this form.This form should be used to ask the other party in your case to answer certain standard questions in writing. These questions are called interrogatories, and they must relate to your case. If the other party fails to answer the questions, you may ask the judge to order the other party to answer the questions. (You cannot ask these questions before the petition has been filed.)
The questions in this form should be used in modification proceedings and are meant to supplement the information provided in the Financial Affidavits, Florida Family Law Rules of Procedure Form 12.902(b) or (c). You should read all of the questions in this form to determine which questions, if any, the other party needs to answer in order to provide you with information not covered in the financial affidavit forms. If there are questions to which you already know the answer, you may choose not to ask them.
This form should be typed or printed in black ink. You must complete the box at the beginning of this form to indicate which questions you are requesting that the other party answer. You should send two copies of this form and the Notice of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a), to the other party. You should also keep a copy for your records. You do not need to file this form with the clerk of the circuit court. However, you must file the Notice of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a), to tell the court that you have sent this form to the other party.
Before proceeding, you should read "General Information for Self-Represented Litigants" found at the beginning of these forms. For further information, see the instructions for Notice of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a), rules 12.280, 12.285, 12.340, and 12.380, Florida Family Law Rules of Procedure and rules 1.280, 1.340, and 1.380, Florida Rules of Civil Procedure.
In addition to the standard questions in this form, you may ask up to 10 additional questions. You should type or print your additional questions on a separate sheet of paper and attach it to this form. If you want to ask more than 10 additional questions, you will need to get permission from the judge.
You may want to inform the other party of the following information: As a general rule, within 30 days after service of interrogatories, the other party must answer the questions in writing and mail (have postmarked) the answers to you. His or her answers shall be written in the blank space provided after each separately numbered interrogatory. If sufficient space is not provided, the answering party may attach additional papers with the answers and refer to them in the space provided in the interrogatories. He or she should be sure to make a copy for him/herself. All answers to these questions are *422 made under oath or affirmation as to their truthfulness. Each question must be answered separately and as completely as the available information permits. The original of the answers to the interrogatories is to be provided to the requesting party. Do not file the original or a copy with the clerk of the circuit court except as provided by Florida Rule of Civil Procedure 1.340(e). The other party may object to a question by writing the legal reason for the objection in the space provided. He or she may also ask the court for a protective order granting him or her permission not to answer certain questions and protecting him or her from annoyance, embarrassment, apprehension, or undue burden or expense. If the other party fails to either answer or object to the questions within 30 days, he or she may be subject to court sanctions.
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.
IN THE CIRCUIT COURT OF THE _____________ JUDICIAL CIRCUIT, IN AND FOR _______________ COUNTY, FLORIDA Case No.: _______________________ Division: ________________________ _______________________________, Petitioner and _______________________________, Respondent. STANDARD FAMILY LAW INTERROGATORIES FOR MODIFICATION PROCEEDINGS *423 The answers to the following questions are intended to supplement the information provided in the Financial Affidavits, Florida Family Law Rules of Procedure Form 12.902(b) or (c). You should answer the group of questions indicated in the above shaded box. The questions should be answered in the blank space provided below each separately numbered question. If sufficient space is not provided, you may attach additional papers with the answers and refer to them in the space provided in the interrogatories. You should be sure to make a copy for yourself. Each question must be answered separately and as completely as the available information permits. All answers are to be made under oath or affirmation as to their truthfulness. I, {name of person answering interrogatories} ___________________________, being sworn, certify that the following information is true: 1. BACKGROUND INFORMATION: a. State your full legal name and any other name by which you have been known. b. State your present residence and telephone numbers. c. State your place and date of birth. 2. EDUCATION: a. List all business, commercial, and professional licenses that you have obtained since the entry of the Final Judgment sought to be modified. b. List all of your education since the entry of the Final Judgment sought to be modified including, but not limited to, vocational or specialized training, including the following: (1) name and address of each educational institution. (2) dates of attendance. (3) degrees or certificates obtained or anticipated dates of same. 3. EMPLOYMENT: a. For each place of your employment or self-employment since the entry of the Final Judgment sought to be modified, state the following: (1) name, address, and telephone number of your employer. (2) dates of employment. (3) job title and brief description of job duties. (4) starting and ending salaries. (5) name of your direct supervisor. (6) all benefits received, including, for example, health, life, and disability insurance; expense account; use of automobile or automobile expense reimbursement; reimbursement for travel, food, or lodging expenses; payment of dues in any clubs or associations; and pension or profit sharing plans. b. Other than as an employee, if you have been engaged in or associated with any business, commercial, or professional activity since the entry of the Final Judgment sought to be modified that was not detailed above, state for each such activity the following: (1) name, address, and telephone number of each activity. (2) dates you were connected with such activity. (3) position title and brief description of activities. (4) starting and ending compensation. (5) name of all persons involved in the business, commercial, or professional activity with you. (6) all benefits and compensation received, including, for example, health, life, and disability insurance; expense account; use of automobile or automobile expense reimbursement; reimbursement for travel, food, or lodging expenses; payment of dues in any clubs or associations; and pension or profit sharing plans. c. If you have been unemployed at any time since the entry of the Final Judgment sought to be modified, state the dates of unemployment. If you have not been employed at any time since *424 the entry of the Final Judgment sought to be modified, give the information requested above in question 3.a for your last period of employment. 4. ASSETS: a. Real Estate. State the street address, if any, and if not, the legal description of all real property that you own or owned during the last 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. For each property, state the following: (1) the names and addresses of any other persons or entities holding any interest and their percentage of interest. (2) the present fair market value. b. Tangible Personal Property. List all items of tangible personal property that are owned by you or in which you have had any interest during the last 3 years, or since the entry of the Final Judgment sought to be modified, if shorter, including, but not limited to, motor vehicles, tools, furniture, boats, jewelry, art objects or other collections, and collectibles whose fair market value exceeds $100. For each item, state the following: (1) the percentage and type interest you hold. (2) the names and addresses of any other persons or entities holding any interest. (3) the present fair market value. c. Intangible Personal Property. Other than the financial accounts (checking, savings, money market, credit union accounts, retirement accounts, or other such cash management accounts) listed in the answers to interrogatories 4.d and 4.e below, list all items of intangible personal property that are owned by you or in which you have had any ownership interest (including closed accounts) within the last 3 years, or since the entry of the Final Judgment sought to be modified, if shorter, including, but not limited to, partnership and business interests (including good will), deferred compensation accounts unconnected with retirement, including but not limited to stock options, sick leave, and vacation pay, stocks, stock funds, mutual funds, bonds, bond funds, real estate investment trusts, receivables, certificates of deposit, notes, mortgages, and debts owed to you by another entity or person. For each item, state the following: (1) the percentage and type interest you hold. (2) the names and addresses of any other persons or entities holding any interest and the names and addresses of the persons and entities who are indebted to you. (3) the present fair market value or the amounts you claim are owned by or owed to you, at the time of answering these interrogatories. You may comply with this interrogatory (4.c) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. However, if the date of acquisition, the purchase price, and the market valuations are not clearly reflected in the periodic statements which are furnished, then these questions must be answered separately. You do not have to resubmit any periodic statements previously furnished under rule 12.285 (Mandatory Disclosure). d. Retirement Accounts: List all information regarding each retirement account/plan, including but not limited to defined benefit plans, 401k, 403B, IRA accounts, pension plans, Florida Retirement System plans (FRS), Federal Government plans, money purchase plans, HR10 (Keogh) plans, profit sharing plans, annuities, employee savings plans, etc. that you have established and/or that have been established for you by you, your employer or any previous employer. For each account, state the following: (1) the name and account number of each account/plan and where it is located. (2) the type of account/plan. (3) the name and address of the fiduciary plan administrator/service representative (4) the present fair market value of your interest in each account/plan. (5) whether you are vested or not vested; and if vested, in what amount, as of a certain date and the schedule of future vesting. (6) the date at which you became/become eligible to receive some funds in this account/plan. (7) monthly benefits of the account/plan if no fair market value is ascertained. *425 (8) beneficiary(ies) and/or alternate payee(s). e. Financial Accounts. For all financial accounts (checking, savings, money market, credit union accounts, or other such cash management accounts) listed in your Financial Affidavit, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of each institution. (2) name in which the account is or was maintained. (3) account numbers. (4) names of each person authorized to make withdrawals from the accounts. (5) highest balance within each of the preceding 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. (6) lowest balance within each of the preceding 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You may comply with this interrogatory (4.e) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure). f. Closed Financial Accounts. For all financial accounts (checking, savings, money market, credit union accounts, or other such cash management accounts) closed within the last 3 years, or since the entry of the Final Judgment sought to be modified, if shorter, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the: (1) name and address of each institution. (2) name in which the account is or was maintained. (3) account numbers. (4) name of each person authorized to make withdrawals from the accounts. (5) date account was closed. g. Trust. For any interest in an estate, trust, insurance policy, or annuity, state the following: (1) if you are the beneficiary of any estate, trust, insurance policy, or annuity, give for each one the following: (a) identification of the estate, trust, insurance policy, or annuity. (b) the nature, amount, and frequency of any distributions of benefits. (c) the total value of the beneficiaries' interest in the benefit. (d) whether the benefit is vested or contingent. (2) if you have established any trust or are the trustee of a trust, state the following: (a) the date the trust was established. (b) the names and addresses of the trustees. (c) the names and addresses of the beneficiaries. (d) the names and addresses of the persons or entities who possess the trust documents. (e) each asset that is held in each trust, with its fair market value. h. Name of Accountant, Bookkeeper, or Records Keeper. State the names, addresses, and telephone numbers of your accountant, bookkeeper, and any other persons who possess your financial records, and state which records each possesses. 5. LIABILITIES: *426 a. Loans, Liabilities, Debts, and Other Obligations. For all loans, liabilities, debts, and other obligations (other than credit cards and charge accounts) listed in your Financial Affidavit, indicate for each the following: (1) name and address of the creditor. (2) name in which the obligation is or was incurred. (3) loan or account number, if any. (4) nature of the security, if any. (5) payment schedule. (6) present balance and current status of your payments. (7) total amount of arrearage, if any. You may comply with this interrogatory (5.a) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure). b. Credit Cards and Charge Accounts. For all financial accounts (credit cards, charge accounts, or other such accounts) listed in your Financial Affidavit, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of the creditor. (2) name in which the account is or was maintained. (3) name of each person authorized to sign on the accounts. (4) account numbers. (5) present balance and current status of your payments. (6) total amount of arrearage, if any. (7) highest and lowest balance within each of the preceding 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You may comply with this interrogatory (5.b) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure). c. Closed Credit Cards and Charge Accounts. As to all financial accounts (credit card, charge accounts, or other such accounts) closed with no remaining balance, within the last 3 years, or since the entry of the Final Judgment sought to be modified, if shorter, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of each creditor. (2) name in which the account is or was maintained. (3) account numbers. (4) name of each person authorized to sign on the accounts. (5) date the balance was paid off. (6) amount of final balance paid off. You may comply with this interrogatory (5.c) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding 3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure). *427 6. MISCELLANEOUS: a. If you are claiming a diminished earning capacity since the entry of the Final Judgment sought to be modified as grounds to modify alimony or deviate from the child support established in your case, describe in detail how your earning capacity is lowered and state all facts upon which you rely in your claim. If unemployed, state how, why, and when you lost your job. b. If you are claiming a change in a mental or physical condition since the entry of the Final Judgment sought to be modified as grounds to modify alimony or change the child support established in your case, describe in detail how your mental and/or physical capacity has changed and state all facts upon which you rely in your claim. Identify the change in your mental and/or physical capacity, and state the name and address of all health care providers involved in the treatment of this mental or physical condition. c. If you are requesting a change in shared or sole parental responsibility, the parenting plan, or any combination thereof, for the minor child(ren), describe in detail the change in circumstances since the entry of the Final Judgment sought to be modified that you feel justify the requested change. State when the change of circumstances occurred, how the change of circumstances affects the child(ren), and why it is in the best interests of the child(ren) that the Court make the requested change. Attach your proposed parenting plan. d. If you do not feel the requested change in shared or sole parental responsibility, the parenting plan, or any combination thereof, for the minor child(ren) is in their best interests, describe in detail any facts since the entry of the Final Judgment sought to be modified that you feel justify the Court denying the requested change. State, in your opinion, what change, if any, in shared or sole parental responsibility, or of the parenting plan is justified or agreeable to you and why it is in the best interests of the child(ren). (7) LONG FORM AFFIDAVIT: If you filed the short form affidavit, Florida Family Law Rules of Procedure Form 12.902(b), and you were specifically requested in the Notice of Service of Standard Family Law Interrogatories to file the Long Form Affidavit, Form 12.902(c), you must do so within the time to serve the answers to these interrogatories. I certify that a copy of this document was [√ one only] ( ) 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: ___________________________ I understand that I am swearing or affirming under oath to the truthfulness of the answers to these interrogatories 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: _______________________________ STATE OF FLORIDA COUNTY OF _____________________ Sworn to or affirmed and signed before me on __________ by _______________. *428 ___________________________________________ 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] I, {full legal name and trade name of nonlawyer} ________________, a nonlawyer, located at {street} ____________, {city} ____________, {state} ________, {phone} _______, helped {name} __________, who is the [√ one only] ___ petitioner or ___ respondent, fill out this form.This form should be used when parents want the court to change the name of their minor child(ren). For the purposes of this proceeding, a person under the age of 18 is a minor. This form is not to be used in connection with an adoption or paternity action. If you want a change of name for your child(ren) because of an adoption or paternity action that is not yet final, the change of name should be done as part of that case.
This form should be typed or printed in black ink. The primary petition should only be completed for one child. If you wish to change the names of more than one child, you should complete and file a Supplemental Form for Petition for Change of Name (Minor Child) for each child. The supplemental form is an attachment to the petition. Be sure that the bottom of each page of each supplemental form is initialed by the petitioner(s). You must obtain a copy of the petitioner(s)'s fingerprints taken by a law enforcement agency and attach it to the petition. There may be a charge for the fingerprinting which you will have to pay. After completing this form, you should sign the form 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.
If both parents agree to the change of name and live in the county where the change of name is sought, you may both file as petitioners. In this situation, service is not necessary, and you need only to set a hearing. You should ask the clerk of court, family law intake staff, or judicial assistant about the local procedure for setting a hearing.
If only one parent is a resident of the county where the change of name(s) is sought or only one parent asks for the child(ren)'s name(s) to be changed, the other parent must be notified and his or her consent obtained, if possible. If the other parent consents to the change of name, a Consent for Change of Name (Minor Child(ren)), Florida Supreme *429 Court Approved Family Law Form 12.982(d), should be filed.
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 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). However, the law regarding constructive service is very complex and you may wish to consult an attorney regarding that issue.
Next, you must obtain a final hearing date for the court to consider your request. 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 (Minor Child(ren)), Florida Supreme Court Approved Family Law Form 12.982(e), which may be used when a judge grants a change of name for a minor child(ren). If you attend the hearing, you should take the final judgment with you. You should complete the top part of the form, including the circuit, county, case number, division, and 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 child(ren)'s name(s). 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 how much those charges are.
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.
The heading of the form calls for the name(s) of the petitioner(s). This is the parent(s) who is (are) requesting the change of their child(ren)'s name(s). The judicial circuit, case number, and division may be obtained from the clerk of court's office when you file the petition.
It may be helpful to compile a list of all of the people and places that will need a copy of the final judgment. This list may include the driver's license office, social security office, banks, schools, etc. A list will help you know how many copies of your order you should get from the clerk of court after your hearing.
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.
IN THE CIRCUIT COURT OF THE _______________ JUDICIAL CIRCUIT, *430 IN AND FOR _______________ COUNTY, FLORIDA Case No.: _______________________ Division: _______________________ IN RE: THE NAME CHANGE OF __________________________________, Petitioner/Father, ___________________________________, Petitioner/Mother. PETITION FOR CHANGE OF NAME (MINOR CHILD(REN)) I/We, {full legal name(s)} ___________________________, being sworn, certify that the following information is true: I am/We are the birth or legal parent(s) of the minor child(ren) named in this petition. [√ only one] a. ___ There is only one minor child named in this petition. b. ___ There are {enter number of children} _________ children named in this petition. The information on the first child is entered below. I/We have attached the completed supplemental forms for each other child. A copy of the petitioner(s)'s fingerprints taken by a law enforcement agency is attached to this petition. THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # 1: : 1. Minor child's complete present name is: ______________________________________________________________________________________________________ I/We request that this 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 {date} _________, in {city, county, state, country} ____ _____________________________________________________________________________________________________. 4. The minor child's father's full legal name: _________________________________________________________. The minor child's mother's full legal name: _________________________________________________________. The minor child's mother's maiden name: _____________________________________________________________. 5. The minor child has lived in the following places since birth: Dates (to/from) Address / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. *431 6. [√ one only] ___ The minor child is not married. ___ The minor child is married to: {full legal name} ___________________________________________. 7. [√ one only] ___ The minor child has no children. ___ The minor child is the parent of the following child(ren): {enter full name(s) and date(s) of birth} ___________________________________________________________________________ ______________________________________________________________________________________________________ 8. Former names. [√ all that apply] ___ The minor child's name has never been changed by a court. ___ The minor child's name previously was changed by court order from _________________________ to ________ on {date} ______________________________________________________________________, by {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)} ________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ 9. 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: ________________________________________________________________________________________ ______________________________________________________________________________________________________ 10. Criminal History. [√ one only] ___ 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) ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. 11. Money Judgments. [√ one only] ___ The minor child has never been adjudicated bankrupt, and no money judgment has ever been entered against him or her. ___ The following money judgment(s) has been entered against him or her: Date Amount Creditor Court entering judgment and case number √ if Paid ____ ______ ________ _______________________________________ [] ____ ______ ________ _______________________________________ [] THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER(S): 12. Petitioner(s) live in ______ County, Florida, at {street address} ___________________________ ______________________________________________________________________________________________________ *432 13. I/We 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. 14. My/our civil rights have never been suspended, or, if ever suspended, they have been fully restored. 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/Father Printed Name: ___________________________ Address: ________________________________ City, State, Zip: _______________________ Telephone Number: _______________________ Fax Number: _____________________________ 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 _____________________________ 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/Mother Printed Name: ____________________________ Address: _________________________________ City, State, Zip: ________________________ Telephone Number: ________________________ Fax Number: ______________________________ STATE OF FLORIDA COUNTY OF _______________ Sworn to or affirmed and signed before me on _________ by _________________________. _____________________________________________ NOTARY PUBLIC or DEPUTY CLERK *433 _____________________________________________ [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] I, {full legal name and trade name of nonlawyer} _________________________________________________, a nonlawyer, located at {street} _________, {city} ______________________________________, {state} ___________, {phone} ___________, helped {name(s)} _____________________, who is (are) the petitioner(s), fill out this form. PETITIONER(S) MUST INITIAL HERE __________ SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (MINOR CHILD(REN)) Case No.: ___________________________________________________________ THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # _______: 1. 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 {date} ______, in {city, county, state, country} _______ _____________________________________________________________________________________________________. 4. The minor child's father's full legal name: _________________________________________________________. The minor child's mother's full legal name: _________________________________________________________. The minor child's mother's maiden name: _____________________________________________________________. 5. The minor child has lived in the following places since birth: Dates (to/from) Address / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. 6. [√ one only] ___ The minor child is not married. ___ The minor child is married to: {full legal name} ___________________________________________. 7. [√ one only] ___ The minor child has no children. ___ The minor child is the parent of the following child(ren): {enter name(s) and date(s) of birth} ___________________________________________________________________________________ ______________________________________________________________________________________________________ *434 8. Former names [√ all that apply] ___ The minor child's name has never been changed by a court. ___ The minor child's name previously was changed by court order from _________________________ to ___________ on {date} ___________________________________________________________________, by {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)} ________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ 9. 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: ________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ 10. Criminal History [√ one only] ___ 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) ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. 11. Money Judgments [√ one only] ___ The minor child has never been adjudicated bankrupt, and no money judgment has ever been entered against him or her. ___ The following money judgment(s) has (have) been entered against him or her: Date Amount Creditor Court entering judgment and case number √ if Paid ____ ______ ________ _________________________________________ [] ____ ______ ________ _________________________________________ [] PETITIONER(S) MUST INITIAL HERE ________This form should be used when a family wants the court to change its name. This form is not to be used in connection with a divorce, 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 done as part of that case.
This form should be typed or printed in black ink. The petition should only be completed for one adult. If you wish to change the name(s) of another adult and/or child(ren), you should complete and file a Supplemental Form for Petition for Change of Name (Family) for each additional family member and file the supplemental form(s) as an attachment to the petition. Be sure that the bottom of each child's supplemental form is initialed. A copy of the fingerprints of each adult family member who is petitioning to have his or her name changed, taken by a law enforcement agency, must be attached to the petition. There may be a charge for the fingerprinting which you will have to pay. After completing this form, it should be signed before a notary public or deputy clerk. You should then file the original with the clerk of the circuit court in the county where you live and keep a copy for your records.
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 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. 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 *436 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 how much those charges are.
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.
The heading of the form calls for the name(s) of the petitioner(s). This is (are) the parent(s) who are requesting the change of their family's name(s). The judicial circuit, case number, and division may be obtained from the clerk of court's office when you file the petition.
It may be helpful to compile a list of all of the people and places that will need a copy of the final judgment. This list may include the driver's license office, social security office, banks, schools, etc. A list will help you know how many copies of your order you should get from the clerk of court after your hearing.
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.
IN THE CIRCUIT COURT OF THE _______________ JUDICIAL CIRCUIT, IN AND FOR _______________ COUNTY, FLORIDA Case No.: _______________________ Division: _______________________ IN RE: THE NAME CHANGE OF ___________________________________, Petitioner/Father, ___________________________________, Petitioner/Mother. PETITION FOR CHANGE OF NAME (FAMILY) I/We, {full legal name(s)} ___________________________, being sworn, certify that the following information is true: There are {enter number} ___ adults named in this petition. A supplemental form is attached for each adult not set out below. *437 There are {enter number} ___ children named in this petition. I am/We are the birth or legal parents of the minor child(ren) named in this petition. I/We have attached a completed supplemental form for each minor child. A copy of the fingerprints of each adult person seeking a name change in this petition, taken by a law enforcement agency, is attached. THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER ( ) HUSBAND ( ) WIFE: 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 father's full legal name: ________________________________________________________________________. My mother's full legal name: ________________________________________________________________________. My mother's maiden name: ____________________________________________________________________________. 5. I have lived in the following places since birth: Dates (to/from) Address / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. 6. Family [√ all that apply] a. ___ I am not married. b. ___ I am married. My spouse's full legal name is: ________________________________________________. c. ___ I do not have child(ren). d. ___ The name(s), age(s), and address(es) of my child(ren) are as follows (all children, including those over 18, must be listed): Name {last, first, middle initial} Age Address, City, State ___________________________________ ___ ____________________________________________________________ ___________________________________ ___ ____________________________________________________________ ___________________________________ ___ ____________________________________________________________ ___________________________________ ___ ____________________________________________________________ ___________________________________ ___ ____________________________________________________________ ___________________________________ ___ ____________________________________________________________ [] Check here if you are continuing these facts on an attached page. 7. Former names [√ all that apply] ___ My name has never been changed by a court. ___ My name previously was changed by court order from ____________________________________ to ____________________ on {date} _____________________________________________________, *438 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 / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ / ___________________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. 9. Business [√ one only] ___ 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 [√ 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 / _______________________________________________________________________________ / _______________________________________________________________________________ / _______________________________________________________________________________ / _______________________________________________________________________________ / _______________________________________________________________________________ [] Check 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 __________ ____________ _______________________________________________________________________ __________ ____________ _______________________________________________________________________ __________ ____________ _______________________________________________________________________ [] Check here if you are continuing these facts on an attached page. *439 12. Criminal History [√ one only] ___ 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) ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. 13. Bankruptcy [√ one only] ___ I have never been adjudicated bankrupt. ___ I was adjudicated bankrupt on {date} _________, in {city} _____________________, {county} _________, {state} ___________________________________________________. [] Check here if you have had additional bankruptcies, and explain on an attached page. 14. Creditor(s)' Judgments [√ 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 √ if Paid ____ ______ ________ _______________________________________ [] ____ ______ ________ _______________________________________ [] ____ ______ ________ _______________________________________ [] ____ ______ ________ _______________________________________ [] [] Check here if these facts are continued on an attached page. 15. 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. 16. My civil rights have never been suspended, or, if my civil rights have been suspended, they have been fully restored. 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: _________________________________ STATE OF FLORIDA COUNTY OF _______________ Sworn to or affirmed and signed before me on _______ by __________________. *440 _____________________________________________ 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] I, {full legal name and trade name of nonlawyer} _________, a nonlawyer, located at {street} _________, {city} ________, {state} __________, {phone} ___________, helped {name} __________________, who is the petitioner, fill out this form. ADULT SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (FAMILY) Case No.: ___________________________ THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER ( ) HUSBAND ( ) WIFE: 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 father's full legal name: ________________________________________________________________________. My mother's full legal name: ________________________________________________________________________. My mother's maiden name: ____________________________________________________________________________. 5. I have lived in the following places since birth: Dates (to/from) Address / __________________________________________________________________________________ / __________________________________________________________________________________ / __________________________________________________________________________________ / __________________________________________________________________________________ / __________________________________________________________________________________ / __________________________________________________________________________________ / __________________________________________________________________________________ / __________________________________________________________________________________ / __________________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. 6. Family [√ all that apply] a. ___ I am not married. b. ___ I am married. My spouse's full legal name is: ________________________________________________. *441 c. ____ I do not have child(ren). d. ____ The name(s), age(s), and address(es) of my child(ren) are as follows (all children, including those over 18, must be listed): Name {last, first, middle initial} Age Address, City, State _______________________ ________ ______________________________________________ _______________________ ________ ______________________________________________ _______________________ ________ ______________________________________________ _______________________ ________ ______________________________________________ [] Check here if you are continuing these facts on an attached page. 7. Former names [√ 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 / _________________________________________________________ / _________________________________________________________ / _________________________________________________________ / _________________________________________________________ / _________________________________________________________ / _________________________________________________________ [] Check here if you are continuing these facts on an attached page. 9. Business [√ one only] ____ 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 [√ one only] ____ I am not in a profession. ____ I am in a profession. My profession is: ____________________________________. I have practiced this profession: *442 Dates (to/from) Place and address / ________________________________________________________ / ________________________________________________________ / ________________________________________________________ / ________________________________________________________ / ________________________________________________________ [] Check 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 __________ ________________ ________________________________________________ __________ ________________ ________________________________________________ __________ ________________ ________________________________________________ [] Check here if you are continuing these facts on an attached page. 12. Criminal History [√ one only] ____ 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) ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ [] Check here if you are continuing these facts on an attached page. 13. Bankruptcy [√ one only] ____ I have never been adjudicated bankrupt. ____ I was adjudicated bankrupt on {date} _____, in {city} ____, {county} _______, {state} ________________________________. [] Check here if you have had additional bankruptcies, and explain on an attached page. 14. Creditor(s)' Judgments [√ 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 √ if Paid ________ _______________ ______________ ___________________________ [] ________ _______________ ______________ ___________________________ [] ________ _______________ ______________ ___________________________ [] ________ _______________ ______________ ___________________________ [] [] Check here if these facts are continued on an attached page. 15. 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. 16. My civil rights have never been suspended, or, if my civil rights have been suspended, they have been fully restored. *443 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: ____________________________ 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] I, {full legal name and trade name of nonlawyer} ______________, a nonlawyer, located at {street} ________, {city} __________,{state} ________, {phone} ________, helped {name} ________, who is the petitioner, fill out this form. PETITIONER(S) MUST INITIAL HERE________ CHILD SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (FAMILY) Case No.:_________________________________ THE FOLLOWING INFORMATION IS TRUE ABOUT MINOR CHILD #________: 1. 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 father's full legal name: __________________________________ *444 The minor child's mother's full legal name: __________________________________ The minor child's mother's maiden name: ______________________________________ 5. The minor child has lived in the following places since birth: Dates (to/from) Address / __________________________________________________________ / __________________________________________________________ / __________________________________________________________ / __________________________________________________________ / __________________________________________________________ / __________________________________________________________ / __________________________________________________________ [] Check here if continuing these facts on an attached page. 6. [√ one only] ____ The minor child is not married ____ The minor child is married to: {full legal name} 7. [√ one only] ____ The minor child has no children. ____ The minor child is the parent of the following child(ren): {enter name(s) and date(s) of birth} ___________________________________________________________ 8. Former names [√ 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} ______________________________________________________ by {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} _____________________________________________. ____ 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)} ______ 9. 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: _____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 10. Criminal History [√ one only] ____ 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) ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ *445 [] Check here if you are continuing these facts on an attached page. 11. Money Judgments [√ one only] ____ The minor child has never been adjudicated bankrupt, and no money judgment has ever been entered against him or her. ____ The following money judgment(s) has been entered against him or her: Date Amount Creditor Court entering judgment and case number √ if Paid ________ ________ ________ ______________________________________________ [] ________ ________ ________ ______________________________________________ [] PETITIONER(S) MUST INITIAL HERE ______[1] Rule 12.015, Family Law Forms, contains a list of Family Law Rules of Procedure Forms. This rule is amended to add the two new forms adopted in this case, form 12.900(g), Agreement Limiting Representation, and 12.900(h), Notice of Related Cases, and to add form 12.913(c), Affidavit of Diligent Search, which was previously adopted by the Court in In re Amendments to the Florida Family Law Rules of Procedure, 962 So. 2d 302 (Fla.2007).
[2] Minor editorial amendments are also made to a number of rules, including amendments to correct references to the Florida Rules of Judicial Administration, which have been renumbered.
