PER CURIAM.
In this case, the Court previously adopted rule and form amendments intended to minimize the amount of unnecessary personal information included in documents filed with the courts. See In re Implementation of Comm. on Privacy & Court Records Recommendations, 78 So.3d 1045 (Fla.2011). Because the amendments to the Florida Supreme Court Approved Family Law Forms were not published for comment prior to their adoption, interested persons were given sixty days from the date of the opinion to "file comments with the Court addressing only the amendments to the approved forms." In re Implementation of Comm. on Privacy & Court Records Recommendations, ___ So.3d ___, ___, 2011 WL 2566360 (Fla.2011), revised, 78 So.3d 1045, 2011 WL 5829543 (Fla.2011). Two comments were filed. One comment addresses an approved form that was amended. The other addresses rule amendments and an approved form that was not amended. We address only the comment on the amended form, which was filed by Judge Renee Goldenberg of the Seventeenth Judicial Circuit. Judge Goldenberg urges that the instructions for Form 12.932 (Certificate of Compliance with Mandatory Disclosure) be amended to provide better notice to self-represented litigants of the limitations on filing personal information unless it is absolutely essential. We agree.
After considering the comments, we further amend Florida Supreme Court Approved Family Law Form 12.932 (Certificate of Compliance with Mandatory Disclosure) and the instructions for that form.1 We add the following caveats to Form 12.932 and the instructions for that form, respectively:
ONLY THE ORIGINAL OF THIS COMPLETED FORM IS FILED WITH THE COURT. EXCEPT FOR THE FINANCIAL AFFIDAVIT AND CHILD SUPPORT GUIDELINES WORKSHEET, NO DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER. THE DOCUMENTS LISTED BELOW ARE TO BE GIVEN TO THE OTHER PARTY.
ONLY THE ORIGINAL OF THE COMPLETED FORM IS FILED WITH THE COURT. EXCEPT FOR THE FINANCIAL AFFIDAVIT AND CHILD SUPPORT GUIDELINES WORKSHEET, NO DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER. THE DOCUMENTS LISTED ON THE FORM ARE TO BE GIVEN TO THE OTHER PARTY.
Including these caveats is consistent with the inclusion of similar caveats in other family law forms and instructions. See, e.g., Fla. Fam. L.R.P. Form 12.930(b) (Standard Family Law Interrogatories for Original or Enforcement Proceedings); Fla. Fam. L.R.P. Form 12.930(c) (Standard Family Law Interrogatories for Modification Proceedings); Fla. Fam. L.R.P. Form 12.930(d) (Notice of Service of Answers to Standard Family Law Interrogatories).
Accordingly, we amend Florida Supreme Court Approved Family Law Form 12.932 and its instructions, as set forth in the appendix to this opinion, fully engrossed for immediate use. Also included in the appendix, fully engrossed for immediate use, is a corrected version of the Child Support Guidelines Chart contained in the Instructions for Florida Family Law Rules of Procedure Form 12.902(e) (Child Support Guidelines Worksheet). The forms also can be accessed and downloaded from this Court's website at www.flcourts.org/ gen_public/family/forms_rules/index.shtml. By amending the forms, we express no opinion as to their correctness or applicability. The amendments shall be effective immediately upon the release of this opinion.
It is so ordered.
CANADY, C.J., and PARIENTE, LEWIS, QUINCE, POLSTON, LABARGA, and PERRY, JJ., concur.
APPENDIX
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.902(e), CHILD SUPPORT GUIDELINES WORKSHEET (01/12)
When should this form be used?
You should complete this worksheet if child support is being requested in your case. If you know the income of the other party, this worksheet should accompany your financial affidavit. If you do not know the other party's income, this form must be completed after the other party files his or her financial affidavit, and serves a copy on you.
This form should be typed or printed in black ink. You should file the original with the clerk of the circuit court in the county where your case is filed and keep a copy for your records.
What should I do next?
A copy of this form must be mailed or hand delivered to the other party in your case, if it is not served on him or her with your initial papers.
Where can I look for more information?
Before proceeding, you should read "General Information for Self-Represented Litigants" found at the beginning of these forms. The words that are in "bold underline" in these instructions are defined there. For further information, see section 61.30, Florida Statutes.
Special notes ...
If you want to keep your address confidential because you are the victim of sexual battery, aggravated child abuse, aggravated stalking, harassment, aggravated battery, or domestic violence, do not enter the address, telephone, and fax information at the bottom of this form. Instead, file a Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h).
The chart below contains the guideline amounts that you should use when calculating child support. This amount is based on the number of children and the combined income of the parents, and it is divided between the parents in direct proportion to their income or earning capacity. From time to time, some of the amounts in the child support guidelines chart will change. Be sure you have the most recent version of the chart before using it.
Because the guidelines are based on monthly amounts, it may be necessary to convert some income and expense figures from other frequencies to monthly. You should do this as follows:
If payment is twice per month Payment amount x 2 = Monthly amount
If payment is every two weeks Payment amount x 26 = Yearly amount due
Yearly amount ÷ 12 = Monthly amount
If payment is weekly Weekly amount x 52 = Yearly amount due
Yearly amount ÷ 12 = Monthly amount
If you or the other parent request that the court award an amount that is different than the guideline amount, you must also complete and attach a Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943.
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.
CHILD SUPPORT GUIDELINES CHART
Combined One Two Three Four Five Six
Monthly Child Children Children Children Children Children
Available
Income
850.00 202 257 259 262 265 268
900.00 213 302 305 309 312 315
950.00 224 347 351 355 359 363
1000.00 235 365 397 402 406 410
1050.00 246 382 443 448 453 458
1100.00 258 400 489 495 500 505
1150.00 269 417 522 541 547 553
1200.00 280 435 544 588 594 600
1250.00 290 451 565 634 641 648
1300.00 300 467 584 659 688 695
1350.00 310 482 603 681 735 743
1400.00 320 498 623 702 765 790
1450.00 330 513 642 724 789 838
1500.00 340 529 662 746 813 869
1550.00 350 544 681 768 836 895
1600.00 360 560 701 790 860 920
1650.00 370 575 720 812 884 945
1700.00 380 591 740 833 907 971
1750.00 390 606 759 855 931 996
1800.00 400 622 779 877 955 1022
1850.00 410 638 798 900 979 1048
1900.00 421 654 818 923 1004 1074
1950.00 431 670 839 946 1029 1101
2000.00 442 686 859 968 1054 1128
2050.00 452 702 879 991 1079 1154
2100.00 463 718 899 1014 1104 1181
2150.00 473 734 919 1037 1129 1207
2200.00 484 751 940 1060 1154 1234
2250.00 494 767 960 1082 1179 1261
2300.00 505 783 980 1105 1204 1287
2350.00 515 799 1000 1128 1229 1314
2400.00 526 815 1020 1151 1254 1340
2450.00 536 831 1041 1174 1279 1367
2500.00 547 847 1061 1196 1304 1394
2550.00 557 864 1081 1219 1329 1420
2600.00 568 880 1101 1242 1354 1447
2650.00 578 896 1121 1265 1379 1473
2700.00 588 912 1141 1287 1403 1500
2750.00 597 927 1160 1308 1426 1524
2800.00 607 941 1178 1328 1448 1549
2850.00 616 956 1197 1349 1471 1573
2900.00 626 971 1215 1370 1494 1598
2950.00 635 986 1234 1391 1517 1622
3000.00 644 1001 1252 1412 1540 1647
3050.00 654 1016 1271 1433 1563 1671
3100.00 663 1031 1289 1453 1586 1695
3150.00 673 1045 1308 1474 1608 1720
3200.00 682 1060 1327 1495 1631 1744
3250.00 691 1075 1345 1516 1654 1769
3300.00 701 1090 1364 1537 1677 1793
3350.00 710 1105 1382 1558 1700 1818
3400.00 720 1120 1401 1579 1723 1842
3450.00 729 1135 1419 1599 1745 1867
3500.00 738 1149 1438 1620 1768 1891
3550.00 748 1164 1456 1641 1791 1915
3600.00 757 1179 1475 1662 1814 1940
3650.00 767 1194 1493 1683 1837 1964
3700.00 776 1208 1503 1702 1857 1987
3750.00 784 1221 1520 1721 1878 2009
3800.00 793 1234 1536 1740 1899 2031
3850.00 802 1248 1553 1759 1920 2053
3900.00 811 1261 1570 1778 1940 2075
3950.00 819 1275 1587 1797 1961 2097
4000.00 828 1288 1603 1816 1982 2119
4050.00 837 1302 1620 1835 2002 2141
4100.00 846 1315 1637 1854 2023 2163
4150.00 854 1329 1654 1873 2044 2185
4200.00 863 1342 1670 1892 2064 2207
4250.00 872 1355 1687 1911 2085 2229
4300.00 881 1369 1704 1930 2106 2251
4350.00 889 1382 1721 1949 2127 2273
4400.00 898 1396 1737 1968 2147 2295
4450.00 907 1409 1754 1987 2168 2317
4500.00 916 1423 1771 2006 2189 2339
4550.00 924 1436 1788 2024 2209 2361
4600.00 933 1450 1804 2043 2230 2384
4650.00 942 1463 1821 2062 2251 2406
4700.00 951 1477 1838 2081 2271 2428
4750.00 959 1490 1855 2100 2292 2450
4800.00 968 1503 1871 2119 2313 2472
4850.00 977 1517 1888 2138 2334 2494
4900.00 986 1530 1905 2157 2354 2516
4950.00 993 1542 1927 2174 2372 2535
5000.00 1000 1551 1939 2188 2387 2551
5050.00 1006 1561 1952 2202 2402 2567
5100.00 1013 1571 1964 2215 2417 2583
5150.00 1019 1580 1976 2229 2432 2599
5200.00 1025 1590 1988 2243 2447 2615
5250.00 1032 1599 2000 2256 2462 2631
5300.00 1038 1609 2012 2270 2477 2647
5350.00 1045 1619 2024 2283 2492 2663
5400.00 1051 1628 2037 2297 2507 2679
5450.00 1057 1638 2049 2311 2522 2695
5500.00 1064 1647 2061 2324 2537 2711
5550.00 1070 1657 2073 2338 2552 2727
5600.00 1077 1667 2085 2352 2567 2743
5650.00 1083 1676 2097 2365 2582 2759
5700.00 1089 1686 2109 2379 2597 2775
5750.00 1096 1695 2122 2393 2612 2791
5800.00 1102 1705 2134 2406 2627 2807
5850.00 1107 1713 2144 2418 2639 2820
5900.00 1111 1721 2155 2429 2651 2833
5950.00 1116 1729 2165 2440 2663 2847
6000.00 1121 1737 2175 2451 2676 2860
6050.00 1126 1746 2185 2462 2688 2874
6100.00 1131 1754 2196 2473 2700 2887
6150.00 1136 1762 2206 2484 2712 2900
6200.00 1141 1770 2216 2495 2724 2914
6250.00 1145 1778 2227 2506 2737 2927
6300.00 1150 1786 2237 2517 2749 2941
6350.00 1155 1795 2247 2529 2761 2954
6400.00 1160 1803 2258 2540 2773 2967
6450.00 1165 1811 2268 2551 2785 2981
6500.00 1170 1819 2278 2562 2798 2994
6550.00 1175 1827 2288 2573 2810 3008
6600.00 1179 1835 2299 2584 2822 3021
6650.00 1184 1843 2309 2595 2834 3034
6700.00 1189 1850 2317 2604 2845 3045
6750.00 1193 1856 2325 2613 2854 3055
6800.00 1196 1862 2332 2621 2863 3064
6850.00 1200 1868 2340 2630 2872 3074
6900.00 1204 1873 2347 2639 2882 3084
6950.00 1208 1879 2355 2647 2891 3094
7000.00 1212 1885 2362 2656 2900 3103
7050.00 1216 1891 2370 2664 2909 3113
7100.00 1220 1897 2378 2673 2919 3123
7150.00 1224 1903 2385 2681 2928 3133
7200.00 1228 1909 2393 2690 2937 3142
7250.00 1232 1915 2400 2698 2946 3152
7300.00 1235 1921 2408 2707 2956 3162
7350.00 1239 1927 2415 2716 2965 3172
7400.00 1243 1933 2423 2724 2974 3181
7450.00 1247 1939 2430 2733 2983 3191
7500.00 1251 1945 2438 2741 2993 3201
7550.00 1255 1951 2446 2750 3002 3211
7600.00 1259 1957 2453 2758 3011 3220
7650.00 1263 1963 2461 2767 3020 3230
7700.00 1267 1969 2468 2775 3030 3240
7750.00 1271 1975 2476 2784 3039 3250
7800.00 1274 1981 2483 2792 3048 3259
7850.00 1278 1987 2491 2801 3057 3269
7900.00 1282 1992 2498 2810 3067 3279
7950.00 1286 1998 2506 2818 3076 3289
8000.00 1290 2004 2513 2827 3085 3298
8050.00 1294 2010 2521 2835 3094 3308
8100.00 1298 2016 2529 2844 3104 3318
8150.00 1302 2022 2536 2852 3113 3328
8200.00 1306 2028 2544 2861 3122 3337
8250.00 1310 2034 2551 2869 3131 3347
8300.00 1313 2040 2559 2878 3141 3357
8350.00 1317 2046 2566 2887 3150 3367
8400.00 1321 2052 2574 2895 3159 3376
8450.00 1325 2058 2581 2904 3168 3386
8500.00 1329 2064 2589 2912 3178 3396
8550.00 1333 2070 2597 2921 3187 3406
8600.00 1337 2076 2604 2929 3196 3415
8650.00 1341 2082 2612 2938 3205 3425
8700.00 1345 2088 2619 2946 3215 3435
8750.00 1349 2094 2627 2955 3224 3445
8800.00 1352 2100 2634 2963 3233 3454
8850.00 1356 2106 2642 2972 3242 3464
8900.00 1360 2111 2649 2981 3252 3474
8950.00 1364 2117 2657 2989 3261 3484
9000.00 1368 2123 2664 2998 3270 3493
9050.00 1372 2129 2672 3006 3279 3503
9100.00 1376 2135 2680 3015 3289 3513
9150.00 1380 2141 2687 3023 3298 3523
9200.00 1384 2147 2695 3032 3307 3532
9250.00 1388 2153 2702 3040 3316 3542
9300.00 1391 2159 2710 3049 3326 3552
9350.00 1395 2165 2717 3058 3335 3562
9400.00 1399 2171 2725 3066 3344 3571
9450.00 1403 2177 2732 3075 3353 3581
9500.00 1407 2183 2740 3083 3363 3591
9550.00 1411 2189 2748 3092 3372 3601
9600.00 1415 2195 2755 3100 3381 3610
9650.00 1419 2201 2763 3109 3390 3620
9700.00 1422 2206 2767 3115 3396 3628
9750.00 1425 2210 2772 3121 3402 3634
9800.00 1427 2213 2776 3126 3408 3641
9850.00 1430 2217 2781 3132 3414 3647
9900.00 1432 2221 2786 3137 3420 3653
9950.00 1435 2225 2791 3143 3426 3659
10000.00 1437 2228 2795 3148 3432 3666
IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT,
IN AND FOR ___________ COUNTY, FLORIDA
Case No.: __________________
Division: __________________
_______________________,
Petitioner,
and
_______________________,
Respondent.
NOTICE OF FILING CHILD SUPPORT GUIDELINES WORKSHEET
PLEASE TAKE NOTICE, that (name) ___________, is filing his/her Child Support Guidelines Worksheet attached and labeled Exhibit 1.
CERTIFICATE OF SERVICE
I certify that a copy of this Notice of Filing with the Child Support Guidelines Worksheet was [check 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: ________________________
Date: _____________________________
_______________________________
Signature of Party
Printed Name _________________
Address: ______________________
City. State, Zip: _____________
Telephone Number _____________
Fax Number ___________________
Honda Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12)
-------------------------------------------------------------------------------------------
| CHILD SUPPORT GUIDELINES WORKSHEET |
|-------------------------------------------------------------------------------------------|
| | A. FATHER | B. MOTHER | TOTAL |
|-------------------------------------------|----------------|---------------|--------------|
| 1. Present Net Monthly Income | | | |
| Enter the amount from line number | | | |
| 27, Section I of Florida Family Law | | | |
| Rules of Procedure Form 12.902(b) | | | |
| or (c), Financial Affidavit. | | | |
|-------------------------------------------|--------------------------------|--------------|
| 2. Basic Monthly Obligation | | |
| There is (are) {number} ____ minor | | |
| child(ren) common to the parties. | | |
| Using the total amount from line 1, | | |
| enter the appropriate amount from | | |
| the child support guidelines chart. | | |
|-------------------------------------------|-----------------------------------------------|
| 3. Percent of Financial Responsibility | % | % |
| Divide the amount on line 1A by the | | |
| total amount on line 1 to get | | |
| Father's percentage financial | | |
| responsibility. Enter answer on line | | |
| 3A. Divide the amount on line 1B by | | |
| the total amount on line 1 to get | | |
| Mother's percentage financial | | |
| responsibility. Enter answer on line | | |
| 3B. | | |
|-------------------------------------------|-----------------------------------------------|
| 4. Share of Basic Monthly Obligation | | |
| Multiply the number on line 2 by the | | |
| percentage on line 3A to get | | |
| Father's share of basic obligation. | | |
| Enter answer on line 4A. | | |
| Multiply the number on line 2 by the | | |
| percentage on line 3B to get | | |
| Mother's share of basic obligation. | | |
| Enter answer on line 4B. | | |
|-------------------------------------------------------------------------------------------|
| Additional Support — Health Insurance, Child Care & Other |
|-------------------------------------------------------------------------------------------|
| 5. | | |
| a. 100% of Monthly Child Care | | |
| Costs | | |
| [Child care costs should not exceed | | |
| the level required to provide quality | | |
| care from a licensed source. See | | |
| section 61.30(7), Fla. Stat. for more | | |
| information.] | | |
-------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------
| CHILD SUPPORT GUIDELINES WORKSHEET |
|-------------------------------------------------------------------------------------------|
| | A. FATHER | B. MOTHER | TOTAL |
|-------------------------------------------|----------------|---------------|--------------|
| b. Total Monthly Child(ren)'s | | |
| Health Insurance Cost | | |
| [This is only amounts actually | | |
| paid for health insurance on the | | |
| child(ren).] | | |
|-------------------------------------------|--------------------------------|--------------|
| c. Total Monthly Child(ren)'s | | |
| Noncovered Medical, Dental and | | |
| Prescription Medication Costs | | |
|-------------------------------------------|--------------------------------|--------------|
| d. Total Monthly Child Care & | | |
| Health Costs [Add lines | | |
| 5a+5b+5c] | | |
|-------------------------------------------------------------------------------------------|
| 6. Additional Support Payments | | | |
| Multiply the number on line 5d by | | | |
| the percentage on line 3A to | | | |
| determine the Father's share. | | | |
| Enter answer on line 6A. | | | |
| Multiply the number on line 5d by | | | |
| the percentage on line 3B to | | | |
| determine the Mother's share. | | | |
| Enter answer on line 6B. | | | |
|-------------------------------------------------------------------------------------------|
| Statutory Adjustments/Credits |
|-------------------------------------------------------------------------------------------|
| 7. | | | |
| a. Monthly child care payments | | | |
| actually made | | | |
|-------------------------------------------|----------------|---------------|--------------|
| b. Monthly health insurance | | | |
| payments actually made | | | |
|-------------------------------------------|----------------|---------------|--------------|
| c. Other payments/credits actually | | | |
| made for any noncovered | | | |
| medical, dental and prescription | | | |
| medication expenses of the | | | |
| child(ren) not ordered to be | | | |
| separately paid on a percentage | | | |
| basis. [See § 61.30 (8), Florida | | | |
| Statutes] | | | |
|-------------------------------------------|----------------|---------------|--------------|
| 8. Total Support Payments actually made | | | |
| [Add 7a through 7c] | | | |
|-------------------------------------------|----------------|---------------|--------------|
| 9. MINIMUM CHILD SUPPORT | | | |
| OBLIGATION FOR EACH PARENT | | | |
| [Line 4 plus line 6; minus line 8] | | | |
-------------------------------------------------------------------------------------------
| Substantial Time-Sharing (GROSS UP METHOD) If each parent exercises time-sharing at least 20 |
| percent of the overnights in the year (73 overnights in the year), complete Nos. 10 through 21 |
|__________________________________________________________________________________________
------------------------------------------------------------------------------------------------------
| CHILD SUPPORT GUIDELINES WORKSHEET |
|------------------------------------------------------------------------------------------------------|
| | A. FATHER | B. MOTHER | TOTAL |
|------------------------------------------------------------------------------------------------------|
| 10. Basic Monthly Obligation × 150% | |
| [Multiply line 2 by 1.5] | |
|-------------------------------------------|----------------------------------------------------------|
| 11. Increased Basic Obligation for each | | | |
| parent | | | |
| Multiply the number on line 10 by | | | |
| the percentage on line 3A to | | | |
| determine the Father's share. | | | |
| Enter answer on line 11A. | | | |
| Multiply the number on line 10 by | | | |
| the percentage on line 3B to | | | |
| determine the Mother's share. | | | |
| Enter answer on line 11B. | | | |
|-------------------------------------------|----------------|---------------|-------------------------|
| 12. Percentage of overnight stays with | % | % | |
| each parent | | | |
| The child(ren) spend(s) ______ | | | |
| overnight stays with the Father each | | | |
| year. Using the number on the | | | |
| above line, multiply it by 100 and | | | |
| divide by 365. Enter this number on | | | |
| line 12A. | | | |
| The child(ren) spend(s) ______ | | | |
| overnight stays with the Mother | | | |
| each year. Using the number on the | | | |
| above line, multiply it by 100 and | | | |
| divide by 365. Enter this number on | | | |
| line 12B. | | | |
|-------------------------------------------|----------------|---------------|-------------------------|
| 13. Parent's support multiplied by other | | | |
| Parent's percentage of overnights | | | |
| [Multiply line 11A by line 12B. Enter | | | |
| this number in 13A. Multiply line | | | |
| 11B by line 12A. Enter this number | | | |
| in 13B.] | | | |
|------------------------------------------------------------------------------------------------------|
| Additional Support — Health Insurance, Child Care & Other |
------------------------------------------------------------------------------------------------------
| 14. | | |
| a. Total Monthly Child Care Costs | | |
| [Child care costs should not exceed the | | |
| level required to provide quality care | | |
| from a licensed source. See section | | |
| 61.30(7), Fla. Stat. for more | | |
| information.] | | |
|------------------------------------------------| |---------|
---------------------------------------------------------------------------------------
| CHILD SUPPORT GUIDELINES WORKSHEET |
|--------------------------------------------------------------------------------------|
| | A. FATHER | B. MOTHER | TOTAL |
|------------------------------------------------|---------------------------|---------|
| b. Total Monthly Child(ren)'s | | |
| Health Insurance Cost. [This is | | |
| only amounts actually paid for | | |
| health insurance on the | | |
| child(ren).] | | |
|------------------------------------------------| |---------|
| c. Total Monthly Child(ren)'s | | |
| Noncovered Medical, Dental and | | |
| Prescription Costs. | | |
|------------------------------------------------| |---------|
| d. Total Monthly Child Care & | | |
| Health Costs [Add lines | | |
| 14a+14b+14c] | | |
|------------------------------------------------|---------------------------|---------|
| 15. Additional Support Payments | | | |
| Multiply the number on line 14d by | | | |
| the percentage on line 3A to | | | |
| determine the Father's share. | | | |
| Enter answer on line 15A. | | | |
| Multiply the number on line 14d by | | | |
| the percentage on line 3B to | | | |
| determine the Mother's share. | | | |
| Enter answer on line 15B. | | | |
|--------------------------------------------------------------------------------------|
| Statutory Adjustments/Credits |
|--------------------------------------------------------------------------------------|
| 16. | | | |
| a. Monthly child care payments | | | |
| actually made | | | |
|--------------------------------------------------------------------------------------|
| b. Monthly health insurance | | | |
| payments actually made | | | |
----------------------------------------------------------------------------------------
| c. Other payments/credits actually | | | |
| made for any noncovered | | | |
| medical, dental and prescription | | | |
| medication expenses of the | | | |
| child(ren) not ordered to be | | | |
| separately paid on a percentage | | | |
| basis. [See Section 61.30 (8), | | | |
| Florida Statutes] | | | |
|------------------------------------------------|-------------|-------------| |
| 17. Total Support Payments actually | | | |
| made [Add 16a through 16c] | | | |
|------------------------------------------------|-------------|-------------| |
| 18. Total Additional Support Transfer | | | |
| Amount [Line 15 minus line 17; Enter | | | |
| any negative number as zero] | | | |
|------------------------------------------------|-------------|-------------| |
----------------------------------------------------------------------------------------
| CHILD SUPPORT GUIDELINES WORKSHEET |
|-------------------------------------------------------------------------------------------|
| | A. FATHER | B. MOTHER | TOTAL |
|-------------------------------------------|----------------|---------------|--------------|
| 19. Total Child Support Owed from | | | |
| Father to Mother [Add line 13A+18A] | | | |
|------------------------------------------------|-------------|-------------| |
| 20. Total Child Support Owed from | | | |
| Mother to Father [Add line 13B+18B] | | | |
|------------------------------------------------|-------------|-------------| |
| 21. Actual Child Support to Be Paid. | $ | $ | |
| [Comparing lines 19 and 20, Subtract | | | |
| the smaller amount owed from the | | | |
| larger amount owed and enter the | | | |
| result in the column for the parent | | | |
| that owes the larger amount of | | | |
| support] | | | |
---------------------------------------------------------------------------------------|
ADJUSTMENTS TO GUIDELINES AMOUNT. If you or the other parent is requesting the Court to award a
child support amount that is more or less than the child support guidelines, you must complete and file
Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form
12.943.
[check one only]
a. ___ Deviation from the guidelines amount is requested. The Motion to Deviate from Child
Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is attached.
b. ___ Deviation from the guidelines amount is NOT requested. The Motion to Deviate from Child
Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is not attached.
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 [check one only] ___ petitioner or ___ respondent, fill out this form.
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.932, CERTIFICATE OF COMPLIANCE WITH MANDATORY DISCLOSURE (01/12)
When should this form be used?
Mandatory disclosure requires each party in a dissolution of marriage case to provide the other party with certain financial information and documents. These documents must be provided by mail or hand delivery to the other party within 45 days of service of the petition for dissolution of marriage or supplemental petition for modification on the respondent. The mandatory disclosure rule applies to all original and supplemental dissolution of marriage cases, except simplified dissolution of marriage cases and cases where the respondent is served by constructive service and does not answer. You should use this form to notify the court and the other party that you have complied with the mandatory disclosure rule.
Each party must provide the other party with the documents listed in section 2 of this form if the relief being sought is permanent regardless of whether it is an initial or supplemental proceeding. ONLY THE ORIGINAL OF THE COMPLETED FORM IS FILED WITH THE COURT. EXCEPT FOR THE FINANCIAL AFFIDAVIT AND CHILD SUPPORT GUIDELINES WORKSHEET, NO DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER. THE DOCUMENTS LISTED ON THE FORM ARE TO BE GIVEN TO THE OTHER PARTY. If your individual gross annual income is under $50,000, you should complete the Family Law Financial Affidavit (Short Form), Florida Family Law Rules of Procedure Form 12.902(b). If your individual gross annual income is $50,000 or more, you should complete the Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(c).
In addition, there are separate mandatory disclosure requirements that apply to temporary financial hearings, which are listed in section 1 of this form. The party seeking temporary financial relief must serve these documents on the other party with the notice of temporary financial hearing. The responding party must either deliver the required documents to the party seeking temporary relief on or before 5:00 p.m., 2 business days before the hearing on temporary relief, or mail (postmark) them to the other party seeking temporary relief 7 days before the hearing on temporary financial relief. Any documents that have already been served under the requirements for temporary or initial proceedings, do not need to be reserved again in the same proceeding. If a supplemental petition is filed, seeking modification, then the mandatory disclosure requirements begin again.
This form should be typed or printed in black ink. After completing this form, you should file the original with the clerk of the circuit court in the county where your case is filed and keep a copy for your records. A copy of this form must be mailed or hand delivered to any other party in your case.
What should I do next?
After you have provided the other party all of the financial information and documents and have filed this form certifying that you have complied with this rule, you are under a continuing duty to promptly give the other party any information or documents that change your financial status or that make the information already provided inaccurate. You should not file with the clerk any of the documents listed in the certificate of compliance other than the financial affidavit and child support guidelines worksheet. Refer to the instructions regarding the petition in your case to determine how you should proceed after filing this form.
Where can I look for more information?
Before proceeding, you should read "General Information for Self-Represented Litigants" found at the beginning of these forms. For further information, see rule 12.285, Florida Family Law Rules of Procedure.
Special notes . . .
You may provide copies of required documents; however, the originals must be produced for inspection if the other party requests to see them.
Although the financial affidavits are based on individual gross income, either party may ask the other party to complete the Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(c), by serving the appropriate interrogatory form. (See Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(b) (original proceedings) or (c) (modification proceedings)).
Any portion of the mandatory disclosure rule may be modified by order of the judge or agreement of the parties. Therefore, you and your spouse may agree that you will not require each other to produce the documents required under the mandatory disclosure rule. This exception does not apply to the Financial Affidavit, Family Law Rules of Procedure Form 12.902(b) or (c), which is required in all cases and cannot be waived.
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: __________________
_______________________,
Petitioner,
and
_______________________,
Respondent.
CERTIFICATE OF COMPLIANCE WITH MANDATORY DISCLOSURE
ONLY THE ORIGINAL OF THIS COMPLETED FORM
IS FILED WITH THE COURT. EXCEPT FOR THE
FINANCIAL AFFIDAVIT AND CHILD SUPPORT
GUIDELINES WORKSHEET, NO DOCUMENTS SHALL
BE FILED IN THE COURT FILE WITHOUT A PRIOR
COURT ORDER. THE DOCUMENTS LISTED BELOW
ARE TO BE GIVEN TO THE OTHER PARTY.
I, {full legal name} ______________________________, certify that I have
complied with the mandatory disclosure required by Florida Family Law Rule 12.285 as follows:
1. FOR TEMPORARY FINANCIAL RELIEF, ONLY:
The date the following documents were served: ___________________________________.
[Check all that apply]
a. ___ Financial Affidavit
( ) Florida Family Law Rules of Procedure Form 12.902(b) (short form)
( ) Florida Family Law Rules of Procedure Form 12.902(c) (long form)
b. ___ ( ) All personal (1040) federal tax, gift tax, and intangible personal property tax
returns for the preceding year; or
( ) Transcript of tax return as provided by IRS form 4506-T; or
( ) IRS forms W-2, 1099, and K-1 for the past year because the Income tax return
for the past year has not been prepared.
c. ___ Pay stubs or other evidence of earned Income for the 3 months before the service
of the financial affidavit.
2. FOR INITIAL, SUPPLEMENTAL, AND PERMANENT FINANCIAL RELIEF:
The date the following documents were served: __________________________________________
[Check all that apply]
a. ___ Financial Affidavit
( ) Florida Family Law Rules of Procedure Form 12.902(b) (short form)
( ) Florida Family Law Rules of Procedure Form 12.902(c) (long form)
b. ___ ( ) All personal (1040) federal and state income tax returns, gift tax returns, and
intangible personal property tax returns for the preceding 3 years;
( ) IRS forms W-2, 1099, and K 1 for the past year because the income tax return
for the past year has not been prepared.
c. ___ Pay stubs or other evidence of earned income for the 3 months before the service
of the financial affidavit.
d. ___ A statement identifying the source and amount of all income for the 3 months
before the service of the financial affidavit, if not reflected on the pay stubs produced
e. ___ All loan applications and financial statements prepared for any purpose or used for
any purpose within the 12 months preceding the service of the financial affidavit
f. ___ All deeds to real estate in which I presently own or owned an interest within the
past 3 years All promissory notes in which I presently own or owned an interest within
the last 12 months. All present leases in which I own an interest.
g. ___ All periodic statements for the last 3 months for all checking accounts and for the
last year for all savings accounts, money market funds, certificates of deposit, etc.
h. ___ All brokerage account statements for the last 12 months.
i. ___ Most recent statement for any pension, profit sharing, deferred compensation, or
retirement plan (for example, IRA, 401(k), 403(b), SEP, KEOGH, etc.) and summary plan
description for any such plan in which I am a participant or alternate payee
j. ___ The declaration page, the last periodic statement, and the certificate for any group
insurance for all life insurance policies insuring my life or the life of me or my spouse.
k. ___ All health and dental insurance cards covering either me or my spouse and/or our
dependent child(ren).
l. ___ Corporate, partnership, and trust tax returns for the last 3 tax years, in which I have
an ownership or interest greater than or equal to 30%.
m. ___ All credit card and charge account statements and other records showing my (our)
indebtedness as of the date of the filing of this action and for the prior 3 months. All
promissory notes on which I presently owe or owned within the past year All lease
agreements I presently owe.
n. ___ All premarital and marital agreements between the parties to this case
o. ___ If a modification proceeding, all written agreements entered Into between the
parties at any time since the order to be modified was entered.
p. ___ All documents and tangible evidence relating to claims for an unequal distribution
of marital property, enhancement or appreciation in nonmarital property, or nonmarital
status of an asset or debt.
q. ___ Any court order directing that I pay or receive spousal support (alimony) or child
support
I certify that a copy of this document was [Check one only] ( ) mailed ( ) faxed and mailed
( ) hand delivered to the person(s) listed below on {date} _________________________
I understand that I am swearing or affirming under oath to the accuracy of my compliance with
the mandatory disclosure requirements of Fla. Fam. L. R. P. 12.285 and that, unless otherwise
indicated with specificity, this disclosure is complete. I further understand that the punishment
for knowingly making a false statement or Incomplete disclosure includes fines and/or
imprisonment.
Other party or his/her attorney:
Name: _________________________________
Address. ______________________________
City, State, Zip: _____________________
Fax Number: ___________________________
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 __________________.
___________________________________
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 [Check one only] ____ petitioner or ____ respondent, fill out this form
