Opinion

In Re: Amendments to the Florida Family Law Rules of Procedure - 2020 Regular-Cycle Report

Court
Supreme Court of Florida
Filed
Nov 12, 2020
Status
Published
Cited by
0 cases

The opinion

Supreme Court of Florida

____________

No. SC20-162

____________

IN RE: AMENDMENTS TO THE FLORIDA FAMILY LAW RULES OF

PROCEDURE—2020 REGULAR-CYCLE REPORT.

November 12, 2020

PER CURIAM.

We have for consideration the regular-cycle report of The Florida Bar’s

Family Law Rules Committee (Committee) proposing amendments to the Florida

Family Law Rules of Procedure (Rules). See Fla. R. Jud. Admin. 2.140(b).1 We

have jurisdiction. See art. V, § 2(a), Fla. Const.

BACKGROUND

The Committee proposes amendments to rules 12.060 (Transfers of

Actions), 12.070 (Process), 12.285 (Mandatory Disclosure), 12.350 (Production of

Documents and Things and Entry on Land for Inspection and Other Purposes),

1. The Committee filed its report prior to the effective date of the

amendments adopted in In re Amendments to Florida Rule of Judicial

Administration 2.140, 289 So. 3d 1264 (Fla. 2020), which “[did] away with the set

schedule for rules committee reports.” Id. at 1264.

12.410 (Subpoena), 12.491 (Child Support Enforcement), and forms 12.900(b)

(Notice of Limited Appearance), 12.900(c) (Consent to Limited Appearance by

Attorney), 12.900(d) (Termination of Limited Appearance), 12.900(e)

(Acknowledgement of Assistance by Attorney), 12.900(g) (Agreement Limiting

Representation), 12.902(b) (Family Law Financial Affidavit (Short Form)),

12.902(c) (Family Law Financial Affidavit (Long Form)), 12.902(e) (Child

Support Guidelines Worksheet), 12.902(f)(3) (Marital Settlement Agreement for

Simplified Dissolution of Marriage), 12.910(a) (Summons: Personal Service on an

Individual), 12.913(b) (Affidavit of Diligent Search and Inquiry), 12.913(c)

(Affidavit of Diligent Search), 12.921 (Notice of Hearing (Child Support

Enforcement Hearing Officer)), 12.928 (Cover Sheet for Family Court Cases),

12.930(a) (Notice of Service of Standard Family Law Interrogatories), 12.930(b)

(Standard Family Law Interrogatories for Original or Enforcement Proceedings),

12.930(c) (Standard Family Law Interrogatories for Modification Proceedings),

12.932 (Certificate of Compliance with Mandatory Disclosure), 12.984(b)

(Response by Parenting Coordinator), 12.984(c) (Parenting Coordinator Report of

an Emergency), 12.996(b) (Notice to Payor), and 12.996(c) (Notice of Filing

Return Receipt). The Committee also proposes new forms 12.975(a) (Petition for

Grandparent Visitation with Minor Child(ren)) and 12.975(b) (Order on

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Grandparent’s Petition for Visitation with Minor Child(ren)). The Board of

Governors of The Florida Bar unanimously approved the proposals.

The Committee published the proposals for comment before filing them with

the Court and received two comments. In response to one of the comments, the

Committee revised several of the proposed rule and form amendments. After the

Committee filed its report, the Court published the proposals for comment. The

Court received one comment.

Upon consideration of the Committee’s report and the comments, we adopt

the amendments to the Florida Family Law Rules of Procedure as proposed, with

minor modifications. We discuss the more significant amendments below.

AMENDMENTS

First, we amend rule 12.060 (Transfers of Actions) to harmonize it with

Florida Rule of Civil Procedure 1.060 (Transfers of Actions) by making dismissal

of an action mandatory if the service fee is not paid within thirty days of

commencing the action.

Next, we amend subdivisions (b)(1)(A) and (b)(1)(B) of rule 12.285

(Mandatory Disclosure) to clarify the service requirements and provide greater

specificity as to when required documents must be served on the other party. Also,

we make several amendments throughout subdivisions (d) (Disclosure

Requirements for Temporary Financial Relief) and (e) (Parties’ Disclosure

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Requirements for Initial or Supplemental Proceedings) of rule 12.285 that increase

the time period for which various documents must be produced, provide greater

specification as to what documents should be produced, and expand the types of

documents that should be produced. In addition to providing a better

understanding of the parties’ financial situations, these amendments will increase

fairness and disclosure. For example, subdivision (d)(2) will now require that

three years of tax returns be produced, and subdivisions (d)(4) and (e)(4) will

require six months of pay stubs. Additionally, credit reports and any other form of

financial disclosure are added to the types of documents that must be produced

under subdivision (e)(6). Also, new subdivision (e)(11) is added to require

disclosure of virtual currency transactions or holdings, and the remainder of

subdivision (e) is renumbered accordingly.

Also, we amend rule 12.491 (Child Support Enforcement) by adding new

subdivisions (e)(1)(A), which provides the required language that must be included

in notices and orders regarding the procedure for a motion to vacate, and (e)(1)(B),

which requires that notices and orders state whether electronic recording or court

reporting is provided by the court or whether the court reporter would be at a

party’s expense. Additionally, a sentence is added to subdivision (f) that requires a

recommended order to include the name and address of the court reporter, if

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present, as well as information on how a litigant can obtain a recording of the

hearing.

Next, we add new sections regarding e-filing and e-service election, which

have previously been added to the Florida Supreme Court Approved Forms, 2 to all

of the instructions in the forms listed above, with the exception of form 12.900(g)

(Agreement Limiting Representation), as it does not get filed with the court.

Additionally, at the Committee’s recommendation to increase self-

represented litigants’ access to the courts, we delete the notary block from forms

12.902(b) (Family Law Financial Affidavit (Short Form)), 12.902(c) (Family Law

Financial Affidavit (Long Form)), 12.913(b) (Affidavit of Diligent Search and

Inquiry), 12.913(c) (Affidavit of Diligent Search), 12.930(b) (Standard Family

Law Interrogatories for Original or Enforcement Proceedings), 12.930(c) (Standard

Family Law Interrogatories for Modification Proceedings), and 12.932 (Certificate

of Compliance with Mandatory Disclosure).

Also, we amend the forms by replacing “Husband” and “Wife” with

“Petitioner” and “Respondent,” making the forms gender-neutral.

Next, we amend form 12.921 (Notice of Hearing (Child Support

Enforcement Hearing Officer)) by adding language from Turner v. Rogers, 564

2. See In re Amends. to Fla. Supreme Court Approved Family Law Forms,

173 So. 3d 19 (Fla. 2015).

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U.S. 431 (2011), explaining that the obligor’s ability to pay is a critical issue in

contempt proceedings and that the court must make an express finding that the

obligor has the ability to pay child support. Additionally, a new paragraph is

added to the form regarding the process to address a motion to vacate so that this

form is consistent with forms 12.920(b) and (c), which are used for a referral to or

a hearing before a general magistrate. However, for additional consistency with

those forms, as well as with rule 12.491(e)(1)(A) (Child Support Enforcement;

General Powers and Duties), we add the phrase “if necessary” to the last sentence

of the new paragraph so that the sentence reads: “The person seeking review must

have the transcript prepared if necessary for the Court’s review.” Lastly, we

modify the reference to form “12.901(b) (Short Form)” in form 12.921 to read

“12.902(b) (Short Form)”, as the Short Form Family Law Financial Affidavit is

form 12.902(b).

Further, we amend form 12.932 (Certificate of Compliance with Mandatory

Disclosure). First, in the instructions to the form, “dissolution of marriage case” is

replaced with “family matter” to clarify that mandatory disclosure is required in all

family law proceedings rather than only in dissolution of marriage cases.

Additionally, many subdivisions are amended throughout the form for consistency

with the amendments to rule 12.285 (Mandatory Disclosure) and to increase

fairness and disclosure. For example, paragraphs 1.c. and 2.c. will now require

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disclosure of six months of paystubs or other evidence of earned income. New

paragraph 2.j. also is added to require the disclosure of virtual currency holdings.

Finally, we adopt new forms 12.975(a) (Petition for Grandparent Visitation

with Minor Child(ren)) and 12.975(b) (Order on Grandparent’s Petition for

Visitation with Minor Child(ren)), with minor technical changes. The Committee

proposed the new forms in response to chapter 2015-134, section 3, Laws of

Florida, which created section 752.011, Florida Statutes (2019), and established the

limited circumstances under which grandparents can petition for visitation rights

with their minor grandchildren. Form 12.975(a) is to be used when a grandparent

files for visitation rights as provided in section 752.011, Florida Statutes (2019),

and form 12.975(b) is a form order to be provided to the court at the hearing on the

petition.

CONCLUSION

Accordingly, the Florida Family Law Rules of Procedure are amended as set

forth in the appendix to this opinion. New language is indicated by underscoring,

and deletions are indicated by struck-through type. The forms are fully engrossed

and ready for use. The forms may also be accessed and downloaded from the

Florida Courts website at https://www.flcourts.org/Resources-Services/Court-

Improvement/Family-Courts/Family-Law-Forms. By adoption of the new and

amended forms, we express no opinion as to their correctness or applicability. The

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amended rules and the amended and new forms shall become effective January 1,

2021, at 12:01 a.m.

It is so ordered.

CANADY, C.J., and POLSTON, LABARGA, LAWSON, MUÑIZ, COURIEL,

and GROSSHANS, JJ., concur.

THE FILING OF A MOTION FOR REHEARING SHALL NOT ALTER THE

EFFECTIVE DATE OF THESE AMENDMENTS.

Original Proceeding – Florida Family Law Rules of Procedure

Cory Aaron Brandfon, Chair, and Hon. Mary Lou Cuellar-Stilo, Past Chair, Family

Law Rules Committee, Tampa, Florida; and Joshua E. Doyle, Executive Director,

and Mikalla Andies Davis, Bar Liaison, The Florida Bar, Tallahassee, Florida,

for Petitioner

Joan K. Koch, Chief Counsel, Child Support Program, Florida Department of

Revenue, Tallahassee, Florida,

Responding with comments

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APPENDIX

RULE 12.060. TRANSFERS OF ACTIONS

(a) – (b) [No Change]

(c) Method. The service charge of the clerk of the court to which an

action is transferred under this rule must be paid by the party who commenced the

action within 30 days from the date the order of transfer is entered, subject to

taxation as provided by law when the action is determined. If the service charge is

not paid within the 30 days, the action maymust be dismissed without prejudice by

the court that entered the order of transfer.

RULE 12.070. PROCESS

(a) – (d) [No Change]

(e) Constructive Service.

(1) [No Change]

(2) For constructive service of process in any case or proceeding

involving parental responsibility, custody, or time-sharing with a minor child, the

petitioner must file an affidavit of diligent search and inquiry that conforms with

Florida Family Law Rules of Procedure Form 12.913(cb). If the responding party

cannot be located, the party must be served with process by publication in the

manner provided by chapter 49, Florida Statutes. The clerk of the circuit court

must mail a copy of the notice to the party’s last known address.

(3) [No Change]

(f) – (l) [No Change]

RULE 12.285. MANDATORY DISCLOSURE

(a) [No Change]

(b) Time for Production of Documents.

(1) Temporary Financial Relief Hearings. Any document

required under this rule in any temporary financial relief proceeding, whether an

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initial proceeding or supplemental proceeding, must be served on the other party

for inspection and copying as follows.

(A) TheAny party seeking relief must serve the required

documents on the other party with the notice ofat least ten days prior to the

temporary financial hearing, unless the documents have already been served under

subdivision (b)(2).

(B) The responding party, if not otherwise seeking relief,

must serve the required documents on the party seeking relief on or before 5:00

p.m., 2 business days before the day of the temporary financial relief hearing if

served by delivery or 7 days before the day of the temporary financial relief

hearing if served by mail or e-mail, unless the documents have been received

previously by the party seeking relief under subdivision (b)(2). A responding party

must be given no less than 12 days to serve the documents required under this rule,

unless otherwise ordered by the court. If the 45-day period for exchange of

documents provided for in subdivision (b)(2) will occur before the expiration of

the 12 days, the provisions of subdivision (b)(2) controlat least five days prior to

the temporary financial hearing, unless the documents have already been served

under subdivision (b)(2) of this rule.

(2) [No Change]

(c) [No Change]

(d) Disclosure Requirements for Temporary Financial Relief. In any

proceeding for temporary financial relief heard within 45 days of the service of the

initial pleading or within any extension of the time for complying with mandatory

disclosure granted by the court or agreed to by the parties, the following

documents must be served on the other party:

(1) [No Change]

(2) All complete federal and state personal income tax returns, gift

tax returns, and intangible personal propertyforeign tax returns filed by the party or

on the party’s behalf for the past 3 years, including all attachments, including

Forms W-2, 1099, K-1, and all accompanying schedules and worksheets

comprising the entire tax return. A party may file a transcript of the tax return as

provided by Internal Revenue Service Form 4506 T in lieu of his or her individual

federal income tax return for purposes of a temporary hearing.

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(3) IRS forms W-2, 1099, and K-1 for the past year, if the income

tax return for that year has not been prepared. If income tax returns have not been

filed for any of the prior 2 years beyond the past year, then IRS forms W-2, 1099,

and K-1 for those prior 2 years as well.

(4) Pay stubs or other evidence of earned income for the 36 months

before service of the financial affidavitcompliance with these disclosure

requirements for temporary financial relief.

(e) Parties’ Disclosure Requirements for Initial or Supplemental

Proceedings. A party must serve the following documents in any proceeding for

an initial or supplemental request for permanent financial relief, including, but not

limited to, a request for child support, alimony, equitable distribution of assets or

debts, or attorneys’ fees, suit money, or costs:

(1) A financial affidavit in substantial conformity with Florida

Family Law Rules of Procedure Form 12.902(b) if the party’s gross annual income

is less than $50,000, or Florida Family Law Rules of Procedure Form 12.902(c) if

the party’s gross annual income is equal to or more than $50,000, which

requirement cannot be waived by the parties. The financial affidavits must also be

filed with the court. A party may request, by using the Standard Family Law

Interrogatories, or the court on its own motion may order, a party whose gross

annual income is less than $50,000 to complete Florida Family Law Rules of

Procedure Form 12.902(c). All documents supporting the income, assets, and

liabilities figures entered into the financial affidavit must also be produced.

(2) All complete federal and state personal income tax returns, gift

tax returns, and intangible personal propertyforeign tax returns filed by the party or

on the party’s behalf for the past 3 years, including all attachments, including

Forms W-2, 1099, K-1, and all accompany schedules and worksheets comprising

the entire tax return. A party may file a transcript of the tax return as provided by

Internal Revenue Service Form 4506T in lieu of his or her individual federal

income tax return for purposes of a temporary hearing.

(3) IRS forms W-2, 1099, and K-1 for the past year, if the income

tax return for that year has not been prepared. If income tax returns have not been

filed for any of the prior 2 years beyond the past year, then IRS forms W-2, 1099,

and K-1 for those prior 2 years as well.

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(4) Pay stubs or other evidence of earned income for the 36 months

before service of the financial affidavitcompliance with these disclosure

requirements for initial or supplemental proceedings.

(5) A statement by the producing party identifying the amount and

source of all income received from any source during the 36 months preceding the

service of the financial affidavit required by this rulecompliance with these

disclosure requirements for initial or supplemental proceedings if not reflected on

the pay stubs produced.

(6) All loan applications, and financial statements, credit reports, or

any other form of financial disclosure, including financial aid forms, prepared or

used within the 1224 months preceding service of that party’s financial affidavit

required by this rulecompliance with these disclosure requirements for initial or

supplemental proceedings, whether for the purpose of obtaining or attempting to

obtain credit or for any other purpose.

(7) All deeds withinevidencing any ownership interest in property

held at any time during the last 3 years, all promissory notes or other documents

evidencing money owed to either party at any time within the last 1224 months,

and all present leases, in which the party owns or owned an interest, whether held

in the party’s name individually, in the party’s name jointly with any other person

or entity, in the party’s name as trustee or guardian for any other persona party or a

minor or adult dependent child of both parties, or in someone else’s name on the

party’s behalf wherein either the party:

(A) is receiving or has received payments at any time within

the last 3 years for leased real or personal property, or

(B) owns or owned an interest.

(8) All periodic statements from the last 312 months for all

checking accounts, and from the last 12 months for all other accounts (for example,

savings accounts, money market funds, certificates of deposit, etc.), regardless of

whether or not the account has been closed, including those held in the party’s

name individually, in the party’s name jointly with any other person or entity, in

the party’s name as trustee or guardian for any other persona party or a minor or

adult dependent child of both parties, or in someone else’s name on the party’s

behalf. For all accounts that have check-writing privileges, copies of canceled

checks and registers, whether written or electronically maintained, shall also be

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produced, so that the payee and purpose of each individual instrument can be

ascertained.

(9) All brokerage account statements in which either party to this

action held within the last 12 months or holds an interest including those held in

the party’s name individually, in the party’s name jointly with any person or entity,

in the party’s name as trustee or guardian any other personfor a party or a minor or

adult dependent child of both parties, or in someone else’s name on the party’s

behalf. For all accounts that have check-writing privileges, copies of canceled

checks and registers, whether written or electronically maintained, shall also be

produced, so that the payee and purpose of each individual instrument can be

ascertained.

(10) The most recent statement and statements for the past 12

months for any profit sharing, retirement, deferred compensation, or pension plan

(for example, IRA, 401(k), 403(b), SEP, KEOGH, or other similar account) in

which the party is a participant or an alternate payee receiving payments and the

summary plan description for any retirement, profit sharing, or pension plan in

which the party is a participant or an alternate payee receiving payments. (The

summary plan description must be furnished to the party on request by the plan

administrator as required by 29 U.S.C. § 1024(b)(4).)

(11) The most recent statement and statements for the past 12

months for any virtual currency transactions in which either party to this action

participated within the last 12 months or holds an interest, including those held in

the party’s name individually, in the party’s name jointly with any person or entity,

in the party’s name as trustee or guardian for a party or a minor or adult dependent

child of both parties, or in someone else’s name on the party’s behalf. Virtual

currency is a digital representation of value that functions as a medium of

exchange, a unit of account, and/or a store of value. A listing of all current

holdings of virtual currency shall also be disclosed.

(112) The declarations page, the last periodic statement, statements

for the past 12 months, and the certificate for all life insurance policies insuring the

party’s life or the life of the party’s spouse, whether group insurance or otherwise,

and all current health and dental insurance cards covering either of the parties

and/or their dependent children.

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(123) Corporate, partnership, and trust tax returns for the last 3 tax

years if the party has an ownership or interest in a corporation, partnership, or trust

greater than or equal to 30%.

(134) All promissory notes evidencing a party’s indebtedness for the

last 1224 months, whether since paid or not, all credit card and charge account

statements and other records showing the party’s indebtedness as of the date of the

filing of this action and for the last 324 months preceding compliance with these

disclosure requirements, and all present lease agreements, whether owed in the

party’s name individually, in the party’s name jointly with any other person or

entity, in the party’s name as trustee or guardian for any other persona party or a

minor or adult dependent child of both parties, or in someone else’s name on the

party’s behalf.

(145) All written premarital or marital agreements entered into at any

time between the parties to this marriage, whether before or during the marriage,

and all affidavits and declarations of non-paternity or judgments of

disestablishment of paternity for any minor or dependent children born or

conceived during the marriage. Additionally, in any modification proceeding, each

party must serve on the opposing party all written agreements entered into between

them at any time since the order to be modified was entered.

(156) All documents and tangible evidence supporting the producing

party’s claim that an asset or liability is nonmarital, for enhancement or

appreciation of nonmarital property, or for an unequal distribution of marital

property. The documents and tangible evidence produced must be for the time

period from the date of acquisition of the asset or debt to the date of production or

from the date of the marriage, if based on premarital acquisition.

(167) Any court orders directing a party to pay or receive spousal or

child support.

(f) [No Change]

(g) Sanctions. Any document to be produced under this rule that is not

served on the opposing party fewer than 24 hourswithin the time periods set forth

in subdivision (b)(1), as applicable, before a nonfinal hearing or in violation of the

court’s pretrial order shall not be admissible in evidence at that hearing unless the

court finds good cause for the delay. In addition, the court may impose other

sanctions authorized by rule 12.380 as may be equitable under the circumstances.

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The court may also impose sanctions upon the offending lawyer in lieu of

imposing sanctions on a party.

(h) Extensions of Time for Complying with Mandatory Disclosure. By

agreement of the parties, the time for complying with mandatory disclosure may be

extended. Either party may also file, at least 5 days before the due date, a motion to

enlarge the time for complying with mandatory disclosure. The court must grant

the request for good cause shown.

(i) – (m) [No Change]

Commentary

[No Change]

Committee Notes

[No Change]

RULE 12.350. PRODUCTION OF DOCUMENTS AND THINGS AND

ENTRY ON LAND FOR INSPECTION AND OTHER

PURPOSES

(a) Request; Scope. Any party may request any other party:

(1) – (3) [No Change]

(b) Procedure. Without leave of court the request may be served on the

petitioner after commencement of the action and on any other party with or after

service of the process and initial pleading on that party. The request must set forth

the items to be inspected, either by individual item or category, and describe each

item and category with reasonable particularity. The request must specify a

reasonable time, place, and manner of making the inspection or performing the

related acts. The party to whom the request is directed must serve a written

response within 30 days after service of the request, except that a defendant may

serve a response within 45 days after service of the process and initial pleading on

that defendant. The court may allow a shorter or longer time. For each item or

category, the response must state that inspection and related activities will be

permitted as requested unless the request is objected to, in which event the reasons

for the objection must be stated. If an objection is made to part of an item or

category, the part must be specified. When producing documents, the response

must include an accompanying notice filed in compliance with Rule of Judicial

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Administration 2.425 with the court that states with specificity each document

produced. When producing documents, the producing party must either produce

them as they are kept in the usual course of business or must identify them to

correspond with the categories in the request. A request for electronically stored

information may specify the form or forms in which electronically stored

information is to be produced. If the responding party objects to a requested form,

or if no form is specified in the request, the responding party must state the form or

forms it intends to use. If a request for electronically stored information does not

specify the form of production, the producing party must produce the information

in a form or forms in which it is ordinarily maintained or in a reasonably usable

form or forms. The party submitting the request may move for an order under rule

12.380 concerning any objection, failure to respond to the request, or any part of it,

or failure to permit the inspection as requested.

(c) [No Change]

(d) Filing of Documents. Unless required by the court, a party shall not

file any of the documents or things produced with the response, although a party

must include an accompanying notice filed in compliance with Rule of Judicial

Administration 2.425 with the court that states with specificity each document

produced. Documents or things may be filed in compliance with Florida Rule of

Judicial Administration 2.425 and rule 12.280(j) when they should be considered

by the court in determining a matter pending before the court.

RULE 12.410. SUBPOENA

(a) – (b) [No Change]

(c) For Production of Documentary Evidence.

(1) Generally. A subpoena may also command the person to whom

it is directed to produce the books, papers, documents (including electronically

stored information), or tangible things designated therein, but the court, on motion

made promptly and in any event at or before the time specified in the subpoena for

compliance with it, may:

(A) quash or modify the subpoena if it is unreasonable and

oppressive, or

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(B) condition denial of the motion upon the advancement by

the person in whose behalf the subpoena is issued of the reasonable cost of

producing the books, papers, documents, or tangible things.

A party seeking a production of evidence at trial which would be

subject to a subpoena may compel such production by serving a notice to produce

such evidence on an adverse party as provided in rule 12.080(ba). Such notice shall

have the same effect and be subject to the same limitations as a subpoena served on

the party.

(2) [No Change]

(d) – (h) [No Change]

Committee Note

[No Change]

RULE 12.491. CHILD SUPPORT ENFORCEMENT

(a) [No Change]

(b) Scope. This rule shall apply to proceedings for:

(1) – (2) [No Change]

(c) – (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) assign a time and place for an appropriate hearing and give

notice to each of the parties as may be required by law;

(A) The notice or order setting the cause for hearing shall

contain the following language in bold type:

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SHOULD YOU WISH TO SEEK REVIEW OF THE ORDER UPON

THE RECOMMENDATIONS OF THE CHILD SUPPORT

ENFORCEMENT HEARING OFFICER, YOU MUST FILE A

MOTION TO VACATE WITHIN 10 DAYS FROM THE DATE OF

ENTRY OF THE ORDER IN ACCORDANCE WITH FLORIDA

FAMILY LAW RULE OF PROCEDURE 12.491(f). YOU WILL BE

REQUIRED TO PROVIDE THE COURT WITH A RECORD

SUFFICIENT TO SUPPORT YOUR POSITION OR YOUR MOTION

WILL BE DENIED. A RECORD ORDINARILY INCLUDES A

WRITTEN TRANSCRIPT OF ALL RELEVANT PROCEEDINGS.

THE PERSON SEEKING REVIEW MUST HAVE THE

TRANSCRIPT PREPARED IF NECESSARY FOR THE COURT’S

REVIEW.

(B) The notice or order setting a matter for hearing shall state

whether electronic recording or a court reporter is provided by the court. If the

court provides electronic recording, the notice shall also state that any party may

provide a court reporter at that party’s expense.

(2) – (4) [No Change]

(f) Entry of Order and Relief from Order. Upon receipt of a

recommended order, the court shall review the recommended order and shall enter

an order promptly unless good cause appears to amend the order, conduct further

proceedings, or refer the matter back to the hearing officer to conduct further

proceedings. If a court reporter was present, the recommended order shall contain

the name and address of the reporter. If the hearing was recorded and the litigant

did not utilize a court reporter, the order shall contain information as to how a

litigant can obtain a copy of the recording. Any party affected by the order may

move to vacate the order by filing a motion to vacate within 10 days from the date

of entry. Any party may file a cross-motion to vacate within 5 days of service of a

motion to vacate, provided, however, that the filing of a cross-motion to vacate

shall not delay the hearing on the motion to vacate unless good cause is shown. A

motion to vacate the order shall be heard within 10 days after the movant applies

for hearing on the motion.

(g) – (h) [No Change]

Commentary

[No Change]

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Committee Note

[No Change]

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INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE

FORM 12.900(b)

NOTICE OF LIMITED APPEARANCE (11/20)

When should this form be used?

This form should be used to provide notice to the court and the other attorney or party when

an attorney is making a limited appearance for a client under Florida Family Law Rule of

Procedure 12.040.

This form should be typed or printed in black ink. After completing and signing this form, the

attorney should file this document with the clerk of the circuit court in the county in which the

action is pending and keep a copy for his or her records.

What should I do next?

A copy of this form must be filed with the court and served on the other party or his or her

attorney. The copy you are serving to the other party must be either mailed, e-mailed, or hand-

delivered to the opposing party or his or her attorney on the same day indicated on the

certificate of service. If it is mailed, it must be postmarked on the date indicated in the

certificate of service. Service must be in accordance with Florida Rule of Judicial Administration

2.516.

IMPORTANT INFORMATION REGARDING E-FILING

The Florida Rules of Judicial Administration now require that all petitions, pleadings, and

documents be filed electronically except in certain circumstances. Self-represented litigants

may file petitions or other pleadings or documents electronically; however, they are not

required to do so. If you choose to file your pleadings or other documents electronically, you

must do so in accordance with Florida Rule of Judicial Administration 2.525, and you must follow

the procedures of the judicial circuit in which you file. The rules and procedures should be

carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION

After the initial service of process of the petition or supplemental petition by the Sheriff or

certified process server, the Florida Rules of Judicial Administration now require that all

documents required or permitted to be served on the other party must be served by electronic

mail (e-mail) except in certain circumstances. You must strictly comply with the format

requirements set forth in the Florida Rules of Judicial Administration. If you elect to participate

in electronic service, which means serving or receiving pleadings by electronic mail (e-mail), or

through the Florida Courts E-Filing Portal, you must review Florida Rule of Judicial

Administration 2.516. You may find this rule at www.flcourts.org through the link to the Rules of

Instructions for Florida Family Law Rules of Procedure Form 12.900(b), Notice of Limited Appearance

(11/20)

- 20 -

Judicial Administration provided under either Family Law Forms: Getting Started, or Rules of

Court in the A-Z Topical Index.

SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT

REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by

email, the procedures must always be followed once the initial election is made.

To serve and receive documents by e-mail, you must designate your e-mail addresses by using

the Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family

Law Form 12.915, and you must provide your e-mail address on each form on which your

signature appears. Please CAREFULLY read the rules and instructions for: Certificate of Service

(General), Florida Supreme Court Approved Family Law Form 12.914; Designation of Current

Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form 12.915; and

Florida Rule of Judicial Administration 2.516.

Where can I look for more information?

See Florida Family Law Rule of Procedure 12.040.

Instructions for Florida Family Law Rules of Procedure Form 12.900(b), Notice of Limited Appearance

(11/20)

- 21 -

IN THE CIRCUIT COURT OF THE _______________________________ JUDICIAL CIRCUIT,

IN AND FOR ___________________________________ COUNTY, FLORIDA

Case No.: ________________________

Division: ________________________

_______________________________,

Petitioner,

and

_______________________________,

Respondent.

NOTICE OF LIMITED APPEARANCE

{Attorney’s name} __________________________________________ files this Notice of Limited

Appearance on behalf of {name} _____________________________________, [choose one

only] ( ) Petitioner ( ) Respondent, for the following limited purpose(s).

[choose all that apply]:

1. ___ The hearing set for {date} _____________________________, at {time} ___________on

the issue(s) of {specify} _______________________________________________________.

2. ___ To represent [check one only] ( ) Petitioner ( ) Respondent on the following issues

throughout the proceedings:

a. ___ Parental responsibility and time-sharing.

b. ___ Equitable distribution of marital assets and liabilities.

c. ___ Alimony.

d. ___ Child support.

e. ___ Other {specify}: _______________________________________________________

The clerk of the above-styled court is requested to enter this notice of record.

Copies of all future court papers should be served on the undersigned attorney at the address

listed and on the [choose one only] ( ) Petitioner ( ) Respondent at {name, address, e-mail

address(es),telephone number, and fax number} _____________________________________

______________________________________________________________________________

Florida Family Law Rules of Procedure Form 12.900(b), Notice of Limited Appearance (11/20)

- 22 -

I certify that a copy of this notice of limited appearance was: [check all used] ( ) e-mailed

( ) mailed ( ) faxed ( ) hand delivered to the person(s) listed below on

{date} _______________________.

Other party or his/her attorney:

Name: _________________________________

Address: _______________________________

City, State, Zip: __________________________

Telephone Number: ______________________

Fax Number: ____________________________

E-mail Address(es): _______________________

________________________________

Signature of Attorney

Printed Name: ____________________

Address: _________________________

City, State, Zip: ____________________

Telephone Number: ________________

E-mail Address(es):_________________

Florida Bar Number:

________________

________________________________

Signature of Petitioner/Respondent

Printed Name: ____________________

Address: _________________________

City, State, Zip: ____________________

Telephone Number: ________________

E-mail Address(es):_________________

Florida Family Law Rules of Procedure Form 12.900(b), Notice of Limited Appearance (11/20)

- 23 -

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE

FORM 12.900(c)

CONSENT TO LIMITED APPEARANCE BY ATTORNEY

(11/20)

When should this form be used?

This form should be used for a client to give consent when an attorney is making a limited

appearance for the client under Florida Family Law Rule of Procedure 12.040.

This form should be typed or printed in black ink. After completing this form, the client should

sign the document. The attorney or client should then file the document with the clerk of the

circuit court in the county in which the action is pending. The attorney and client should each

keep a copy for his or her records.

What should I do next?

A copy of this form must be served on the other party or his or her attorney. The copy you are

serving to the other party must be either mailed, e-mailed, or hand-delivered to the opposing

party or his or her attorney on the same day indicated on the certificate of service. If it is mailed,

it must be postmarked on the date indicated in the certificate of service. Service must be in

accordance with Florida Rule of Judicial Administration 2.516.

IMPORTANT INFORMATION REGARDING E-FILING

The Florida Rules of Judicial Administration now require that all petitions, pleadings, and

documents be filed electronically except in certain circumstances. Self-represented litigants

may file petitions or other pleadings or documents electronically; however, they are not

required to do so. If you choose to file your pleadings or other documents electronically, you

must do so in accordance with Florida Rule of Judicial Administration 2.525, and you must follow

the procedures of the judicial circuit in which you file. The rules and procedures should be

carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION

After the initial service of process of the petition or supplemental petition by the Sheriff or

certified process server, the Florida Rules of Judicial Administration now require that all

documents required or permitted to be served on the other party must be served by electronic

mail (e-mail) except in certain circumstances. You must strictly comply with the format

requirements set forth in the Florida Rules of Judicial Administration. If you elect to participate

in electronic service, which means serving or receiving pleadings by electronic mail (e-mail), or

through the Florida Courts E-Filing Portal, you must review Florida Rule of Judicial

Administration 2.516. You may find this rule at www.flcourts.org through the link to the Rules of

Instructions for Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by

Attorney (11/20)

- 24 -

Judicial Administration provided under either Family Law Forms: Getting Started, or Rules of

Court in the A-Z Topical Index.

SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT

REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by

email, the procedures must always be followed once the initial election is made.

To serve and receive documents by e-mail, you must designate your e-mail addresses by using

the Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family

Law Form 12.915, and you must provide your e-mail address on each form on which your

signature appears. Please CAREFULLY read the rules and instructions for: Certificate of Service

(General), Florida Supreme Court Approved Family Law Form 12.914; Designation of Current

Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form 12.915; and

Florida Rule of Judicial Administration 2.516.

Where can I look for more information?

See Florida Family Law Rule of Procedure 12.040.

Instructions for Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by

Attorney (11/20)

- 25 -

IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,

IN AND FOR COUNTY, FLORIDA

Case No.:

Division:

,

Petitioner,

and

,

Respondent.

CONSENT TO LIMITED APPEARANCE BY ATTORNEY

{Name} _______________________________________, the [check one only]

( ) Petitioner ( ) Respondent, consents to the limited representation by counsel,

{attorney’s name} ___________________________________________, for the following limited

purpose(s) [ check all that apply]:

1. ____The hearing set for {date} ___________________, at {time}________ on the issue(s) of {specify}

___________________________________________________________________.

2. ___To represent [ check one only] ( ) Petitioner ( ) Respondent on the following issues

throughout the proceedings:

a. ___Parental responsibility and time-sharing.

b. ___ Equitable distribution of marital assets and liabilities.

c. ___ Alimony.

d. ___ Child support.

e. ___ Other {specify}: _______________________________________________________

The clerk of the above-styled court is requested to enter this notice of record.

I certify that a copy of this consent to limited appearance was: [check all used] ( ) e-mailed ( )

mailed ( ) faxed ( ) hand delivered to the person(s) listed below on {date} _________.

Other party or his/her attorney:

Name: ________________________________

Address: ______________________________

City, State, Zip: _________________________

Telephone Number: ______________________

Fax Number: ____________________________

E-mail Address(es): _______________________

Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by Attorney (11/20)

- 26 -

_______________________________________

Signature of Petitioner/Respondent

Printed Name: ___________________________

Address: _______________________________

City, State, Zip: __________________________

Telephone Number: ______________________

Fax Number: ____________________________

E-mail Address(es): _______________________

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:

[fill in all blanks] This form was prepared for the: {choose only one} ( ) Petitioner ( ) Respondent

This form was completed with the assistance of:

{name of individual} ____________________________________________________________,

{name of business} _____________________________________________________________,

{address} ___________________________________________________________________,

{city} __________________, {state} ____, {zip code} ______, {telephone number} _________.

Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by Attorney (11/20)

- 27 -

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM

12.900(d)

TERMINATION OF LIMITED APPEARANCE (11/20)

When should this form be used?

This form should be used by an attorney who is terminating a limited appearance for a client under Florida

Family Law Rule of Procedure 12.040.

This form should be typed or printed in black ink. After completing this form, the attorney should sign this

document and then file this document with the clerk of the circuit court in the county in which the action

is pending. The attorney should keep a copy for his or her records.

What should I do next?

A copy of this form must be filed with the court and served on the other party or his or her attorney. The

copy you are serving to the other party must be either mailed, e-mailed, or hand-delivered to the opposing

party or his or her attorney on the same day indicated on the certificate of service. If it is mailed, it must

be postmarked on the date indicated in the certificate of service. Service must be in accordance with

Florida Rule of Judicial Administration 2.516.

IMPORTANT INFORMATION REGARDING E-FILING

The Florida Rules of Judicial Administration now require that all petitions, pleadings, and documents be

filed electronically except in certain circumstances. Self-represented litigants may file petitions or other

pleadings or documents electronically; however, they are not required to do so. If you choose to file

your pleadings or other documents electronically, you must do so in accordance with Florida Rule of

Judicial Administration 2.525, and you must follow the procedures of the judicial circuit in which you file.

The rules and procedures should be carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION

After the initial service of process of the petition or supplemental petition by the Sheriff or certified

process server, the Florida Rules of Judicial Administration now require that all documents required or

permitted to be served on the other party must be served by electronic

mail (e-mail) except in certain circumstances. You must strictly comply with the format requirements

set forth in the Florida Rules of Judicial Administration. If you elect to participate

in electronic service, which means serving or receiving pleadings by electronic mail (e-mail), or through

the Florida Courts E-Filing Portal, you must review Florida Rule of Judicial Administration 2.516. You may

find this rule at www.flcourts.org through the link to the Rules of Judicial Administration provided under

either Family Law Forms: Getting Started, or Rules of Court in the A-Z Topical Index.

SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT

REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by email, the

procedures must always be followed once the initial election is made.

Instructions for Florida Family Law Rules of Procedure Form 12.900(d), Termination of Limited Appearance (11/20)

- 28 -

To serve and receive documents by e-mail, you must designate your e-mail addresses by using the

Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form

12.915, and you must provide your e-mail address on each form on which your signature appears.

Please CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme

Court Approved Family Law Form 12.914; Designation of Current Mailing and E-mail Address, Florida

Supreme Court Approved Family Law Form 12.915; and Florida Rule of Judicial Administration 2.516.

Where can I look for more information?

See Florida Family Law Rule of Procedure 12.040.

Instructions for Florida Family Law Rules of Procedure Form 12.900(d), Termination of Limited Appearance (11/20)

- 29 -

IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,

IN AND FOR COUNTY, FLORIDA

Case No.:

Division:

,

Petitioner,

and

,

Respondent.

TERMINATION OF LIMITED APPEARANCE

{Attorney’s name} , files this Termination of Limited

Appearance on behalf of the [check one only] ( ) Petitioner ( ) Respondent, {name}, ________

______________________________________, and certifies that the proceeding or matter is concluded.

The clerk of the above-styled court is requested to enter this Notice of Termination of Limited

Appearance of record. Copies of all future court papers should be served on the [check one only]

( ) Petitioner ( ) Respondent at: {name, address, e-mail address(es), fax number, and telephone

number} _____________________________________________________________________________

.

I certify that a copy of this termination of limited appearance was: [check all used] ( ) e-mailed

( ) mailed ( ) faxed ( ) hand delivered to the person(s) listed below on {date} _________________.

Other party or his/her attorney:

Name:

Address:

City, State, Zip:

Telephone Number: _______________________

Fax Number:

E-mail Address(es):________________________

Client Party:

Name:

Address:

City, State, Zip:

Telephone Number: ______________________

Fax Number:

E-mail Address(es): _______________________

_______________________________________

Signature of Attorney

Printed Name:

Address:

City, State, Zip:

Florida Family Law Rules of Procedure Form 12.900(d), Termination of Limited Appearance (11/20)

- 30 -

Telephone Number:

E-mail Address(es): _______________________

Florida Bar Number:

Florida Family Law Rules of Procedure Form 12.900(d), Termination of Limited Appearance (11/20)

- 31 -

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE

FORM 12.900(e)

ACKNOWLEDGMENT OF ASSISTANCE BY ATTORNEY

(11/20)

When should this form be used?

This form, when added to the signature page of any petition, pleading, or motion, should be filed with the

court when an attorney making a limited appearance under Florida Family Law Rule of Procedure 12.040

has assisted the petitioner or respondent in the preparation of the document. The petitioner or

respondent should then sign the pleading and include his/her name and address.

What should I do next?

A copy of this form must be filed with the court and served on the other party or his or her attorney. The

copy you are serving to the other party must be either mailed, e-mailed, or hand-delivered to the opposing

party or his or her attorney on the same day indicated on the certificate of service. If it is mailed, it must

be postmarked on the date indicated in the certificate of service. Service must be in accordance with

Florida Rule of Judicial Administration 2.516.

IMPORTANT INFORMATION REGARDING E-FILING

The Florida Rules of Judicial Administration now require that all petitions, pleadings, and documents be

filed electronically except in certain circumstances. Self-represented litigants may file petitions or other

pleadings or documents electronically; however, they are not required to do so. If you choose to file

your pleadings or other documents electronically, you must do so in accordance with Florida Rule of

Judicial Administration 2.525, and you must follow the procedures of the judicial circuit in which you file.

The rules and procedures should be carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION

After the initial service of process of the petition or supplemental petition by the Sheriff or certified

process server, the Florida Rules of Judicial Administration now require that all documents required or

permitted to be served on the other party must be served by electronic mail (e-mail) except in certain

circumstances. You must strictly comply with the format requirements set forth in the Florida Rules of

Judicial Administration. If you elect to participate in electronic service, which means serving or receiving

pleadings by electronic mail (e-mail), or through the Florida Courts E-Filing Portal, you must review

Florida Rule of Judicial Administration 2.516. You may find this rule at www.flcourts.org through the link

to the Rules of Judicial Administration provided under either Family Law Forms: Getting Started, or Rules

of Court in the A-Z Topical Index.

SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT

REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by email, the

procedures must always be followed once the initial election is made.

Instructions for Florida Family Law Rules of Procedure Form 12.900(e), Acknowledgment of Assistance by Attorney

(11/20)

- 32 -

To serve and receive documents by e-mail, you must designate your e-mail addresses by using the

Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form

12.915, and you must provide your e-mail address on each form on which your signature appears.

Please CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme

Court Approved Family Law Form 12.914; Designation of Current Mailing and E-mail Address, Florida

Supreme Court Approved Family Law Form 12.915; and Florida Rule of Judicial Administration 2.516.

Where can I get more information?

See the instructions to Florida Family Law Rules of Procedure Forms 12.900(b)-(d) and Rule 12.040.

Before proceeding, you should read General Information for Self-Represented Litigants found at the

beginning of these forms. For more information, see rule 12.080, Florida Family Law Rules of Procedure.

Instructions for Florida Family Law Rules of Procedure Form 12.900(e), Acknowledgment of Assistance by Attorney

(11/20)

- 33 -

{Name}, , [check one only] ( ) Petitioner

( ) Respondent, certifies that he/she has received the assistance of the following attorney in the

preparation of this document.

Attorney Name:

Address:

City, State, Zip:

Telephone Number:

E-mail Address(es): _______________________

Florida Bar Number:

Florida Family Law Rules of Procedure Form 12.900(e), Acknowledgment of Assistance by Attorney (11/20)

- 34 -

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE

FORM 12.900(g)

AGREEMENT LIMITING REPRESENTATION (11/20)

When should this form be used?

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. This form is not to be filed with the clerk of the court.

Where can I look for more information?

See Rules Reg. Fla. Bar 4-1.2(c), 4-4.2(b), and 4-4.3(b) and Florida Family Law Rule of Procedure 12.040.

Instructions for Florida Family Law Rules of Procedure Form 12.900(g), Agreement Limiting Representation (11/20)

- 35 -

AGREEMENT LIMITING REPRESENTATION

(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 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.

Florida Family Law Rules of Procedure Form 12.900(g), Agreement Limiting Representation (11/20)

- 36 -

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

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: ________________

E-mail Address(es): _________________ E-mail Address(es): _________________

Florida Bar Number: ________________

Date: __________________________ Date: __________________________

I HAVE BEEN PROVIDED A FULLY EXECUTED COPY OF THIS AGREEMENT LIMITING REPRESENTATION

_______________________________

Client

Florida Family Law Rules of Procedure Form 12.900(g), Agreement Limiting Representation (11/20)

- 37 -

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE

FORM 12.902(b)

FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM)

(11/20)

When should this form be used?

This form should be used when you are involved in a family law case which requires a financial affidavit

and your individual gross income is UNDER $50,000 per year unless:

(1) You are filing a simplified dissolution of marriage under rule 12.105 and both parties have waived

the filing of a financial affidavit;

(2) You have no minor children, no support issues, and have filed a written settlement agreement

disposing of all financial issues; or

(3) The court lacks jurisdiction to determine any financial issues.

This form should be typed or printed in black ink. You should file this document with the clerk of the

circuit court in the county where the petition was filed and keep a copy for your records.

What should I do next?

A copy of this form must be filed with the court and served on the other party or his or her attorney in

your case within 45 days of being served with the petition, if it is not served on him or her with your initial

papers. The copy you are serving to the other party must be either mailed, e-mailed, or hand-delivered to

the opposing party or his or her attorney on the same day indicated on the certificate of service. If it is

mailed, it must be postmarked on the date indicated in the certificate of service. Service must be in

accordance with Florida Rule of Judicial Administration 2.516.

IMPORTANT INFORMATION REGARDING E-FILING

The Florida Rules of Judicial Administration now require that all petitions, pleadings, and documents be

filed electronically except in certain circumstances. Self-represented litigants may file petitions or other

pleadings or documents electronically; however, they are not required to do so. If you choose to file

your pleadings or other documents electronically, you must do so in accordance with Florida Rule of

Judicial Administration 2.525, and you must follow the procedures of the judicial circuit in which you file.

The rules and procedures should be carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION

After the initial service of process of the petition or supplemental petition by the Sheriff or certified

process server, the Florida Rules of Judicial Administration now require that all documents required or

permitted to be served on the other party must be served by electronic mail (e-mail) except in certain

circumstances. You must strictly comply with the format requirements set forth in the Florida Rules of

Instructions for Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form)

(11/20)

- 38 -

Judicial Administration. If you elect to participate in electronic service, which means serving or receiving

pleadings by electronic mail (e-mail), or through the Florida Courts E-Filing Portal, you must review

Florida Rule of Judicial Administration 2.516. You may find this rule at www.flcourts.org through the link

to the Rules of Judicial Administration provided under either Family Law Forms: Getting Started, or Rules

of Court in the A-Z Topical Index.

SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT

REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by email, the

procedures must always be followed once the initial election is made.

To serve and receive documents by e-mail, you must designate your e-mail addresses by using the

Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form

12.915, and you must provide your e-mail address on each form on which your signature appears.

Please CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme

Court Approved Family Law Form 12.914; Designation of Current Mailing and E-mail Address, Florida

Supreme Court Approved Family Law Form 12.915; and Florida Rule of Judicial Administration 2.516.

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 Florida Family Law Rule of Procedure 12.285.

Special notes...

If you want to keep your address confidential because you have been found by a judge to be 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 Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form

12.980(h).

The affidavit must be completed using monthly income and expense amounts. If you are paid or your

bills are due on a schedule which is not monthly, you must convert those amounts. Hints are provided

below for making these conversions.

Hourly - If you are paid by the hour, you may convert your income to monthly as follows:

Hourly amount x Hours worked per week = Weekly amount

Weekly amount x 52 Weeks per year = Yearly amount

Yearly amount ÷ 12 Months per year = Monthly Amount

Daily - If you are paid by the day, you may convert your income to monthly as follows:

Daily amount x Days worked per week = Weekly amount

Weekly amount x 52 Weeks per year = Yearly amount

Yearly amount ÷ 12 Months per year = Monthly Amount

Weekly - If you are paid by the week, you may convert your income to monthly as follows:

Instructions for Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form)

(11/20)

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Weekly amount x 52 Weeks per year = Yearly amount

Yearly amount ÷ 12 Months per year = Monthly Amount

Bi-weekly - If you are paid every two weeks, you may convert your income to monthly as follows:

Bi-weekly amount x 26 = Yearly amount

Yearly amount ÷ 12 Months per year = Monthly Amount

Semi-monthly - If you are paid twice per month, you may convert your income to monthly as follows:

Semi-monthly amount x 2 = Monthly Amount

Expenses may be converted in the same manner.

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.

Instructions for Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form)

(11/20)

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IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,

IN AND FOR COUNTY, FLORIDA

Case No.: ______________________

Division: _______________________

,

Petitioner,

and

,

Respondent.

FAMILY LAW FINANCIAL AFFIDAVIT (SHORT FORM)

(Under $50,000 Individual Gross Annual Income)

I, {full legal name} , being sworn, certify that the following

information is true:

My Occupation: Employed by: ___________________________

Business Address: ________________________________________________________________

Pay rate: $ ( ) every week ( ) every other week ( ) twice a month ( ) monthly

( ) other: ____________

___ Check here if unemployed and explain on a separate sheet your efforts to find employment.

SECTION I. PRESENT MONTHLY GROSS INCOME:

All amounts must be MONTHLY. See the instructions with this form to figure out money amounts for

anything that is NOT paid monthly. Attach more paper, if needed. Items included under “other” should

be listed separately with separate dollar amounts.

1. $______ Monthly gross salary or wages

2. ______ Monthly bonuses, commissions, allowances, overtime, tips, and similar payments

3. _______ Monthly business income from sources such as self-employment, partnerships, close

corporations, and/or independent contracts (gross receipts minus ordinary and necessary

expenses required to produce income) (Attach sheet itemizing such income and expenses.)

4. _______ Monthly disability benefits/SSI

5. _______ Monthly Workers’ Compensation

6. _______ Monthly Unemployment Compensation

7. _______ Monthly pension, retirement, or annuity payments

8. _______ Monthly Social Security benefits

9. _______ Monthly alimony actually received (Add 9a and 9b)

9a. From this case: $ _______

9b. From other case(s): $ _______

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (11/20)

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10. _______ Monthly interest and dividends

11. _______ Monthly rental income (gross receipts minus ordinary and necessary expenses

required to produce income) (Attach sheet itemizing such income and expense items.)

12. _______ Monthly income from royalties, trusts, or estates

13. _______ Monthly reimbursed expenses and in-kind payments to the extent that they

reduce personal living expenses

14. _______ Monthly gains derived from dealing in property (not including nonrecurring gains)

15. _______ Any other income of a recurring nature (list source) _________________________

16. __________________________________________________________________________

17. $ _______ TOTAL PRESENT MONTHLY GROSS INCOME (Add lines 1–16)

PRESENT MONTHLY DEDUCTIONS:

18. $______ Monthly federal, state, and local income tax (corrected for filing status and allowable

dependents and income tax liabilities)

a. Filing Status ____________

b. Number of dependents claimed _______

19. _______ Monthly FICA or self-employment taxes

20. _______ Monthly Medicare payments

21. _______ Monthly mandatory union dues

22. _______ Monthly mandatory retirement payments

23. _______ Monthly health insurance payments (including dental insurance), excluding portion

paid for any minor children of this relationship

24. _______ Monthly court-ordered child support actually paid for children from another

relationship

25. _______ Monthly court-ordered alimony actually paid (Add 25a and 25b)

25a. from this case: $ _______

25b. from other case(s): $ _______

26. $_______ TOTAL DEDUCTIONS ALLOWABLE UNDER SECTION 61.30, FLORIDA STATUTES

(Add lines 18 through 25)

27. $_______ PRESENT NET MONTHLY INCOME (Subtract line 26 from line 17)

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (11/20)

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SECTION II. AVERAGE MONTHLY EXPENSES

Proposed/Estimated Expenses. If this is a dissolution of marriage case and your expenses as listed

below do not reflect what you actually pay currently, you should write “estimate” next to each amount

that is estimated.

A. HOUSEHOLD:

Mortgage or rent $ _______ E. OTHER EXPENSES NOT LISTED ABOVE

Property taxes $_______ Clothing $ _______

Utilities $_______ Medical/Dental (uninsured) $_______

Telephone $ _______ Grooming $ _______

Food $ _______ Entertainment $_______

Meals outside home $_______ Gifts $_______

Maintenance/Repairs $ _______ Religious organizations $_______

Other: __________ $_______ Miscellaneous $_______

Other: ______________ $ _______

B. AUTOMOBILE ____________________ $_______

Gasoline $ _______ ____________________ $_______

Repairs $_______ ____________________ $_______

Insurance $_______ ____________________ $_______

____________________ $_______

C. CHILD(REN)’S EXPENSES

Day care $ _______

Lunch money $_______ F. PAYMENTS TO CREDITORS

Clothing $ _______ CREDITOR: MONTHLY

Grooming $_______ PAYMENT

Gifts for holidays $ _______ ____________________ $_______

Medical/Dental (uninsured) $ _______ ____________________ $_______

Other: ______________ $ _______ ____________________ $_______

____________________ $_______

D. INSURANCE ____________________ $_______

Medical/Dental (if not listed on ____________________ $_______

lines 23 or 45) $ _______ ____________________ $_______

Child(ren)’s medical/dental $ _______ ____________________ $_______

Life $ _______ ____________________ $_______

Other: $ _______ ____________________ $_______

____________________ $_______

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (11/20)

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28. $_______ TOTAL MONTHLY EXPENSES (add ALL monthly amounts in A through F above)

SUMMARY

29. $_______ TOTAL PRESENT MONTHLY NET INCOME (from line 27 of SECTION I. INCOME)

30. $_______ TOTAL MONTHLY EXPENSES (from line 28 above)

31. $_______ SURPLUS (If line 29 is more than line 30, subtract line 30 from line 29. This is the amount

of your surplus. Enter that amount here.)

32. ($_______) (DEFICIT) (If line 30 is more than line 29, subtract line 29 from line 30. This is the amount

of your deficit. Enter that amount here.)

SECTION III. ASSETS AND LIABILITIES

Use the nonmarital column only if this is a petition for dissolution of marriage and you believe an item

is “nonmarital,” meaning it belongs to only one of you and should not be divided. You should indicate

to whom you believe the item(s) or debt belongs. (Typically, you will only use this column if property/debt

was owned/owed by one spouse before the marriage. See the “General Information for Self-

Represented Litigants” found at the beginning of these forms and section 61.075(1), Florida Statutes, for

definitions of “marital” and “nonmarital” assets and liabilities.)

A. ASSETS:

DESCRIPTION OF ITEM(S). List a description of each separate Nonmarital

item owned by you (and/or your spouse, if this is a petition Current (check correct column)

for dissolution of marriage). LIST ONLY LAST 4 DIGITS OF Fair

ACCOUNT NUMBERS. Check the line next to any asset(s) Market

Value Petitioner Respondent

which you are requesting the judge award to you.

Cash (on hand) $

Cash (in banks or credit unions)

Stocks, Bonds, Notes

Real estate: (Home)

(Other)

Automobiles

Other personal property

Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)

Other

____Check here if additional pages are attached.

Total Assets (add next column) $

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (11/20)

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B. LIABILITIES:

DESCRIPTION OF ITEM(S). List a description of each separate Current Nonmarital

debt owed by you (and/or your spouse, if this is a petition for Amount (check correct column)

dissolution of marriage). LIST ONLY LAST 4 DIGITS OF Owed

ACCOUNT NUMBERS. Check the line next to any debt(s) for

which you believe you should be responsible. Petitioner Respondent

Mortgages on real estate: First mortgage on home $

Second mortgage on home

Other mortgages

Auto loans

Charge/credit card accounts

Other

____Check here if additional pages are attached.

Total Debts (add next column) $

C. CONTINGENT ASSETS AND LIABILITIES:

INSTRUCTIONS: If you have any POSSIBLE assets (income potential, accrued vacation or sick leave, bonus,

inheritance, etc.) or POSSIBLE liabilities (possible lawsuits, future unpaid taxes, contingent tax liabilities,

debts assumed by another), you must list them here.

Contingent Assets Nonmarital

Possible (check correct column)

Check the line next to any contingent asset(s) which you Value

are requesting the judge award to you. Petitioner Respondent

$

Total Contingent Assets $

Contingent Liabilities Nonmarital

Possible (check correct column)

Check the line next to any contingent debt(s) for which Amount

you believe you should be responsible. Owed Petitioner Respondent

$

Total Contingent Liabilities $

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (11/20)

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SECTION IV. CHILD SUPPORT GUIDELINES WORKSHEET

(Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet, MUST be

filed with the court at or prior to a hearing to establish or modify child support. This requirement cannot

be waived by the parties.)

[Check one only]

____ A Child Support Guidelines Worksheet IS or WILL BE filed in this case. This case involves the

establishment or modification of child support.

____ A Child Support Guidelines Worksheet IS NOT being filed in this case. The establishment or

modification of child support is not an issue in this case.

I certify that a copy of this document was [check all used]: ( ) e-mailed ( ) mailed ( ) faxed

( ) hand delivered to the person(s) listed below on {date} ________________________________.

Other party or his/her attorney:

Name: _____________________________

Address: ____________________________

City, State, Zip: _______________________

Telephone Number: ___________________

Fax Number: _________________________

E-mail Address(es): _____________________

Under penalties of perjury, I declare that I have read this document and the facts stated in it are true.

Dated:

Signature of Party

Printed Name: ________________________________

Address: _____________________________________

City, State, Zip: ________________________________

Telephone Number: ____________________________

Fax Number: __________________________________

E-mail Address(es): ____________________________

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:

[fill in all blanks] This form was prepared for the: {choose only one} ( ) Petitioner ( ) Respondent

This form was completed with the assistance of:

{name of individual} __________________________________________________________,

{name of business} ___________________________________________________________,

{address} ___________________________________________________________________,

{city} __________________, {state} ____, {zip code} ______, {telephone number} _________.

Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (11/20)

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INSTRUCTIONS FOR FLORIDA FAMILY LAW RULE OF PROCEDURE

FORM 12.902(c)

FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM)

(11/20)

When should this form be used?

This form should be used when you are involved in a family law case which requires a financial affidavit

and your individual gross income is $50,000 OR MORE per year unless:

(1) You are filing a simplified dissolution of marriage under rule 12.105 and both parties have waived

the filing of financial affidavits;

(2) you have no minor children, no support issues, and have filed a written settlement agreement

disposing of all financial issues; or

(3) the court lacks jurisdiction to determine any financial issues.

This form should be typed or printed in black ink. After completing this form, you should sign the form.

You should then file this document with the clerk of the circuit court in the county where the petition

was filed and keep a copy for your records.

What should I do next?

A copy of this form must be served on the other party in your case within 45 days of being served with

the petition, if it is not served on him or her with your initial papers. Service must be in accordance with

Florida Rule of Judicial Administration 2.516.

A copy of this form must be filed with the court and served on the other party or his or her attorney. The

copy you are serving to the other party must be either mailed, e-mailed, or hand-delivered to the opposing

party or his or her attorney on the same day indicated on the certificate of service. If it is mailed, it must

be postmarked on the date indicated in the certificate of service.

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 Florida Family Law Rule of Procedure 12.285.

IMPORTANT INFORMATION REGARDING E-FILING

The Florida Rules of Judicial Administration now require that all petitions, pleadings, and documents be

filed electronically except in certain circumstances. Self-represented litigants may file petitions or other

pleadings or documents electronically; however, they are not required to do so. If you choose to file

your pleadings or other documents electronically, you must do so in accordance with Florida Rule of

Judicial Administration 2.525, and you must follow the procedures of the judicial circuit in which you file.

The rules and procedures should be carefully read and followed.

Instructions for Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form)

(11/20)

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IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION

After the initial service of process of the petition or supplemental petition by the Sheriff or certified

process server, the Florida Rules of Judicial Administration now require that all documents required or

permitted to be served on the other party must be served by electronic mail (e-mail) except in certain

circumstances. You must strictly comply with the format requirements set forth in the Florida Rules of

Judicial Administration. If you elect to participate in electronic service, which means serving or receiving

pleadings by electronic mail (e-mail), or through the Florida Courts E-Filing Portal, you must review

Florida Rule of Judicial Administration 2.516. You may find this rule at www.flcourts.org through the link

to the Rules of Judicial Administration provided under either Family Law Forms: Getting Started, or Rules

of Court in the A-Z Topical Index.

SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT

REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by email, the

procedures must always be followed once the initial election is made.

To serve and receive documents by e-mail, you must designate your e-mail addresses by using the

Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form

12.915, and you must provide your e-mail address on each form on which your signature appears.

Please CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme

Court Approved Family Law Form 12.914; Designation of Current Mailing and E-mail Address, Florida

Supreme Court Approved Family Law Form 12.915; and Florida Rule of Judicial Administration 2.516.

Special notes...

If you want to keep your address confidential because you have been found by a judge to be 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 Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form

12.980(h).

The affidavit must be completed using monthly income and expense amounts. If you are paid or your

bills are due on a schedule which is not monthly, you must convert those amounts. Hints are provided

below for making these conversions.

Instructions for Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form)

(11/20)

- 48 -

Hourly - If you are paid by the hour, you may convert your income to monthly as follows:

Hourly amount x Hours worked per week = Weekly amount

Weekly amount x 52 Weeks per year = Yearly amount

Yearly amount ÷ 12 Months per year = Monthly Amount

Daily - If you are paid by the day, you may convert your income to monthly as follows:

Daily amount x Days worked per week = Weekly amount

Weekly amount x 52 Weeks per year = Yearly amount

Yearly amount ÷ 12 Months per year = Monthly Amount

Weekly - If you are paid by the week, you may convert your income to monthly as follows:

Weekly amount x 52 Weeks per year = Yearly amount

Yearly amount ÷ 12 Months per year = Monthly Amount

Bi-weekly - If you are paid every two weeks, you may convert your income to monthly as follows:

Bi-weekly amount x 26 = Yearly amount

Yearly amount ÷ 12 Months per year = Monthly Amount

Semi-monthly - If you are paid twice per month, you may convert your income to monthly as

follows:

Semi-monthly amount x 2 = Monthly Amount

Expenses may be converted in the same manner.

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.

Instructions for Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form)

(11/20)

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IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,

IN AND FOR COUNTY, FLORIDA

Case No.:

Division:

,

Petitioner,

and

,

Respondent.

FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM)

($50,000 or more Individual Gross Annual Income)

I, {full legal name} , being sworn, certify

that the following information is true:

SECTION I. INCOME

1. My age is: ___________________

2. My occupation is: ________________________________________________________________

3. I am currently

[Check all that apply]

a. ____ Unemployed

Describe your efforts to find employment, how soon you expect to be employed, and the pay

you expect to receive: __________________________________________________________

____________________________________________________________________________

b. ____ Employed by: ____________________________________________________________

Address: ____________________________________________________________________

City, State, Zip code: ________________________________ Telephone Number: _________

Pay rate: $ ______ ( ) every week ( ) every other week ( ) twice a month

( ) monthly ( ) other: ________________________________________________________

If you are expecting to become unemployed or change jobs soon, describe the change you

expect and why and how it will affect your income: _________________________________

___________________________________________________________________________

___________________________________________________________________________.

____ Check here if you currently have more than one job. List the information above for the

second job(s) on a separate sheet and attach it to this affidavit.

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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c. _____ Retired. Date of retirement: _______________________________________________

Employer from whom retired: ___________________________________________________

Address: _____________________________________________________________________

City, State, Zip code: _______________________________ Telephone Number: __________

LAST YEAR’S GROSS INCOME: Your Income Other Party’s Income (if known)

YEAR _____ $ _______ $ _______

PRESENT MONTHLY GROSS INCOME:

All amounts must be MONTHLY. See the instructions with this form to figure out money amounts for

anything that is NOT paid monthly. Attach more paper, if needed. Items included under “other” should

be listed separately with separate dollar amounts.

1. $______ Monthly gross salary or wages

2. _______ Monthly bonuses, commissions, allowances, overtime, tips, and similar payments

3. _______ Monthly business income from sources such as self-employment, partnerships, close

corporations, and/or independent contracts (Gross receipts minus ordinary and necessary

expenses required to produce income.)(Attach sheet itemizing such income and expenses.)

4. _______ Monthly disability benefits/SSI

5. _______ Monthly Workers’ Compensation

6. _______ Monthly Unemployment Compensation

7. _______ Monthly pension, retirement, or annuity payments

8. _______ Monthly Social Security benefits

9. _______ Monthly alimony actually received (Add 9a and 9b)

9a. From this case: $________

9b. From other case(s): $________

10. _______ Monthly interest and dividends

11. _______ Monthly rental income (gross receipts minus ordinary and necessary expenses required to

produce income) (Attach sheet itemizing such income and expense items.)

12. _______ Monthly income from royalties, trusts, or estates

13. _______ Monthly reimbursed expenses and in-kind payments to the extent that they reduce

personal living expenses (Attach sheet itemizing each item and amount.)

14. _______ Monthly gains derived from dealing in property (not including nonrecurring gains)

_______ Any other income of a recurring nature (identify source):

15. _______________________________________________________________________________

16. _______________________________________________________________________________

17. $_________ TOTAL PRESENT MONTHLY GROSS INCOME (Add lines 1 through 16.)

PRESENT MONTHLY DEDUCTIONS:

All amounts must be MONTHLY. See the instructions with this form to figure out money amounts for

anything that is NOT paid monthly.

18. $_______ Monthly federal, state, and local income tax (corrected for filing status and allowable

dependents and income tax liabilities)

a. Filing Status

b. Number of dependents claimed

19. _______ Monthly FICA or self-employment taxes

20. _______ Monthly Medicare payments

21. _______ Monthly mandatory union dues

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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22. _______ Monthly mandatory retirement payments

23. _______ Monthly health insurance payments (including dental insurance), excluding portion paid for

any minor children of this relationship

24. _______ Monthly court-ordered child support actually paid for children from another relationship

25. _______ Monthly court-ordered alimony actually paid (Add 25a and 25b)

25a. from this case: $ _________

25b. from other case(s): $ _________

26. $______ TOTAL DEDUCTIONS ALLOWABLE UNDER SECTION 61.30, FLORIDA STATUTES

(Add lines 18 through 25.)

27. $______ PRESENT NET MONTHLY INCOME

(Subtract line 26 from line 17.)

SECTION II. AVERAGE MONTHLY EXPENSES

Proposed/Estimated Expenses. If this is a dissolution of marriage case and your expenses as listed

below do not reflect what you actually pay currently, you should write “estimate” next to each amount

that is estimated.

HOUSEHOLD:

1. $______ Monthly mortgage or rent payments

2. _______ Monthly property taxes (if not included in mortgage)

3. _______ Monthly insurance on residence (if not included in mortgage)

4. _______ Monthly condominium maintenance fees and homeowner’s association fees

5. _______ Monthly electricity

6. _______ Monthly water, garbage, and sewer

7. _______ Monthly telephone

8. _______ Monthly fuel oil or natural gas

9. _______ Monthly repairs and maintenance

10. _______ Monthly lawn care

11. _______ Monthly pool maintenance

12. _______ Monthly pest control

13. _______ Monthly misc. household

14. _______ Monthly food and home supplies

15. _______ Monthly meals outside home

16. _______ Monthly cable t.v.

17. _______ Monthly alarm service contract

18. _______ Monthly service contracts on appliances

19. _______ Monthly maid service

Other:

20. __________________________________________________________________________________

21. __________________________________________________________________________________

22. __________________________________________________________________________________

23. __________________________________________________________________________________

24. __________________________________________________________________________________

25. $__________ SUBTOTAL (Add lines 1 through 24.)

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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AUTOMOBILE:

26. $______ Monthly gasoline and oil

27. _______ Monthly repairs

28. _______ Monthly auto tags and emission testing

29. _______ Monthly insurance

30. _______ Monthly payments (lease or financing)

31. _______ Monthly rental/replacements

32. _______ Monthly alternative transportation (bus, rail, car pool, etc.)

33. _______ Monthly tolls and parking

34. _______ Other: _________________________________________________

35. $_______ SUBTOTAL (Add lines 26 through 34.)

MONTHLY EXPENSES FOR CHILDREN COMMON TO BOTH PARTIES:

36. $______ Monthly nursery, babysitting, or day care

37. _______ Monthly school tuition

38. _______ Monthly school supplies, books, and fees

39. _______ Monthly after school activities

40. _______ Monthly lunch money

41. _______ Monthly private lessons or tutoring

42. _______ Monthly allowances

43. _______ Monthly clothing and uniforms

44. _______ Monthly entertainment (movies, parties, etc.)

45. _______ Monthly health insurance

46. _______ Monthly medical, dental, prescriptions (nonreimbursed only)

47. _______ Monthly psychiatric/psychological/counselor

48. _______ Monthly orthodontic

49. _______ Monthly vitamins

50. _______ Monthly beauty parlor/barber shop

51. _______ Monthly nonprescription medication

52. _______ Monthly cosmetics, toiletries, and sundries

53. _______ Monthly gifts from child(ren) to others (other children, relatives, teachers, etc.)

54. _______ Monthly camp or summer activities

55. _______ Monthly clubs (Boy/Girl Scouts, etc.)

56. _______ Monthly time-sharing expenses

57. _______ Monthly miscellaneous

58. $_______ SUBTOTAL (Add lines 36 through 57.)

MONTHLY EXPENSES FOR CHILD(REN) FROM ANOTHER RELATIONSHIP

(other than court-ordered child support)

59. $________________________________________________________________________________

60. __________________________________________________________________________________

61. __________________________________________________________________________________

62. __________________________________________________________________________________

63. $_______ SUBTOTAL (Add lines 59 through 62.)

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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MONTHLY INSURANCE:

64. $______ Health insurance (if not listed on lines 23 or 45)

65. _______ Life insurance

66. _______ Dental insurance.

Other:

67.________________________________________________________________________________

68.________________________________________________________________________________

69. $_______ SUBTOTAL (Add lines 66 through 68, exclude lines 64 and 65.)

OTHER MONTHLY EXPENSES NOT LISTED ABOVE:

70. $______ Monthly dry cleaning and laundry

71. _______Monthly clothing

72. _______ Monthly medical, dental, and prescription (unreimbursed only)

73. _______ Monthly psychiatric, psychological, or counselor (unreimbursed only)

74. _______ Monthly non-prescription medications, cosmetics, toiletries, and sundries

75. _______ Monthly grooming

76._______ Monthly gifts

77._______ Monthly pet expenses

78._______ Monthly club dues and membership

79._______ Monthly sports and hobbies

80._______ Monthly entertainment

81._______ Monthly periodicals/books/tapes/CDs

82._______ Monthly vacations

83._______ Monthly religious organizations

84._______ Monthly bank charges/credit card fees

85._______ Monthly education expenses

86.______ Other: (include any usual and customary expenses not otherwise mentioned in the items

listed above)______________________________________________________________

87.__________________________________________________________________________________

88.__________________________________________________________________________________

89.__________________________________________________________________________________

90. $_______ SUBTOTAL (Add lines 70 through 89.)

MONTHLY PAYMENTS TO CREDITORS: (only when payments are currently made by you on outstanding

balances). List only last 4 digits of account numbers.

MONTHLY PAYMENT AND NAME OF CREDITOR(s):

91. $_________________________________________________________________________________

92.__________________________________________________________________________________

93.__________________________________________________________________________________

94.__________________________________________________________________________________

95.__________________________________________________________________________________

96.__________________________________________________________________________________

97.__________________________________________________________________________________

98.__________________________________________________________________________________

99.__________________________________________________________________________________

100._________________________________________________________________________________

101._________________________________________________________________________________

102._________________________________________________________________________________

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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103.______________________________________________________________________________

104. $_______ SUBTOTAL (Add lines 91 through 103.)

105. $_______TOTAL MONTHLY EXPENSES:

(Add lines 25, 35, 58, 63, 69, 90, and 104 of Section II, Expenses.)

SUMMARY

106. $_______ TOTAL PRESENT MONTHLY NET INCOME (from line 27 of SECTION I. INCOME)

107. $_______ TOTAL MONTHLY EXPENSES (from line 105 above)

108. $_______ SURPLUS (If line 106 is more than line 107, subtract line 107 from line 106. This is the

amount of your surplus. Enter that amount here.)

109. ($______)(DEFICIT) (If line 107 is more than line 106, subtract line 106 from line 107. This is

the amount of your deficit. Enter that amount here.)

SECTION III. ASSETS AND LIABILITIES

A. ASSETS (This is where you list what you OWN.)

INSTRUCTIONS:

STEP 1: In column A, list a description of each separate item owned by you (and/or your spouse, if

this is a petition for dissolution of marriage). Blank spaces are provided if you need to list more than

one of an item.

STEP 2: If this is a petition for dissolution of marriage, check the line in Column A next to any item

that you are requesting the judge award to you.

STEP 3: In column B, write what you believe to be the current fair market value of all items listed.

STEP 4: Use column C only if this is a petition for dissolution of marriage and you believe an item

is “nonmarital,” meaning it belongs to only one of you and should not be divided. You should

indicate to whom you believe the item belongs. (Typically, you will only use Column C if property

was owned by one spouse before the marriage. See the “General Information for Self-Represented

Litigants” found at the beginning of these forms and section 61.075(1), Florida Statutes, for

definitions of “marital” and “nonmarital” assets and liabilities.)

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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A B C

ASSETS: DESCRIPTION OF ITEM(S) Current Nonmarital

Fair (Check correct column)

LIST ONLY LAST FOUR DIGITS OF ACCOUNT NUMBERS. Market

Check the line next to any asset(s) which you are Value

requesting the judge award to you. Petitioner Respondent

Cash (on hand) $

Cash (in banks or credit unions)

Stocks/Bonds

Notes (money owed to you in writing)

Money owed to you (not evidenced by a note)

Real estate: (Home)

(Other)

Business interests

Automobiles

Boats

Other vehicles

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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Retirement plans (Profit Sharing, Pension, IRA,

401(k)s, etc.)

Furniture & furnishings in home

Furniture & furnishings elsewhere

Collectibles

Jewelry

Life insurance (cash surrender value)

Sporting and entertainment (T.V., stereo, etc.)

equipment

Other assets:

Total Assets (add column B) $

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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B. LIABILITIES/DEBTS (This is where you list what you OWE.)

INSTRUCTIONS:

STEP 1: In column A, list a description of each separate debt owed by you (and/or your spouse, if

this is a petition for dissolution of marriage). Blank spaces are provided if you need to list more than

one of an item.

STEP 2: If this is a petition for dissolution of marriage, check the line in Column A next to any debt(s)

for which you believe you should be responsible.

STEP 3: In column B, write what you believe to be the current amount owed for all items listed.

STEP 4: Use column C only if this is a petition for dissolution of marriage and you believe an item

is “nonmarital,” meaning the debt belongs to only one of you and should not be divided. You

should indicate to whom you believe the debt belongs. (Typically, you will only use Column C if the

debt was owed by one spouse before the marriage. See the “General Information for Self-

Represented Litigants” found at the beginning of these forms and section 61.075(1), Florida

Statutes, for definitions of “marital” and “nonmarital” assets and liabilities.)

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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A B C

LIABILITIES: DESCRIPTION OF ITEM(S) Current Amount Nonmarital

Owed (Check correct column)

LIST ONLY LAST FOUR DIGITS OF ACCOUNT NUMBERS.

Check the line next to any debt(s) for which you believe

you should be responsible. Petitioner Respondent

Mortgages on real estate: First mortgage on home $

Second mortgage on home

Other mortgages

Charge/credit card accounts

Auto loan

Auto loan

Bank/Credit Union loans

Money you owe (not evidenced by a note)

Judgments

Other:

Total Debts (add column B) $

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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C. NET WORTH (excluding contingent assets and liabilities)

$_______Total Assets (enter total of Column B in Asset Table; Section A)

$_______Total Liabilities (enter total of Column B in Liabilities Table; Section B)

$_______TOTAL NET WORTH (Total Assets minus Total Liabilities)

(excluding contingent assets and liabilities)

D. CONTINGENT ASSETS AND LIABILITIES

INSTRUCTIONS:

If you have any POSSIBLE assets (income potential, accrued vacation or sick leave, bonus, inheritance,

etc.) or POSSIBLE liabilities (possible lawsuits, future unpaid taxes, contingent tax liabilities, debts

assumed by another), you must list them here.

A B C

Contingent Assets Nonmarital

Possible Value (Check correct column)

Check the line next to any contingent asset(s) which

you are requesting the judge award to you. Petitioner Respondent

$

Total Contingent Assets $

A B C

Contingent Liabilities Nonmarital

Possible Amount (Check correct column)

Owed

Check the line next to any contingent debt(s) for

which you believe you should be responsible. Petitioner Respondent

$

Total Contingent Liabilities $

E. CHILD SUPPORT GUIDELINES WORKSHEET. Florida Family Law Rules of Procedure Form 12.902(e),

Child Support Guidelines Worksheet, MUST be filed with the court at or prior to a hearing to

establish or modify child support. This requirement cannot be waived by the parties.

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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[Check one only]

____A Child Support Guidelines Worksheet IS or WILL BE filed in this case. This case involves the

establishment or modification of child support.

____A Child Support Guidelines Worksheet IS NOT being filed in this case. The establishment or

modification of child support is not an issue in this case.

I certify that a copy of this financial affidavit was [check all used]: ( ) e-mailed ( ) mailed, ( ) faxed

( ) hand delivered to the person(s) listed below on {date} ____________________.

Other party or his/her attorney:

Name: _____________________________

Address: ____________________________

City, State, Zip: _______________________

Telephone Number: __________________

Fax Number: _________________________

E-mail Address(es): _____________________

Under penalties of perjury, I declare that I have read this document and the facts stated in it are true.

Dated: ______________________ __________________________________________

Signature of Party

Printed Name: ______________________________

Address: ___________________________________

City, State, Zip: ______________________________

Telephone Number: __________________________

Fax Number: ________________________________

E-mail Address(es): ____________________________

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:

[fill in all blanks] This form was prepared for the: {choose only one} ( ) Petitioner ( ) Respondent

This form was completed with the assistance of:

{name of individual} ___________________________________________________________,

{name of business} _______________________________________________________________,

{address} ___________________________,

{city} ____,{state} _, {telephone number} ______________________.

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (11/20)

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INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE

FORM 12.902(e)

CHILD SUPPORT GUIDELINES WORKSHEET (11/20)

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 this document 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 filed with the court and served on the other party or his or her attorney. The

copy you are serving to the other party must be either mailed, emailed, or hand-delivered to the opposing

party or his or her attorney on the same day indicated on the certificate of service. If it is mailed, it must

be postmarked on the date indicated in the certificate of service. Service must be in accordance with

Florida Rule of Judicial Administration 2.516.

IMPORTANT INFORMATION REGARDING E-FILING

The Florida Rules of Judicial Administration now require that all petitions, pleadings, and documents be

filed electronically except in certain circumstances. Self-represented litigants may file petitions or other

pleadings or documents electronically; however, they are not required to do so. If you choose to file

your pleadings or other documents electronically, you must do so in accordance with Florida Rule of

Judicial Administration 2.525, and you must follow the procedures of the judicial circuit in which you file.

The rules and procedures should be carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION

After the initial service of process of the petition or supplemental petition by the Sheriff or certified

process server, the Florida Rules of Judicial Administration now require that all documents required or

permitted to be served on the other party must be served by electronic mail (e-mail) except in certain

circumstances. You must strictly comply with the format requirements set forth in the Florida Rules of

Judicial Administration. If you elect to participate in electronic service, which means serving or receiving

pleadings by electronic mail (e-mail), or through the Florida Courts E-Filing Portal, you must review

Florida Rule of Judicial Administration 2.516. You may find this rule at www.flcourts.org through the link

to the Rules of Judicial Administration provided under either Family Law Forms: Getting Started, or Rules

of Court in the A-Z Topical Index.

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (11/20)

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SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT

REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by email, the

procedures must always be followed once the initial election is made.

To serve and receive documents by e-mail, you must designate your e-mail addresses by using the

Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form

12.915, and you must provide your e-mail address on each form on which your signature appears.

Please CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme

Court Approved Family Law Form 12.914; Designation of Current Mailing and E-mail Address, Florida

Supreme Court Approved Family Law Form 12.915; and Florida Rule of Judicial Administration 2.516.

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 have been found by a judge to be 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 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.

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (11/20)

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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.

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (11/20)

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CHILD SUPPORT GUIDELINES CHART

Combined One Two Three Four Five Six

Monthly Child Children Children Children Children Children

Available

Income

800.00 190 211 213 216 218 220

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

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet

(11/20)

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Combined One Two Three Four Five Six

Monthly Child Children Children Children Children Children

Available

Income

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

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet

(11/20)

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Combined One Two Three Four Five Six

Monthly Child Children Children Children Children Children

Available

Income

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

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet

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Combined One Two Three Four Five Six

Monthly Child Children Children Children Children Children

Available

Income

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

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet

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Combined One Two Three Four Five Six

Monthly Child Children Children Children Children Children

Available

Income

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

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet

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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 all used]: ( ) e-mailed ( ) mailed ( ) faxed ( ) hand delivered to the person(s) listed

below on {date} __________.

Other party or his/her attorney:

Name: _____________________________

Address: ____________________________

City, State, Zip: _______________________

Telephone Number: ___________________

Fax Number: _________________________

E-mail Address(es): ____________________

Signature of Party or his/her Attorney

Printed Name: _________________________

Address: ______________________________

City, State, Zip: _________________________

Telephone Number: _____________________

Fax Number: ___________________________

E-mail Address(es): ______________________

Florida Bar Number: _____________________

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (11/20)

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CHILD SUPPORT GUIDELINES WORKSHEET

A. PETITIONER B. RESPONDENT TOTAL

1. Present Net Monthly Income

Enter the amount from line 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

Petitioner’s percentage of

financial responsibility. Enter

answer on line 3A. Divide the

amount on line 1B by the total

amount on line 1 to get

Respondent’s percentage

of 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

Petitioner’s share of basic

obligation. Enter answer on line

4A. Multiply the number on line 2

by the percentage on line 3B to

Respondent’s share of basic

obligation.

Enter answer on line 4B.

Additional Support — Health Insurance, Child Care & Other

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (11/20)

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CHILD SUPPORT GUIDELINES WORKSHEET

A. PETITIONER B. RESPONDENT TOTAL

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), Florida Statutes,

for more information.]

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 Petitioner’s share.

Enter answer on line 6A. Multiply the

number on line 5d by the percentage

on line 3B to determine the

Respondent’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.

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (11/20)

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CHILD SUPPORT GUIDELINES WORKSHEET

A. PETITIONER B. RESPONDENT TOTAL

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.)

8. Total Support Payments actually made

(A

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