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8353 SW 124th STREET SUITE 204 MIAMI, FL 33156
Office: 786-484-1238 FAX: 866-683-5105 www.apexlegalsolutions.info
Thank you for purchasing your divorce packet for Miami Dade County, here are a few important details:
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1 – You must make an appointment with the Miami Dade Self Help Program in order to turn in the documents.
They will charge you $15 (credit, debit or money order) to review your divorce documents. If the divorce is in
mutual agreement and you do not want to go to court contact our office for options and a $40 discount for our
complete services.
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Call - 305-349-7800 Option 3
When you request an appointment for a divorce let them know that you do not have a client number and that
you have your own divorce papers.
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2 – Make sure to sign and notarize all the forms, if your spouse refuses to sign go to our website and download
the summons form on our forms page and bring it to your appointment with the self help program.
3 – The last 2 pages of the file can be used if you make less than $21,600 a year and would like to request a
waiver of the court filing fee. These pages are to be provided to the court clerk AFTER the rest of the
documents have been approved by the staff from the Miami Dade Self Help Program.
Gracias por comprar un paquete the formularios de divorcio de Miami Dade County, detalles
importantes:
1 - Debes hacer una cita en el programa de Miami Dade Self Help para entregar tus documentos. Ellos te
cobraran $15 (credito, debito o money order) Si el divorcio es en mutuo acuerdo y no quieres ir a corte llama a
nuestra oficina para informacion sobre nuestros servicios completes y un descuento de $40.
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Llame al - 305-349-7800 Opcion 3
Solicite una cita para su divorcio, hágales saber que no tiene numero de cliente y que tiene sus documentos
propios
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2 – Asegúrese de firmar y autenticar todos los formularios, si tu cónyuge se niega a firmar dirigase a nuestro
sitio web y descarge el formulario de summons en nuestra página de formularios y llevelo a su cita con el
programa de self-help.
3 - Las ultimas dos paginas del paquete de formularios son para pedir un perdon de los gastos de corte siempre
y cuando ganes menos de $21,600 al año. Tales paginas se otorgan al clerk de la corte DESPUES de que el resto
del paquete son aprobados por el Self Help.
MIAMI DADE FAMILY COURT SELF HELP PROGRAM
LAWSON THOMAS COURTHOUSE
175 NW 1ST STREET
24TH FLOOR
MIAMI, FL 33125
Cover Sheet for Family Court Cases
I. Case Style
11th
IN THE CIRCUIT COURT OF THE ______________
JUDICIAL CIRCUIT,
IN AND FOR ______________
MIAMI DADE COUNTY, FLORIDA
Case No.: ________________
Judge: __________________
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_____________________________
Petitioner
and
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_____________________________
Respondent
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II. Type of Action/Proceeding. Place a check beside the proceeding you are initiating. If you are
simultaneously filing more than one type of proceeding against the same opposing party,
such as a modification and an enforcement proceeding, complete a separate cover sheet for
each action being filed. If you are reopening a case, choose one of the three options below
it.
✔ Initial Action/Petition
(A) ___
(B) ___ Reopening Case
1. ___ Modification/Supplemental Petition
2. ___ Motion for Civil Contempt/Enforcement
3. ___ Other
III. Type of Case. If the case fits more than one type of case, select the most definitive.
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(A) ___ Simplified Dissolution of Marriage
✔ Dissolution of Marriage
(B) ___
(C) ___ Domestic Violence
(D) ___ Dating Violence
(E) ___ Repeat Violence
(F) ___ Sexual Violence
(G) ___ Support IV‐D (Department of Revenue, Child Support Enforcement)
(H) ___ Support Non‐IV‐D (not Department of Revenue, Child Support Enforcement)
(I) ___ UIFSA IV‐D (Department of Revenue, Child Support Enforcement)
(J) ___ UIFSA Non‐IV‐D (not Department of Revenue, Child Support Enforcement)
(K) ___ Other Family Court
(L) ___ Adoption Arising Out Of Chapter 63
(M) ___ Name Change
(N) ___ Paternity/Disestablishment of Paternity
(O) ___ Juvenile Delinquency
(P) ___ Petition for Dependency
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Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases (01/10)
(Q) ___ Shelter Petition
(R) ___ Termination of Parental Rights Arising Out Of Chapter 39
(S) ___ Adoption Arising Out Of Chapter 39
(T) ___ CINS/FINS
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IV. Rule of Judicial Administration 2.545(d) requires that a Notice of Related Cases Form, Family
Law Form 12.900(h), be filed with the initial pleading/petition by the filing attorney or self‐
represented litigant in order to notify the court of related cases. Is Form 12.900(h) being
filed with this Cover Sheet for Family Court Cases and initial pleading/petition?
___ No, to the best of my knowledge, no related cases exist.
___ Yes, all related cases are listed on Family Law Form 12.900(h).
ATTORNEY OR PARTY SIGNATURE
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I CERTIFY that the information I have provided in this cover sheet is accurate to the best
of my knowledge and belief.
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Signature________________________________________ FL Bar No.: _____________________
Attorney or party
(Bar number,if attorney)
________________________________________
(Type or print name)
______________________
Date
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,
whose address is {street}___________________________ , {city}_________________________,
{state}______ , {phone}____________________, helped {name}__________________________,
who is the [choose one only] ___ petitioner or ___ respondent, fill out this form.
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Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases (01/10)
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11th
IN THE CIRCUIT COURT OF THE _____________________
JUDICIAL CIRCUIT,
MIAMI DADE
IN AND FOR ______________________________
COUNTY, FLORIDA
Case No: ________________________
Division: ________________________
_________________________________,
Petitioner,
And
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_________________________________,
Respondent.
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PETITION FOR DISSOLUTION OF MARRIAGE
WITH NO DEPENDENT OR MINOR CHILD(REN) OR PROPERTY
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I, {full legal name} ______________________________________________________, the
[ Choose only one] ( ) Husband ( ) Wife, being sworn, certify that the following statements are true:
1. JURISDICTION/RESIDENCE
( ) Husband ( ) Wife ( ) Both has (have) lived in Florida for at least 6 months before the filing of
this Petition for Dissolution of Marriage.
2. The husband [Choose only one] ( ) is ( ) is not a member of the military service.
The wife [Choose only one]
(
) is ( ) is not a member of the military service.
3. MARRIAGE HISTORY
Date of marriage: {month, day, year} ________________________________________________
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4. THERE ARE NO MINOR (under 18) OR DEPENDENT CHILD(REN) COMMON TO BOTH PARTIES AND
THE WIFE IS NOT PREGNANT.
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5. A completed Notice of Social Security Number, Florida Supreme Court Approved Family Law Form
12.902(j), is filed with this petition.
6. THIS PETITION FOR DISSOLUTION OF MARRIAGE SHOULD BE GRANTED BECAUSE:
[Choose only one]
a. _____ The marriage is irretrievably broken.
b. _____ One of the parties has been adjudged mentally incapacitated for a period of 3 years
before the filing of this petition. A copy of the Judgment of Incapacity is attached.
7. THERE ARE NO MARITAL ASSETS OR LIABILITIES.
8. PETITIONER FOREVER GIVES UP HIS/HER RIGHTS TO SPOUSAL SUPPORT (ALIMONY) FROM
RESPONDENT.
Florida Supreme Court Approved Law Form 12.901(b)(3), Petition for Dissolution of Marriage with No Dependent
or Minor Child(ren) or Property (10/11)
9. [If Petitioner is also the Wife, Choose only one] ( ) yes ( ) no Petitioner/Wife wants to be known
by her former name, which was {full legal name} _________________________________.
10. Other relief {specify}: ________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
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PETITIONER’S REQUEST (This section summarizes what you are asking the Court to include in the final
judgment of dissolution of marriage.)
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Petitioner requests that the Court enter an order dissolving the marriage and:
[ Choose all that apply]
1. ____ restoring Wife’s former name as specified in paragraph 9 of this petition;
2. ____ awarding other relief as specified in paragraph 10 of this petition; and any other terms the
Court deems necessary.
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: __________________________________
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Florida Supreme Court Approved Law Form 12.901(b)(3), Petition for Dissolution of Marriage with No Dependent
or Minor Child(ren) or Property (10/11)
STATE OF FLORIDA
COUNTY OF ____________________
Sworn to or affirmed and signed before me on ____________ by _______________________________.
_____________________________________________
NOTARY PUBLIC or DEPUTY CLERK
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Personally known
Produced identification
Type of identification produced ________________________________
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____
____
____
_____________________________________________
[Print, type, or stamp commissioned name of notary or
deputy clerk.]
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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, whose address is {street} _________________________, {city} ______________________,
{state} ______________,{phone} ______, helped {name} _______________________________, who is the petitioner, fill out this form.
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Florida Supreme Court Approved Law Form 12.901(b)(3), Petition for Dissolution of Marriage with No Dependent
or Minor Child(ren) or Property (10/11)
11th
IN THE CIRCUIT COURT OF THE
IN AND FOR
MIAMI DADE
Petitioner,
JUDICIAL CIRCUIT,
COUNTY, FLORIDA
Case No.:
Division:
,
and
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Respondent.
,
NOTICE OF SOCIAL SECURITY NUMBER
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I, {full legal name}
certify that my social security number is
, as required in section
61.052(7), sections 61.13(9) or (10), section 742.031(3), sections 742.032(1)–(3), and/or sections
742.10(1)–(2), Florida Statutes. My date of birth is
.
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[/ one only]
1. This notice is being filed in a dissolution of marriage case in which the parties have
children in common.
no minor
2. This notice is being filed in a paternity or child support case, or in a dissolution of marriage in
which the parties have minor children in common. The minor child(ren)'s name(s), date(s) of
birth, and social security number(s) is/are:
Name
Birth date
Social Security Number
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{Attach additional pages if necessary.}
Disclosure of social security numbers shall be limited to the purpose of administration of the Title IV-D
program for child support enforcement.
Florida Supreme Court Approved Family Law Form 12.902(j), Notice of Social Security Number (9/00)
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in
this notice and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated:
Signature
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
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STATE OF FLORIDA
COUNTY OF ________
Sworn to or affirmed and signed before me on
by
.
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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: [ N fill in all blanks]
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I, {full legal name and trade name of nonlawyer}
, {city}
a nonlawyer, located at {street}
, {phone}
, helped {name}
{state}
petitioner or
respondent, fill out this form.
who is the [ / one only]
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Florida Supreme Court Approved Family Law Form 12.902(j), Notice of Social Security Number (9/00)
,
,
,
11th
IN THE CIRCUIT COURT OF THE
IN AND FOR
MIAMI DADE
Petitioner,
JUDICIAL CIRCUIT,
COUNTY, FLORIDA
Case No.:
Division:
,
and
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Respondent.
,
NOTICE OF SOCIAL SECURITY NUMBER
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I, {full legal name}
certify that my social security number is
, as required in section
61.052(7), sections 61.13(9) or (10), section 742.031(3), sections 742.032(1)–(3), and/or sections
742.10(1)–(2), Florida Statutes. My date of birth is
.
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[/ one only]
1. This notice is being filed in a dissolution of marriage case in which the parties have
children in common.
no minor
2. This notice is being filed in a paternity or child support case, or in a dissolution of marriage in
which the parties have minor children in common. The minor child(ren)'s name(s), date(s) of
birth, and social security number(s) is/are:
Name
Birth date
Social Security Number
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{Attach additional pages if necessary.}
Disclosure of social security numbers shall be limited to the purpose of administration of the Title IV-D
program for child support enforcement.
Florida Supreme Court Approved Family Law Form 12.902(j), Notice of Social Security Number (9/00)
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in
this notice and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated:
Signature
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
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STATE OF FLORIDA
COUNTY OF ________
Sworn to or affirmed and signed before me on
by
.
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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: [ N fill in all blanks]
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I, {full legal name and trade name of nonlawyer}
, {city}
a nonlawyer, located at {street}
, {phone}
, helped {name}
{state}
petitioner or
respondent, fill out this form.
who is the [ / one only]
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Florida Supreme Court Approved Family Law Form 12.902(j), Notice of Social Security Number (9/00)
,
,
,
11th
IN THE CIRCUIT COURT OF THE _____________________
JUDICIAL CIRCUIT,
IN AND FOR ______________________________
COUNTY, FLORIDA
MIAMI DADE
Case No: ________________________
Division: ________________________
_________________________________,
Petitioner,
And
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Respondent.
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ANSWER, WAIVER, AND REQUEST FOR COPY OF FINAL JUDGMENT OF
DISSOLUTION OF MARRIAGE
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, Respondent, being sworn, certify
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I, {full legal name}
that the following information is true:
1. Respondent answers the Petition for Dissolution of Marriage filed in this action and admits all
the allegations. By admitting all of the allegations in the petition, respondent agrees to all relief
requested in the petition including any requests regarding parenting and time-sharing, child
support, alimony, distribution of marital assets and liabilities, and temporary relief.
2. Respondent waives notice of hearing as well as all future notices in connection with the Petition
for Dissolution of Marriage, as filed. Respondent also waives appearance at the final hearing.
3. Respondent requests that a copy of the Final Judgment of Dissolution of Marriage entered in
this case be forwarded to Respondent at the address below.
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4. If this case involves minor child(ren), a completed Uniform Child Custody Jurisdiction and
Enforcement Act (UCCJEA) Affidavit, Florida Supreme Court Approved Family Law Form
12.902(d), is filed with this answer.
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5. A completed Notice of Social Security Number, Florida Supreme Court Approved Family Law
Form 12.902(j), is filed with this answer.
6. A completed Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form
12.902(b) or (c), ( ) is filed with this answer ( ) will be timely filed.
Florida Supreme Court Approved Family Law Form 12.903(a), Answer, Waiver, and Request for Copy of Final Judgment of
Dissolution of Marriage (12/10)
I certify that a copy of this document was [Choose only one] ( ) 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: __________________________________
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I understand that I am swearing or affirming under oath to the truthfulness of the claims
made in this motion and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
_______________________________________
Signature of RESPONDENT
Printed Name: ___________________________
Address: _______________________________
City, State, Zip: __________________________
Telephone Number: ______________________
Fax Number: ___________________________
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Dated: ______________________
STATE OF FLORIDA
COUNTY OF ____________________
Sworn to or affirmed and signed before me on __________ by ___________________________.
_______________________________________
NOTARY PUBLIC or DEPUTY CLERK
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_______________________________________
[Print, type, or stamp commissioned name of notary or
deputy clerk.]
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____
____
____
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, whose address is {street} __________________________, {city} _____________________,
{state} ______________,{phone} ______, helped {name} _______________________________, who is
the respondent, fill out this form.
Answer, Waiver, and Request for Copy of Final Judgment of Dissolution of Marriage, Florida Supreme Court
Approved Form 12.903(a)(12/10)
11th
IN THE CIRCUIT COURT OF THE
MIAMI DADE
IN AND FOR
Petitioner,
JUDICIAL CIRCUIT,
COUNTY, FLORIDA
Case No.:
Division:
,
and
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Respondent.
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FINAL JUDGMENT OF DISSOLUTION OF MARRIAGE WITH
NO PROPERTY OR DEPENDENT OR MINOR CHILD(REN) (UNCONTESTED)
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This cause came before this Court for a hearing on a Petition for Dissolution of Marriage. The
Court, having reviewed the file and heard the testimony, makes these findings of fact and reaches these
conclusions of law:
The Court has jurisdiction over the subject matter and the parties.
2.
At least one party has been a resident of the State of Florida for more than 6 months immediately
before filing the Petition for Dissolution of Marriage.
3.
The parties have no minor or dependent children in common, and the wife is not pregnant.
4.
The marriage between the parties is irretrievably broken. Therefore, the marriage between the
parties is dissolved, and the parties are restored to the status of being single.
5.
There is no marital property or marital debts to divide, as the parties have previously divided all of
their personal property. Therefore, each is awarded the personal property he or she presently has
in his or her possession. Each party shall be responsible for any debts in his or her own name.
6.
( ) yes ( ) no The wife’s former name of {full legal name}
is restored.
7.
The Court reserves jurisdiction to enforce this judgment.
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1.
CIRCUIT JUDGE
COPIES TO:
Petitioner (or his or her attorney)
Respondent (or his or her attorney)
Other:
Florida Supreme Court Approved Family Law Form 12.990(b)(3), Final Judgment of Dissolution of Marriage with No Property or
Minor Child(ren) (Uncontested) (9/00)
11th
IN THE CIRCUIT/COUNTY COURT OF THE ------------------ JUDICIAL CIRCUIT
DADE
IN AND FOR MIAMI
---------------COUNTY, FLORIDA
_____________________________________
Plaintiff/Petitioner or In the Interest Of vs.
______________________________________
Defendant//Respondent
CASE NO.______________________
APPLICATION FOR DETERMINATION OF CIVIL INDIGENT STATUS
Notice to Applicant: If you qualify for civil indigence you must enroll in the clerk’s office payment plan and pay a
one-time administrative fee of $25.00. This fee shall not be charged for Dependency or Chapter 39 Termination of
Parental Rights actions.
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1. I have ______dependents. (Include only those persons you list on your U.S. Income tax return.)
Are you Married?...Yes….No Does your Spouse Work?...Yes….No
Annual Spouse Income? $_____________
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2. I have a net income of $_______________ paid ( ) weekly ( ) every two weeks ( ) semi-monthly ( ) monthly ( ) yearly ( ) other
_____________.
(Net income is your total income including salary, wages, bonuses, commissions, allowances, overtime, tips and similar payments,
minus deductions required by law and other court-ordered payments such as child support.)
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3. I have other income paid ( ) weekly ( ) every two weeks ( ) semi-monthly ( ) monthly ( ) yearly ( ) other _____________.
(Circle “Yes” and fill in the amount if you have this kind of income, otherwise circle “No”)
__________ No
Veterans’ benefits....................................................Yes $
Workers compensation............................................Yes $
Income from absent family members ......................Yes $
Stocks/bonds ...........................................................Yes $
Rental income..........................................................Yes $
Dividends or interest................................................Yes $
Other kinds of income not on the list .......................Yes $
Gifts .........................................................................Yes $
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Second Job .............................................Yes $
Social Security benefits
For you....................................Yes $
For child(ren) ..........................Yes $
Unemployment compensation ................Yes $
Union payments ......................................Yes $
Retirement/pensions ...............................Yes $
Trusts ......................................................Yes $
__________
__________
__________
__________
__________
__________
No
No
No
No
No
No
__________ No
__________
No
__________
No
__________
No
__________
No
__________
No
__________
No
__________
No
I understand that I will be required to make payments for fees and costs to the clerk in accordance with §57.082(5), Florida Statutes,
as provided by law, although I may agree to pay more if I choose to do so.
4. I have other assets: (Circle “yes” and fill in the value of the property, otherwise circle “No”)
Cash........................................................Yes $ __________ No
Savings account ......................................................Yes $
Bank account(s) ......................................Yes $ __________ No
Stocks/bonds ...........................................................Yes $
Certificates of deposit or
Homestead Real Property*......................................Yes $
money market accounts..........................Yes $ __________ No
Motor Vehicle* .........................................................Yes $
Boats* .....................................................Yes $ __________ No
Non-homestead real property/real estate* ..............Yes $
__________ No
__________ No
__________
No
__________
No
__________
No
*show loans on these assets in paragraph 5
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Check one: I ( ) DO ( ) DO NOT expect to receive more assets in the near future. The asset is_____________________________.
6. I have a private lawyer in this case………… Yes No
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5. I have total liabilities and debts of $________ as follows: Motor Vehicle $__________, Home $__________, Other Real Property $__________, Child Support paid direct $__________, Credit Cards $__________, Medical Bills $__________, Cost of medicines (monthly) $______________, Other $__________. A person who knowingly provides false information to the clerk or the court in seeking a determination of indigent status under s. 57.082, F.S.
commits a misdemeanor of the first degree, punishable as provided in s.775.082, F.S. or s. 775.083, F.S. I attest that the information I have
provided on this application is true and accurate to the best of my knowledge.
Signed this _________ day of _______________, 20____.
___________
________________________
Date of Birth
Driver’s License or ID Number
Phone
_______________________________________
Address, P O Address, Street, City, State, Zip Code
____________________________________
Signature of Applicant for Indigent Status
Print Full Legal Name _____________________
Number: __________________________
CLERK’S DETERMINATION
Based on the information in this Application, I have determined the applicant to be ( ) Indigent ( ) Not Indigent, according to s. 57.082, F.S. Dated this _________ day of ______________, 20 ____. Clerk of the Circuit Court by
This form was completed with the assistance of: __________________________________________________
Clerk/Deputy Clerk/Other authorized person.
APPLICANTS FOUND NOT TO BE INDIGENT MAY SEEK REVIEW BY A JUDGE BY ASKING FOR A HEARING TIME.
THERE IS NO FEE FOR THIS REVIEW. Sign here if you want the judge to review the clerk’s decision __________________________________________
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11th
IN THE CIRCUIT COURT OF THE
MIAMI DADE
IN AND FOR
JUDICIAL CIRCUIT,
COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
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,
Respondent.
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NOTICE OF RELATED CASES
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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 proceedif 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):
S.
N
Division:
Type of Proceeding. [ √ all that apply]
Dissolution of Marriage
Custody
Child Support
Juvenile Dependency
Termination of Parental Rights
Domestic/Sexual/Dating/Repeat
Violence Injunctions
Mental Health
FO
IN
Related Case No. 1
Case Name(s):
Petitioner
Respondent
Case No.:
Paternity
Adoption
Modification/Enforcement/Contempt Proceedings
Juvenile Delinquency
Criminal
Other {specify}_______________________
Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related (01/09)
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):
W
W
Relationship of cases [√ all that apply]:
pending case involves same parties, children, or issues;
may affect court’s jurisdictionorder 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:
IO
E UT
PL L 8
M SO 23
SA AL 4-1
EG -48
XL 86
7
PE
.A
W
Related Case No. 2
Case Name(s):
Petitioner:
Respondent:
Case No.:
Division:
S.
N
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):
FO
IN
Relationship of cases [√ all that apply]:
pending case involves same parties, children, or issues;
may affect court’s jurisdictionorder in related case may conflict with an order in this case;
order in this case may conflict with previous order in related case.
Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related (01/09)
Statement as to the relationship of the cases:
Related Case No. 3
Case Name(s):
Petitioner:
Respondent:
Case No.:
Division:
W
W
IO
E UT
PL L 8
M SO 23
SA AL 4-1
EG -48
XL 86
7
PE
.A
W
Type of Proceeding. [ √ all that apply]
Paternity
Dissolution of Marriage
Adoption
Custody
Modification/Enforcement/Contempt Proceedings
Child Support
Juvenile Delinquency
Juvenile Dependency
Criminal
Termination of Parental Rights
Other {specify}_______________________
Domestic/Sexual/Dating/Repeat
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):
S.
N
Relationship of cases [√ all that apply]:
pending case involves same parties, children, or issues;
may affect court’s jurisdictionorder 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:
FO
IN
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 Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related (01/09)
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:
W
W
CERTIFICATE OF SERVICE
IO
E UT
PL L 8
M SO 23
SA AL 4-1
EG -48
XL 86
7
PE
.A
W
____________________________________
Petitioner’s Signature
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
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
N
S.
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.
FO
IN
Florida Family Law Rules of Procedure Form 12.900(h), Notice of Related (01/09)