In Re: Amendments To The Florida Family Law Rules
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Supreme Court of Florida
____________
No. SC08-1660
____________
IN RE: AMENDMENTS TO THE FLORIDA FAMILY LAW RULES.
[October 16, 2008]
PER CURIAM.
The Florida Bar’s Family Law Rules Committee (Committee) has filed a
“Fast-Track Report to Implement Chapter 2008-61, Laws of Florida.” The
Committee proposes several amendments to the Florida Family Law Rules of
Procedure, as well as several Family Law Rules of Procedure Forms, in order to
conform to the recent legislation. We have jurisdiction. See art. V, § 2(a), Fla.
Const.
The relevant legislation, chapter 2008-61, Laws of Florida, amended
various sections of Chapter 61, Florida Statutes, and related statutes, to remove the
references to “custody,” “primary residential parent,” “secondary residential
parent,” and “visitation.” The statutes now require the court to create or approve a
“parenting plan” which establishes how divorced parents will share the
responsibilities of childrearing and decision-making with regard to the child and
sets forth a time-sharing schedule. See generally Ch. 2008-61, §§ 2, 8, Laws of
Fla. (amending §§ 61.046 and 61.13, Fla. Stat. (2007)). The effective date of this
legislation is October 1, 2008.
In order to incorporate these legislative changes into the family law rules
and forms, the Committee has proposed amendments to rules 12.010 (Scope,
Purpose, and Title); 12.200 (Case Management and Pretrial Conferences); 12.210
(Parties); 12.363 (Evaluation of Minor Child); 12.491 (Child Support
Enforcement); 12.610 (Injunction for Domestic, Repeat, Dating, and Sexual
Violence); and 12.650 (Override of Family Violence Indicator); and forms
12.900(b) (Notice of Limited Appearance); 12.900(c) (Consent to Limited
Appearance by Attorney); 12.902(e) (Child Support Guidelines Worksheet);
12.930(b) (Standard Family Law Interrogatories for Original or Enforcement
Proceedings); and 12.930(c) (Standard Family Law Interrogatories for
Modification Proceedings). We adopt the amendments as proposed by the
Committee. 1
Accordingly, the Florida Family Law Rules of Procedure are hereby
amended as set forth in the appendix to this opinion. New language is
1. Minor editorial amendments are also made. Additionally, some minor
amendments proposed by the Committee in this case were also proposed in In re
Amendments to Florida Family Law Rules, No. SC08-92 (Fla. Oct. 16, 2008), and
are being addressed by the Court in that case.
-2-
underscored; deleted language is struck through. The forms are fully engrossed
and ready for use. The amended rules and forms shall be effective immediately.
Because the amendments were not published for comment prior to adoption,
interested persons shall have sixty days from the date of this opinion in which to
file comments with the Court. 2
It is so ordered.
QUINCE, C.J., and WELLS, ANSTEAD, PARIENTE, LEWIS, and CANADY,
JJ., concur.
POLSTON, J., did not participate.
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION, AND
IF FILED, DETERMINED.
Original Proceeding – Florida Family Law Rules
Robyn L. Vines, Chair, Family Law Rules Committee, Fort Lauderdale, Florida,
and John F. Harkness, Jr., Executive Director, The Florida Bar, Tallahassee,
Florida,
for Petitioner
2. An original and nine paper copies of all comments must be filed with the
Court on or before December 15, 2008, with a certificate of service verifying that a
copy has been served on the committee chair, Robyn L. Vines, 200 E. Broward
Blvd., Fort Lauderdale, Florida 33301-1963, as well as a separate request for oral
argument if the person filing the comment wishes to participate in oral argument,
which may be scheduled in this case. The committee chair has until January 5,
2009, to file a response to any comments filed with the Court. Electronic copies of
all comments and responses also must be filed in accordance with the Court's
administrative order In re Mandatory Submission of Electronic Copies of
Documents, Fla. Admin. Order No. AOSC04-84 (Sept. 13, 2004).
-3-
APPENDIX
RULE 12.010.
(a)
SCOPE, PURPOSE, AND TITLE
Scope.
(1) These rules apply to all actions concerning family matters,
including actions concerning domestic, repeat, dating, and sexual violence, except
as otherwise provided by the Florida Rules of Juvenile Procedure or the Florida
Probate Rules. “Family matters,” “family law matters,” or “family law cases” as
used within these rules include, but are not limited to, matters arising from
dissolution of marriage, annulment, support unconnected with dissolution of
marriage, paternity, child support, custodial care of or access toan action involving
a parenting plan for a minor child or children (except as otherwise provided by the
Florida Rules of Juvenile Procedure), adoption, proceedings for emancipation of a
minor, declaratory judgment actions related to premarital, marital, or post-marital
agreements (except as otherwise provided, when applicable, by the Florida Probate
Rules), injunctions for domestic, repeat, dating, and sexual violence, and all
proceedings for modification, enforcement, and civil contempt of these actions.
(2)
[No change]
(b) – (c) [No change]
RULE 12.200.
(a)
CASE MANAGEMENT AND PRETRIAL
CONFERENCES
Case Management Conference.
(1) Family Law Proceedings, Generally. A case management
conference may be ordered by the court at any time on the court’s initiative. A party
may request a case management conference 30 days after service of a petition or
complaint. At such a conference the court may:
(A) – (L) [No change]
(M) refer the cause for a parenting plan recommendation,
social investigation and study, home study, or psychological evaluation and
allocate the initial expense for that study;
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(N) – (O) [No change]
(2)
[No change]
(b) – (d) [No change]
Commentary
[No change]
Committee Note
[No change]
RULE 12.210.
PARTIES
Parties to an action filed under the Florida Family Law Rules of Procedure shall
be governed by Florida Rule of Civil Procedure 1.210, except that rule 1.210 shall
not be read to require that a child is an indispensable party for a dissolution of
marriage or child custody proceedingaction involving a parenting plan for a minor
child or children.
RULE 12.363.
(a)
EVALUATION OF MINOR CHILD
Appointment of Mental Health Professional or Other Expert.
(1) When the issue of visitation, parental responsibility, or
residential placement ofa parenting plan for a minor child is in controversy, the
court, on motion of any party or the court’s own motion, may appoint a licensed
mental health professional or other expert for an examination, evaluation, testing,
or interview of any minor child or to conduct a social or home study investigation.
The parties may agree on the particular expert to be appointed, subject to approval
by the court. If the parties have agreed, they shall submit an order including the
name, address, telephone number, area of expertise, and professional qualifications
of the expert. If the parties have agreed on the need for an expert and cannot agree
on the selection, the court shall appoint an expert.
(2) – (6) [No change]
(b) – (e) [No change]
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Committee Note
[No change]
RULE 12.491.
CHILD SUPPORT ENFORCEMENT
(a)
[No change]
(b)
Scope. This rule shall apply to proceedings for
(1)
[No change]
(2) the enforcement of any support order for the custodial parent or
other person entitled to receive child support in conjunction with an ongoing child
support or child support arrearage order,
when a party seeking support is receiving services pursuant to Title IV-D of the
Social Security Act (42 U.S.C. §§ 651 et seq.) and to non-Title IV-D proceedings
upon administrative order of the chief justice.
(c) – (h) [No change]
Commentary
[No change]
Committee Note
[No change]
RULE 12.610.
(a) – (b)
(c)
INJUNCTIONS FOR DOMESTIC, REPEAT,
DATING, AND SEXUAL VIOLENCE
[No change]
Orders of Injunction.
(1)
Consideration by Court.
-6-
(A) – (B) [No change]
(C) Final Judgment of Injunction for Protection Against
Domestic Violence. The court shall conduct a hearing and make a finding of
whether domestic violence occurred or whether imminent danger of domestic
violence exists. If the court determines that an injunction will be issued, the court
shall also rule on the following:
(i)
whether the respondent may have any contact with
the petitioner, and if so, under what conditions;
(ii)
exclusive use of the parties’ shared residence;
(iii) petitioner’s temporary custody oftime-sharing with
the minor child or children;
(iv) whether respondent will have temporary
visitationtime-sharing with the minor child or children will occur and
whether it will be supervised;
(v)
whether temporary child support will be ordered;
(vi)
whether temporary spousal support will be
ordered; and
(vii) such other relief as the court deems necessary for
the protection of the petitioner.
The court, with the consent of the parties, may refer the parties to mediation by a
certified family mediator to attempt to resolve the details as to the above rulings.
This mediation shall be the only alternative dispute resolution process offered by
the court. Any agreement reached by the parties through mediation shall be
reviewed by the court and, if approved, incorporated into the final judgment. If no
agreement is reached the matters referred shall be returned to the court for
appropriate rulings. Regardless of whether all issues are resolved in mediation, an
injunction for protection against domestic violence shall be entered or extended the
same day as the hearing on the petition commences.
(2)
[No change]
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(3)
Service of Injunctions.
(A)
[No change]
(B)
Permanent Injunction.
(i)
Party Present at Hearing. The parties may
acknowledge receipt of the permanent injunction for protection against domestic,
repeat, dating, or sexual violence in writing on the face of the original order. If a
party is present at the hearing and that party fails or refuses to acknowledge the
receipt of a certified copy of the injunction, the clerk shall cause the order to be
served by mailing certified copies of the injunction to the parties who were present
at the hearing at the last known address of each party. Service by mail is complete
upon mailing. When an order is served pursuant to this subdivision, the clerk shall
prepare a written certification to be placed in the court file specifying the time,
date, and method of service and within 24 hours shall forward a copy of the
injunction and the clerk’s affidavit of service to the sheriff with jurisdiction over
the residence of the petitioner. This procedure applies to service of orders to
modify or vacate injunctions for protection against domestic, repeat, dating, or
sexual violence.
(ii)
[No change]
(4) – (7) [No change]
Commentary
[No change]
Committee Note
[No change]
RULE 12.650.
OVERRIDE OF FAMILY VIOLENCE INDICATOR
(a)
[No change]
(b)
Definitions.
(1) “Authorized person” means a person as defined in 42 U.S.C. §
653(c) and § 663(d)(2). It includes any agent or attorney of the Title IV-D agency
-8-
of this or any other state, the court that has authority to issue an order or to serve as
the initiating court in an action to seek an order against a noncustodial parent or
other person obligated to pay child support for the support and maintenance of a
child, or any agent of such court, the resident parent, or other person entitled to
receive child support, legal guardian, attorney, or agent of a child (other than a
child receiving assistance under 42 U.S.C. §§ 601 et seq.), and any state agency
that administers a child welfare, family preservation, or foster care program. It also
includes any agent or attorney of this or any other state who has the duty or
authority under the law of such state to enforce a child custody or visitation
determination or order establishing a parenting plan; the court that has jurisdiction
to make or enforce such a child custody or visitation determination or order
establishing a parenting plan, or any agent of such court; and any agent or attorney
of the United States, or of a state, who has the duty or authority to investigate,
enforce, or bring a prosecution with respect to the unlawful taking or restraint of a
child.
(2) “Authorized purpose” means a purpose as defined in 42 U.S.C.
§ 653(a)(2) and § 663(b). It includes establishing parentage, establishing, setting
the amount of, modifying, or enforcing child support obligations, or making or
enforcing child custody or visitation orders or orders establishing parenting plans.
It also includes enforcing any state or federal law with respect to the unlawful
taking or restraint of a child.
(3) – (7) [No change]
(c) – (i) [No change]
Commentary
[No change]
Committee Note
2008 Amendment. Chapter 2008-61, Laws of Florida, effective October 1,
2008, eliminated such terms as “custodial parent,” “noncustodial parent,” and
“visitation” from Chapter 61, Florida Statutes. Instead, parents are to formulate a
parenting plan that includes, among other things, their time-sharing schedule for
their minor children. These statutory changes are reflected in the amendments to
-9-
the definitions in this rule. However, because 42 U.S.C. § 653 includes the terms
“custody” and “visitation,” these terms have not been excised from the remainder
of the rule.
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INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.900(b), NOTICE OF LIMITED APPEARANCE (10/08)
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 the original 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 mailed or hand delivered to the other party or his or her attorney
and to the attorney’s client.
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
(10/08)
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
, [ √ one only] ( )
on behalf of {name}
Petitioner ( ) Respondent, for the following limited purpose(s) [ √ all that apply]:
1. ___ The hearing set for {date}
, at {time}
on the
issue(s) of {specify}
2. ___ To represent [ √ one only] ( ) Petitioner ( ) Respondent on the following issues
throughout the proceedings:
a. ___ Parental responsibility, including establishing a parenting plan.
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 mailed to the undersigned attorney at the
address listed and to the [ √ one only] ( ) Petitioner ( ) Respondent at {name, address, and
telephone number}
I certify that a copy of this notice of limited appearance was: ( ) mailed, ( ) faxed and
mailed, or ( ) hand delivered to the person(s) listed below on {date}
Other party or his/her attorney:
Name:
Address:
City, State, Zip:
Fax Number:
Florida Family Law Rules of Procedure Form 12.900(b), Notice of Limited Appearance (10/08)
.
.
.
Signature of Attorney
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Florida Bar Number
Signature of Petitioner/Respondent
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Florida Family Law Rules of Procedure Form 12.900(b), Notice of Limited Appearance (10/08)
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.900(c), CONSENT TO LIMITED APPEARANCE BY
ATTORNEY (10/08)
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 it. The attorney or client should then file it 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 mailed or hand delivered to the other party or his or her attorney.
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 (10/08)
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 [ √ one only] ( ) Petitioner ( ) Respondent,
consents to the limited representation by counsel, {attorney’s name}
,
for the following limited purpose(s) [ √ all that apply]:
1. ___The hearing set for {date}
, at {time} on the issue(s) of {specify}
2. ___To represent [ √ one only] ( ) Petitioner ( ) Respondent on the following issues
throughout the proceedings:
a. ___Parental responsibility, including establishing a parenting plan.
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: ( ) mailed, ( ) faxed and
.
mailed, or ( ) 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:
Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by Attorney
(10/08)
.
Signature of Petitioner/Respondent
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS
BELOW: [fill in all blanks]
I, {full legal name and trade name of nonlawyer}
a nonlawyer, located at {street}
, {city}
{state}
, {phone}
, helped {name}
who is the [ √ one only] petitioner or respondent, fill out this form.
Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by Attorney
(10/08)
,
,
,
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.902(e), CHILD SUPPORT GUIDELINES WORKSHEET (10/08)
When should this form be used?
You should complete this worksheet if child support is being requested in your case. If you know
the income of the other party, this worksheet should accompany your financial affidavit. If you do
not know the other party’s income, this form must be completed after the other party files his or
her financial affidavit, and serves a copy on you.
This form should be typed or printed in black ink. You should file the original with the clerk of the
circuit court in the county where your case is filed and keep a copy for your records.
What should I do next?
A copy of this form must be mailed or hand delivered to the other party in your case, if it is not
served on him or her with your initial papers.
Where can I look for more information?
Before proceeding, you should read “General Information for Self‐Represented Litigants” found at
the beginning of these forms. The words that are in “bold underline” in these instructions are
defined there. For further information, see section 61.30, Florida Statutes.
Special notes...
If this is a domestic violence case and you want to keep your address confidential for safety reasons,
do not enter the address, telephone, and fax information at the bottom of this form. Instead, file
Petitioner’s 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:
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(10/08)
If payment is twice per month
Payment amount x
2
=
Monthly amount
If payment is every two weeks
Payment amount x
Yearly amount
÷
26 =
12 =
Yearly amount due
Monthly amount
If payment is weekly
Weekly amount
Yearly amount
52 =
12 =
Yearly amount due
Monthly amount
x
÷
If you or the other parent request that the court award an amount that is different than the
guideline amount, you must also complete and attach a Motion to Deviate from Child Support
Guidelines, Florida Supreme Court Approved Family Law Form 12.943.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out
these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law
Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out
these forms also must put his or her name, address, and telephone number on the bottom of the
last page of every form he or she helps you complete.
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(10/08)
CHILD SUPPORT GUIDELINES CHART
Combined
Monthly
Net
Income
650.00
700.00
750.00
800.00
850.00
900.00
950.00
1000.00
1050.00
1100.00
1150.00
1200.00
1250.00
1300.00
1350.00
1400.00
1450.00
1500.00
1550.00
1600.00
1650.00
1700.00
1750.00
1800.00
1850.00
1900.00
1950.00
2000.00
2050.00
2100.00
2150.00
2200.00
2250.00
2300.00
2350.00
2400.00
2450.00
2500.00
2550.00
2600.00
2650.00
2700.00
2750.00
2800.00
One
Child
74
119
164
190
202
213
224
235
246
258
269
280
290
300
310
320
330
340
350
360
370
380
390
400
410
421
431
442
452
463
473
484
494
505
515
526
536
547
557
568
578
588
597
607
Two
Children
75
120
166
211
257
302
347
365
382
400
417
435
451
467
482
498
513
529
544
560
575
591
606
622
638
654
670
686
702
718
734
751
767
783
799
815
831
847
864
880
896
912
927
941
Three
Children
75
121
167
213
259
305
351
397
443
489
522
544
565
584
603
623
642
662
681
701
720
740
759
779
798
818
839
859
879
899
919
940
960
980
1000
1020
1041
1061
1081
1101
1121
1141
1160
1178
Four
Children
76
123
169
216
262
309
355
402
448
495
541
588
634
659
681
702
724
746
768
790
812
833
855
877
900
923
946
968
991
1014
1037
1060
1082
1105
1128
1151
1174
1196
1219
1242
1265
1287
1308
1328
Five Six
Children Children
77
78
124
125
171
173
218
220
265
268
312
315
359
363
406
410
453
458
500
505
547
553
594
600
641
648
688
695
735
743
765
790
789
838
813
869
836
895
860
920
884
945
907
971
931
996
955
1022
979
1048
1004
1074
1029
1101
1054
1128
1079
1154
1104
1181
1129
1207
1154
1234
1179
1261
1204
1287
1229
1314
1254
1340
1279
1367
1304
1394
1329
1420
1354
1447
1379
1473
1403
1500
1426
1524
1448
1549
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(10/08)
Combined
Monthly
Net
Income
2850.00
2900.00
2950.00
3000.00
3050.00
3100.00
3150.00
3200.00
3250.00
3300.00
3350.00
3400.00
3450.00
3500.00
3550.00
3600.00
3650.00
3700.00
3750.00
3800.00
3850.00
3900.00
3950.00
4000.00
4050.00
4100.00
4150.00
4200.00
4250.00
4300.00
4350.00
4400.00
4450.00
4500.00
4550.00
4600.00
4650.00
4700.00
4750.00
4800.00
4850.00
4900.00
4950.00
One
Child
616
626
635
644
654
663
673
682
691
701
710
720
729
738
748
757
767
776
784
793
802
811
819
828
837
846
854
863
872
881
889
898
907
916
924
933
942
951
959
968
977
986
993
Two
Children
956
971
986
1001
1016
1031
1045
1060
1075
1090
1105
1120
1135
1149
1164
1179
1194
1208
1221
1234
1248
1261
1275
1288
1302
1315
1329
1342
1355
1369
1382
1396
1409
1423
1436
1450
1463
1477
1490
1503
1517
1530
1542
Three
Children
1197
1215
1234
1252
1271
1289
1308
1327
1345
1364
1382
1401
1419
1438
1456
1475
1493
1503
1520
1536
1553
1570
1587
1603
1620
1637
1654
1670
1687
1704
1721
1737
1754
1771
1788
1804
1821
1838
1855
1871
1888
1905
1927
Four
Children
1349
1370
1391
1412
1433
1453
1474
1495
1516
1537
1558
1579
1599
1620
1641
1662
1683
1702
1721
1740
1759
1778
1797
1816
1835
1854
1873
1892
1911
1930
1949
1968
1987
2006
2024
2043
2062
2081
2100
2119
2138
2157
2174
Five Six
Children Children
1471
1573
1494
1598
1517
1622
1540
1647
1563
1671
1586
1695
1608
1720
1631
1744
1654
1769
1677
1793
1700
1818
1723
1842
1745
1867
1768
1891
1791
1915
1814
1940
1837
1964
1857
1987
1878
2009
1899
2031
1920
2053
1940
2075
1961
2097
1982
2119
2002
2141
2023
2163
2044
2185
2064
2207
2085
2229
2106
2251
2127
2273
2147
2295
2168
2317
2189
2339
2209
2361
2230
2384
2251
2406
2271
2428
2292
2450
2313
2472
2334
2494
2354
2516
2372
2535
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(10/08)
Combined
Monthly
Net
Income
5000.00
5050.00
5100.00
5150.00
5200.00
5250.00
5300.00
5350.00
5400.00
5450.00
5500.00
5550.00
5600.00
5650.00
5700.00
5750.00
5800.00
5850.00
5900.00
5950.00
6000.00
6050.00
6100.00
6150.00
6200.00
6250.00
6300.00
6350.00
6400.00
6450.00
6500.00
6550.00
6600.00
6650.00
6700.00
6750.00
6800.00
6850.00
6900.00
6950.00
7000.00
7050.00
7100.00
7150.00
One
Child
1000
1006
1013
1019
1025
1032
1038
1045
1051
1057
1064
1070
1077
1083
1089
1096
1102
1107
1111
1116
1121
1126
1131
1136
1141
1145
1150
1155
1160
1165
1170
1175
1179
1184
1189
1193
1196
1200
1204
1208
1212
1216
1220
1224
Two
Children
1551
1561
1571
1580
1590
1599
1609
1619
1628
1638
1647
1657
1667
1676
1686
1695
1705
1713
1721
1729
1737
1746
1754
1762
1770
1778
1786
1795
1803
1811
1819
1827
1835
1843
1850
1856
1862
1868
1873
1879
1885
1891
1897
1903
Three
Children
1939
1952
1964
1976
1988
2000
2012
2024
2037
2049
2061
2073
2085
2097
2109
2122
2134
2144
2155
2165
2175
2185
2196
2206
2216
2227
2237
2247
2258
2268
2278
2288
2299
2309
2317
2325
2332
2340
2347
2355
2362
2370
2378
2385
Four
Children
2188
2202
2215
2229
2243
2256
2270
2283
2297
2311
2324
2338
2352
2365
2379
2393
2406
2418
2429
2440
2451
2462
2473
2484
2495
2506
2517
2529
2540
2551
2562
2573
2584
2595
2604
2613
2621
2630
2639
2647
2656
2664
2673
2681
Five Six
Children Children
2387
2551
2402
2567
2417
2583
2432
2599
2447
2615
2462
2631
2477
2647
2492
2663
2507
2679
2522
2695
2537
2711
2552
2727
2567
2743
2582
2759
2597
2775
2612
2791
2627
2807
2639
2820
2651
2833
2663
2847
2676
2860
2688
2874
2700
2887
2712
2900
2724
2914
2737
2927
2749
2941
2761
2954
2773
2967
2785
2981
2798
2994
2810
3008
2822
3021
2834
3034
2845
3045
2854
3055
2863
3064
2872
3074
2882
3084
2891
3094
2900
3103
2909
3113
2919
3123
2928
3133
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(10/08)
Combined
Monthly
Net
Income
7200.00
7250.00
7300.00
7350.00
7400.00
7450.00
7500.00
7550.00
7600.00
7650.00
7700.00
7750.00
7800.00
7850.00
7900.00
7950.00
8000.00
8050.00
8100.00
8150.00
8200.00
8250.00
8300.00
8350.00
8400.00
8450.00
8500.00
8550.00
8600.00
8650.00
8700.00
8750.00
8800.00
8850.00
8900.00
8950.00
9000.00
9050.00
9100.00
9150.00
9200.00
9250.00
9300.00
9350.00
9400.00
One
Child
1228
1232
1235
1239
1243
1247
1251
1255
1259
1263
1267
1271
1274
1278
1282
1286
1290
1294
1298
1302
1306
1310
1313
1317
1321
1325
1329
1333
1337
1341
1345
1349
1352
1356
1360
1364
1368
1372
1376
1380
1384
1388
1391
1395
1399
Two
Children
1909
1915
1921
1927
1933
1939
1945
1951
1957
1963
1969
1975
1981
1987
1992
1998
2004
2010
2016
2022
2028
2034
2040
2046
2052
2058
2064
2070
2076
2082
2088
2094
2100
2106
2111
2117
2123
2129
2135
2141
2147
2153
2159
2165
2171
Three
Children
2393
2400
2408
2415
2423
2430
2438
2446
2453
2461
2468
2476
2483
2491
2498
2506
2513
2521
2529
2536
2544
2551
2559
2566
2574
2581
2589
2597
2604
2612
2619
2627
2634
2642
2649
2657
2664
2672
2680
2687
2695
2702
2710
2717
2725
Four
Children
2690
2698
2707
2716
2724
2733
2741
2750
2758
2767
2775
2784
2792
2801
2810
2818
2827
2835
2844
2852
2861
2869
2878
2887
2895
2904
2912
2921
2929
2938
2946
2955
2963
2972
2981
2989
2998
3006
3015
3023
3032
3040
3049
3058
3066
Five Six
Children Children
2937
3142
2946
3152
2956
3162
2965
3172
2974
3181
2983
3191
2993
3201
3002
3211
3011
3220
3020
3230
3030
3240
3039
3250
3048
3259
3057
3269
3067
3279
3076
3289
3085
3298
3094
3308
3104
3318
3113
3328
3122
3337
3131
3347
3141
3357
3150
3367
3159
3376
3168
3386
3178
3396
3187
3406
3196
3415
3205
3425
3215
3435
3224
3445
3233
3454
3242
3464
3252
3474
3261
3484
3270
3493
3279
3503
3289
3513
3298
3523
3307
3532
3316
3542
3326
3552
3335
3562
3344
3571
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(10/08)
Combined
Monthly
Net
Income
9450.00
9500.00
9550.00
9600.00
9650.00
9700.00
9750.00
9800.00
9850.00
9900.00
9950.00
10000.00
One
Child
1403
1407
1411
1415
1419
1422
1425
1427
1430
1432
1435
1437
Two
Children
2177
2183
2189
2195
2201
2206
2210
2213
2217
2221
2225
2228
Three
Children
2732
2740
2748
2755
2763
2767
2772
2776
2781
2786
2791
2795
Four
Children
3075
3083
3092
3100
3109
3115
3121
3126
3132
3137
3143
3148
Five Six
Children Children
3353
3581
3363
3591
3372
3601
3381
3610
3390
3620
3396
3628
3402
3634
3408
3641
3414
3647
3420
3653
3426
3659
3432
3666
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(10/08)
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 [ √ one only] ( ) mailed ( ) faxed and mailed ( ) hand delivered to the person(s) listed
below on {date}
Other party or his/her attorney:
Name:
Address:
City, State, Zip:
Fax Number:
Date:
.
Signature of Party
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (10/08)
CHILD SUPPORT GUIDELINES WORKSHEET
A. FATHER
B. MOTHER
TOTAL
1. Present Net Monthly Income
Enter the amount from line number 27, Section I of O‘ Florida Family Law Rules
of Procedure Form 12.902(b) or [(c)]), Financial Affidavit.
2. Basic Monthly Obligation
There is (are) {number} minor child(ren) common to the parties. Using
the total amount from line 1, enter the appropriate amount from the child support
guidelines chart.
3. Percent of Financial Responsibility
.%
. %
Divide the amount on line 1A by the total amount on line 1 to get Father’s
percentage financial responsibility. Enter answer on line 3A.
Divide the amount on line 1B by the total amount on line 1 to get Mother’s
percentage financial responsibility. Enter answer on line 3B.
4. Share of Basic Monthly Obligation
Multiply the number on line 2 by the percentage on line 3A to get Father’s share
of basic obligation. Enter answer on line 4A.
Multiply the number on line 2 by the percentage on line 3B to get Mother’s share
of basic obligation. Enter answer on line 4B.
Additional Support — Health Insurance, Child Care & Other
5a. 75% of Monthly Child Care Costs
[Child care costs should not exceed the level required to provide quality care from
a licensed source for the child(ren). See section 61.30(7), Fla. Stat. for more
information.]
5b. Total Monthly Child(ren)’s Health Insurance Cost
[This is only amounts actually paid for health insurance on the child(ren).]
5c. Total Monthly Child(ren)’s Noncovered Medical,
Dental and Prescription Medication Costs
5d. Total Monthly Child Care & Health Costs [Add lines
5a+5b+5c]
6. Additional Support Payments
Multiply the number on line 5d by the percentage on line 3A to determine the
Father’s share.
Enter answer on line 6A.
Multiply the number on line 5d by the percentage on line 3B to determine the
Mother’s share.
Enter answer on line 6B.
Statutory Adjustments/Credits
7a. Monthly child care payments actually made
7b. Monthly health insurance payments actually made
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (10/08)
CHILD SUPPORT GUIDELINES WORKSHEET
7c. Other payments/credits actually made for any
noncovered medical, dental and prescription
medication expenses of the child(ren) not ordered
to be separately paid on a percentage basis. [See § 61.30
(8), Florida Statutes]
8. Total Support Payments actually made [Add 7a through 7c]
9. MINIMUM CHILD SUPPORT OBLIGATION FOR
EACH PARENT [Line 4 plus line 6; minus line 8]
Substantial Time‐Sharing (GROSS UP METHOD) If each parent exercises time‐sharing at least 40
percent of the overnights in the year (146 overnights in the year), complete Nos. 10 through 21
A. FATHER
B. MOTHER
TOTAL
10. Basic Monthly Obligation x 150% [ Multiply line 2 by 1.5]
11. Increased Basic Obligation for each parent
Multiply the number on line 10 by the percentage on line 3A to determine the
Father’s share.
Enter answer on line 11A.
Multiply the number on line 10 by the percentage on line 3B to determine the
Mother’s share.
Enter answer on line 11B.
12. Percentage of overnight stays with each parent
The child(ren) spend(s) overnight stays with the father each year. Using the
number on the above line, multiply it by 100 and divide by 365. Enter this number
on line 12A.
The child(ren) spend(s) overnight stays with the mother each year. Using the
number on the above line, multiply it by 100 and divide by 365. Enter this number
on line 12B.
%
13. Parent’s support multiplied by other Parent’s
percentage of overnights [Multiply line 11A by line 12B. Enter this
%
number in 13A. Multiply line 11B by line 12A. Enter this number in 13B.]
Additional Support — Health Insurance, Child Care & Other
14a. Total Monthly Child Care Costs
[Child care costs should not exceed the level required to provide quality care from a
licensed source for the child(ren). See section 61.30(7), Fla. Stat. for more information.]
14b. Total Monthly Child(ren)’s Health Insurance Cost
[This is only amounts actually paid for health insurance on the child(ren).]
14c. Total Monthly Child(ren)’s Noncovered Medical,
Dental and Prescription Medication Costs
14d. Total Monthly Child Care & Health Costs [Add lines
14a+14b+14c]
15. Additional Support Payments
Multiply the number on line 14d by the percentage on line 3A to determine the
Father’s share.
Enter answer on line 15A.
Multiply the number on line 14d by the percentage on line 3B to determine the
Mother’s share.
Enter answer on line 15B.
Statutory Adjustments/Credits
16a. Monthly child care payments actually made
16b. Monthly health insurance payments actually made
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (10/08)
CHILD SUPPORT GUIDELINES WORKSHEET
16c. Other payments/credits actually made for any
noncovered medical, dental and prescription
medication expenses of the child(ren) not ordered to
be separately paid on a percentage basis. [See § 61.30 (8),
Florida Statutes]
17. Total Support Payments actually made [Add 16a through
16c]
18. Total Additional Support Transfer Amount [Line 15
minus line 17; Enter any negative number as zero]
19. Total Child Support Owed from Father to Mother
[Add line 13A+18A]
20. Total Child Support Owed from Mother to Father
[Add line 13B+18B]
21. Actual Child Support to Be Paid. [Comparing lines 19 and
20, Subtract the smaller amount owed from the larger amount owed and enter the
result in the column for the parent that owes the larger amount of support]
$ ‐or‐ $
ADJUSTMENTS TO GUIDELINES AMOUNT. If you or the other parent is requesting the Court to
award a child support amount that is more or less than the child support guidelines, you must
complete and file Motion to Deviate from Child Support Guidelines, Florida Supreme Court
Approved Family Law Form 12.943.
[ √ one only]
a. __ Deviation from the guidelines amount is requested. The Motion to Deviate from
Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is
attached.
b. __ Deviation from the guidelines amount is NOT requested. The Motion to Deviate
from Child Support Guidelines, Florida Supreme Court Approved Family Law Form
12.943, is not attached.
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS
BELOW: [fill in all blanks]
I, {full legal name and trade name of nonlawyer}
a nonlawyer, located at {street}
, {city}
{state}
, {phone}
, helped {name}
who is the [ √ one only] petitioner or respondent, fill out this form.
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (10/08)
,
,
,
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE
FORM 12.930(b), STANDARD FAMILY LAW INTERROGATORIES FOR
ORIGINAL OR ENFORCEMENT PROCEEDINGS (10/08)
When should this form be used?
This form should be used to ask the other party in your case to answer certain standard
questions in writing. These questions are called interrogatories, and they must relate to your
case. If the other party fails to answer the questions, you may ask the judge to order the other
party to answer the questions. (You cannot ask these questions before the petition has been
filed.)
The questions in this form should be used in original proceedings or enforcement proceedings
and are meant to supplement the information provided in the Financial Affidavit, Florida Family
Law Rules of Procedure Form 12.902(b) or (c). You should read all of the questions in this form
to determine which questions, if any, the other party needs to answer in order to provide you
with information not covered in the financial affidavit forms. If there are questions to which you
already know the answer, you may choose not to ask them.
This form should be typed or printed in black ink. You must complete the box at the beginning of
this form to indicate which questions you are requesting that the other party answer. You
should send 2 copies of this form and the Notice of Service of Standard Family Law
Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a), to the other party. You
should also keep a copy for your records. You should not file this form with the clerk of the
circuit court. However, you must file the Notice of Service of Standard Family Law
Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a), to tell the court that you
have sent this form to the other party.
Where can I look for more information?
Before proceeding, you should read “General Information for Self‐Represented Litigants”
found at the beginning of these forms. For further information, see the instructions for Notice
of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form
12.930(a), rules 12.280, 12.285, 12.340, and 12.380, Florida Family Law Rules of Procedure, and
rules 1.280, 1.340, and 1.380, Florida Rules of Civil Procedure.
Instructions for Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law
Interrogatories for Original or Enforcement Proceedings (10/08)
Special notes...
In addition to the standard questions in this form, you may ask up to 10 additional questions.
You should type or print legibly your additional questions on a separate sheet of paper and
attach it to this form. If you want to ask more than 10 additional questions, you will need to get
permission from the judge.
You may want to inform the other party of the following information: As a general rule, within
30 days after service of interrogatories, the other party must answer the questions in writing
and mail (have postmarked) the answers to you. His or her answers shall be written in the blank
space provided after each separately numbered interrogatory. If sufficient space is not
provided, the answering party may attach additional papers with the answers and refer to them
in the space provided in the interrogatories. He or she should be sure to make a copy for
him/herself. All answers to these questions are made under oath or affirmation as to their
truthfulness. Each question must be answered separately and as completely as the available
information permits. The original of the answers to the interrogatories is to be provided to the
requesting party. Do not file the original or a copy with the clerk of the circuit court except as
provided in Florida Rule of Civil Procedure 1.340(c). The other party may object to a question by
writing the legal reason for the objection in the space provided. He or she may also ask the
court for a protective order granting him or her permission not to answer certain questions and
protecting him or her from annoyance, embarrassment, apprehension, or undue burden or
expense. If the other party fails to either answer or object to the questions within 30 days, he or
she may be subject to court sanctions.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill
out these forms, that person must give you a copy of Disclosure from Nonlawyer, Florida Family
Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill
out these forms also must put his or her name, address, and telephone number on the bottom
of the last page of every form he or she helps you complete.
Instructions for Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law
Interrogatories for Original or Enforcement Proceedings (10/08)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
STANDARD FAMILY LAW INTERROGATORIES
FOR ORIGINAL OR ENFORCEMENT PROCEEDINGS
TO BE COMPLETED BY THE PARTY SERVING THESE INTERROGATORIES
I am requesting that the following standard questions be answered: [ √ all that apply]
1
2
3
4
5
Background
Information
Education
Employment
Assets
Liabilities
In addition, I am requesting that the attached {#}
answered.
6
7
Miscellaneous Long Form
Affidavit
questions be
The answers to the following questions are intended to supplement the information
provided in the Financial Affidavits, Florida Family Law Rules of Procedure Form 12.902(b) or (c).
You should answer the group of questions indicated in the above shaded box. The questions
should be answered in the blank space provided below each separately numbered question. If
sufficient space is not provided, you may attach additional papers with the answers and refer to
them in the space provided in the interrogatories. You should be sure to make a copy for
yourself. Each question must be answered separately and as completely as the available
information permits. All answers are to be made under oath or affirmation as to their
truthfulness.
I, {name of person answering interrogatories}
being sworn, certify that the following information is true:
1. BACKGROUND INFORMATION:
a. State your full legal name and any other name by which you have been known.
b. State your present residence and telephone numbers.
c. State your place and date of birth.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
,
2. EDUCATION:
a. List all business, commercial, and professional licenses that you have obtained.
b. List all of your education including, but not limited to, vocational or specialized
training, including the following:
(1) name and address of each educational institution.
(2) dates of attendance.
(3) degrees or certificates obtained or anticipated dates of same.
3. EMPLOYMENT:
a. For each place of your employment or self‐employment during the last 3 years,
state the following:
(1) name, address, and telephone number of your employer.
(2) dates of employment.
(3) job title and brief description of job duties.
(4) starting and ending salaries.
(5) name of your direct supervisor.
(6) all benefits received, including, for example, health, life, and disability
insurance; expense account; use of automobile or automobile expense
reimbursement; reimbursement for travel, food, or lodging expenses;
payment of dues in any clubs or associations; and pension or profit
sharing plans.
b. Other than as an employee, if you have been engaged in or associated with any
business, commercial, or professional activity within the last 3 years that was
not detailed above, state for each such activity the following:
(1) name, address, and telephone number of each activity.
(2) dates you were connected with such activity.
(3) position title and brief description of activities.
(4) starting and ending compensation.
(5) name of all persons involved in the business, commercial, or
professional activity with you.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
(6) all benefits and compensation received, including, for example, health,
life, and disability insurance; expense account; use of automobile or
automobile expense reimbursement; reimbursement for travel, food, or
lodging expenses; payment of dues in any clubs or associations; and
pension or profit sharing plans.
c. If you have been unemployed at any time during the last 3 years, state the dates
of unemployment. If you have not been employed at any time in the last 3
years, give the information requested above in question 3.a for your last
period of employment.
4. ASSETS:
a. Real Estate. State the street address, if any, and if not, the legal description of
all real property that you own or owned during the last 3 years. For each
property, state the following:
(1) the names and addresses of any other persons or entities holding any
interest and their percentage of interest.
(2) the purchase price, the cost of any improvements made since it was
purchased, and the amount of any depreciation taken.
(3) the fair market value on the date of your separation from your spouse.
(4) the fair market value on the date of the filing of the petition for
dissolution of marriage.
b. Tangible Personal Property. List all items of tangible personal property that are
owned by you or in which you have had any interest during the last 3 years
including, but not limited to, motor vehicles, tools, furniture, boats, jewelry, art
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
objects or other collections, and collectibles whose fair market value exceeds
$100. For each item, state the following:
(1) the percentage and type interest you hold.
(2) the names and addresses of any other persons or entities holding any
interest.
(3) the date you acquired your interest.
(4) the purchase price.
(5) the present fair market value.
(6) the fair market value on the date of your separation from your spouse.
(7) the fair market value on the date of the filing of the petition for
dissolution of marriage.
c. Intangible Personal Property. Other than the financial accounts (checking,
savings, money market, credit union accounts, retirement accounts, or other
such cash management accounts) listed in the answers to interrogatories 4.d and
4.e below, list all items of intangible personal property that are owned by you or
in which you have had any ownership interest (including closed accounts) within
the last 3 years, including but not limited to, partnership and business interests
(including good will), deferred compensation accounts unconnected with
retirement, including but not limited to stock options, sick leave, and vacation
pay, stocks, stock funds, mutual funds, bonds, bond funds, real estate
investment trust, receivables, certificates of deposit, notes, mortgages, and
debts owed to you by another entity or person. For each item, state the
following:
(1) the percentage and type interest you hold.
(2) the names and addresses of any other persons or entities holding any
interest and the names and addresses of the persons and entities who
are indebted to you.
(3) the date you acquired your interest.
(4) the purchase price, acquisition cost, or loaned amount.
(5) the fair market value or the amounts you claim are owned by or owed
to you:
(a) presently, at the time of answering these interrogatories.
(b) on the date of your separation from your spouse.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
(c) on the date of the filing of the petition for dissolution of marriage.
You may comply with this interrogatory (4.c) by providing copies of all periodic
(monthly, quarterly, semi‐annual, or annual) account statements for each such
account for the preceding 3 years. However, if the date of acquisition, the purchase
price and the market valuations are not clearly reflected in the periodic statements
which are furnished then these questions must be answered separately. You do not
have to resubmit any periodic statements previously furnished under rule 12.285
(Mandatory Disclosure).
d. Retirement Accounts: List all information regarding each retirement
account/plan, including but not limited to defined benefit plans, 401k, 403B,
IRA accounts, pension plans, Florida Retirement System plans (FRS), Federal
Government plans, money purchase plans, HR10 (Keogh) plans, profit sharing
plans, annuities, employee savings plans, etc. that you have established and/or
that have been established for you by you, your employer, or any previous
employer. For each account, state the following:
(1) the name and account number of each account/plan and where it is
located.
(2) the type of account/plan.
(3) the name and address of the fiduciary plan administrator/service
representative.
(4) the fair market value of your interest in each account/plan.
(a) present value.
(b) value on the date of separation.
(c) value on the date of filing of the petition for dissolution of marriage
(5) whether you are vested or not vested; and if vested, in what amount, as
of a certain date and the schedule of future vesting.
(6) the date at which you became/become eligible to receive some funds in
this account/plan.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
(7) monthly benefits of the account/plan if no fair market value is
ascertained.
(8) beneficiary(ies) and/or alternate payee(s).
e. Financial Accounts. For all financial accounts (checking, savings, money market,
credit union accounts, or other such cash management accounts) listed in your
Financial Affidavit, in which you have had any legal or equitable interest,
regardless of whether the interest is or was held in your own name
individually, in your name with another person, or in any other name, give the
following:
(1) name and address of each institution.
(2) name in which the account is or was maintained.
(3) account numbers.
(4) name of each person authorized to make withdrawals from the
accounts.
(5) highest balance within each of the preceding 3 years.
(6) lowest balance within each of the preceding 3 years.
You may comply with this interrogatory (4.e) by providing copies of all periodic
(monthly, quarterly, semi‐annual, or annual) account statements for each such
account for the preceding 3 years. You do not have to resubmit account statements
previously furnished pursuant to rule 12.285 (Mandatory Disclosure).
f. Closed Financial Accounts. For all financial accounts (checking, savings, money
market, credit union accounts, or other such cash management accounts)
closed within the last 3 years, in which you have had any legal or equitable
interest, regardless of whether the interest is or was held in your own name
individually, in your name with another person, or in any other name, give the
following:
(1) name and address of each institution.
(2) name in which the account is or was maintained.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
(3) account numbers.
(4) name of each person authorized to make withdrawals from the
accounts.
(5) date account was closed.
g. Trust. For any interest in an estate, trust, insurance policy, or annuity, state the
following:
(1) If you are the beneficiary of any estate, trust, insurance policy, or
annuity, give for each one the following:
(a) identification of the estate, trust, insurance policy, or annuity.
(b) the nature, amount, and frequency of any distributions of benefits.
(c) the total value of the beneficiaries’ interest in the benefit.
(d) whether the benefit is vested or contingent.
(2) If you have established any trust or are the trustee of a trust, state the
following:
(a) the date the trust was established.
(b) the names and addresses of the trustees.
(c) the names and addresses of the beneficiaries.
(d) the names and addresses of the persons or entities who possess the
trust documents.
(e) each asset that is held in each trust, with its fair market value.
h. Canceled Life Insurance Policies. For all policies of life insurance within the
preceding 3 years that you no longer hold, own, or have any interest in, state
the following:
(1) name of company that issued the policy and policy number.
(2) name, address, and telephone number of agent who issued the policy.
(3) amount of coverage.
(4) name of insured.
(5) name of owner of policy.
(6) name of beneficiaries.
(7) premium amount.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
(8) date the policy was surrendered.
(9) amount, if any, of monies distributed to the owner.
i. Name of Accountant, Bookkeeper, or Records Keeper. State the names,
addresses, and telephone numbers of your accountant, bookkeeper, and any
other persons who possess your financial records, and state which records
each possesses.
j. Safe Deposit Boxes, Lock Boxes, Vaults, Etc. For all safe deposit boxes, lock
boxes, vaults, or similar types of depositories, state the following:
(1) The names and addresses of all banks, depositories, or other places
where, at any time during the period beginning 3 years before the
initiation of the action, until the date of your answering this
interrogatory, you did any of the following:
(a) had a safe deposit box, lock box, or vault.
(b) were a signatory or co‐signatory on a safe deposit box, lock box, or
vault.
(c) had access to a safe deposit box, lock box, or vault.
(d) maintained property.
(2) The box or identification numbers and the name and address of each
person who has had access to any such depository during the same time
period.
(3) All persons who have possession of the keys or combination to the safe
deposit box, lock box, or vault.
(4) Any items removed from any safe deposit boxes, lock boxes, vaults, or
similar types of depositories by you or your agent during that time,
together with the present location and fair market value of each item.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
(5) All items in any safe deposit boxes, lock boxes, vaults, or similar types of
depositories and fair market value of each item.
5. LIABILITIES:
a. Loans, Liabilities, Debts, and Other Obligations. For all loans, liabilities, debts,
and other obligations (other than credit cards and charge accounts) listed in
your Financial Affidavit, indicate for each the following:
(1) name and address of the creditor.
(2) name in which the obligation is or was incurred.
(3) loan or account number, if any.
(4) nature of the security, if any.
(5) payment schedule.
(6) present balance and current status of your payments.
(7) total amount of arrearage, if any.
(8) balance on the date of your separation from your spouse.
(9) balance on the date of the filing of the petition for dissolution of
marriage.
You may comply with this interrogatory (5.a) by providing copies of all periodic
(monthly, quarterly, semi‐annual, or annual) account statements for each such
account for the preceding 3 years. You do not have to resubmit account statements
previously furnished under rule 12.285 (Mandatory Disclosure).
b. Credit Cards and Charge Accounts. For all financial accounts (credit cards,
charge accounts, or other such accounts) listed in your Financial Affidavit, in
which you have had any legal or equitable interest, regardless of whether the
interest is or was held in your own name individually, in your name with another
person, or in any other name, give the following:
(1) name and address of the creditor.
(2) name in which the account is or was maintained.
(3) names of each person authorized to sign on the accounts.
(4) account numbers.
(5) present balance and current status of your payments.
(6) total amount of arrearage, if any.
(7) balance on the date of your separation from your spouse.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
(8) balance on the date of the filing of the petition for dissolution of
marriage.
(9) highest and lowest balance within each of the preceding 3 years.
You may comply with this interrogatory (5.b) by providing copies of all periodic
(monthly quarterly, semi‐annual, or annual) account statements for each such account
for the preceding 3 years. You do not have to resubmit account statements previously
furnished under rule 12.285 (Mandatory Disclosure).
c. Closed Credit Cards and Charge Accounts. For all financial accounts (credit
cards, charge accounts, or other such accounts) closed with no remaining
balance, within the last 3 years, in which you have had any legal or equitable
interest, regardless of whether the interest is or was held in your own name
individually, in your name with another person, or in any other name, give the
following:
(1) name and address of each creditor.
(2) name in which the account is or was maintained.
(3) account numbers.
(4) names of each person authorized to sign on the accounts.
(5) date the balance was paid off.
(6) amount of final balance paid off.
You may comply with this interrogatory (5.c) by providing copies of all periodic
(monthly, quarterly, semi‐annual, or annual) account statements for each such
account for the preceding 3 years. You do not have to resubmit account statements
previously furnished under rule 12.285 (Mandatory Disclosure).
6. MISCELLANEOUS:
a. If you are claiming an unequal distribution of marital property or enhancement
or appreciation of nonmarital property, state the amount claimed and all facts
upon which you rely in your claim.
b. If you are claiming an asset or liability is nonmarital, list the asset or liability and
all facts upon which you rely in your claim.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
c. If the mental or physical condition of a spouse or child is an issue, identify the
person and state the name and address of all health care providers involved in
the treatment of that person for said mental or physical condition.
d. Detail your proposed parenting plan for the minor child(ren), including your
proposed time‐sharing schedule. Alternatively, attach a copy of your proposed
parenting plan.
e. If you are claiming that the other parent’s contact or time‐sharing with the
minor child(ren) should be limited, or that you should have sole parental
responsibility for the minor child(ren), with or without time‐sharing with the
other parent, or that you should have ultimate responsibility over specific
aspects of the child(ren)’s welfare or that these responsibilities should be
divided between you and the other parent, state your reasons and all facts upon
which you rely to support your claim.
7. LONG FORM AFFIDAVIT: If you filed the short form affidavit, Florida Family Law Rules of
Procedure Form 12.902(b), and you were specifically requested in the Notice of Service
of Standard Family Law Interrogatories to file the Long Form Affidavit, Form12.902(c),
you must do so within the time to serve the answers to these interrogatories.
I certify that a copy of this document was [ √ one only] ( ) mailed ( ) faxed and mailed
( ) hand delivered to the person(s) listed below on {date}
Other party or his/her attorney:
Name:
Address:
City, State, Zip:
Fax Number:
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
.
I understand that I am swearing or affirming under oath to the truthfulness of the
answers to these interrogatories and that the punishment for knowingly making a false
statement includes fines and/or imprisonment.
Dated:
Signature of Party
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
STATE OF FLORIDA
COUNTY OF
Sworn to or affirmed and signed before me on by
NOTARY PUBLIC or DEPUTY CLERK
[Print, type, or stamp commissioned name of
notary or deputy clerk.]
Personally known
Produced identification
Type of identification produced
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS
BELOW: [fill in all blanks]
I, {full legal name and trade name of nonlawyer}
a nonlawyer, located at {street}
, {city}
, helped {name}
{state}
, {phone}
who is the [ √ one only] petitioner or respondent, fill out this form.
Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or
Enforcement Proceedings (10/08)
.
,
,
,
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM
12.930(c), STANDARD FAMILY LAW INTERROGATORIES FOR
MODIFICATION PROCEEDINGS (10/08)
When should this form be used?
This form should be used to ask the other party in your case to answer certain standard questions in
writing. These questions are called interrogatories, and they must relate to your case. If the other party
fails to answer the questions, you may ask the judge to order the other party to answer the questions.
(You cannot ask these questions before the petition has been filed.)
The questions in this form should be used in modification proceedings and are meant to supplement
the information provided in the Financial Affidavits, Florida Family Law Rules of Procedure Form
12.902(b) or (c). You should read all of the questions in this form to determine which questions, if any,
the other party needs to answer in order to provide you with information not covered in the financial
affidavit forms. If there are questions to which you already know the answer, you may choose not to ask
them.
This form should be typed or printed in black ink. You must complete the box at the beginning of this
form to indicate which questions you are requesting that the other party answer. You should send two
copies of this form and the Notice of Service of Standard Family Law Interrogatories, Florida Family Law
Rules of Procedure Form 12.930(a), to the other party. You should also keep a copy for your records.
You do not need to file this form with the clerk of the circuit court. However, you must file the Notice
of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form
12.930(a), to tell the court that you have sent this form to the other party.
Where can I look for more information?
Before proceeding, you should read “General Information for Self‐Represented Litigants” found at the
beginning of these forms. For further information, see the instructions for Notice of Service of
Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a), rules
12.280, 12.285, 12.340, and 12.380, Florida Family Law Rules of Procedure and rules 1.280, 1.340, and
1.380, Florida Rules of Civil Procedure.
Special notes...
In addition to the standard questions in this form, you may ask up to 10 additional questions. You
should type or print your additional questions on a separate sheet of paper and attach it to this form. If
you want to ask more than 10 additional questions, you will need to get permission from the judge.
You may want to inform the other party of the following information: As a general rule, within 30 days
after service of interrogatories, the other party must answer the questions in writing and mail (have
postmarked) the answers to you. His or her answers shall be written in the blank space provided after
each separately numbered interrogatory. If sufficient space is not provided, the answering party may
Instructions for Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for
Modification Proceedings (10/08)
attach additional papers with the answers and refer to them in the space provided in the
interrogatories. He or she should be sure to make a copy for him/herself. All answers to these questions
are made under oath or affirmation as to their truthfulness. Each question must be answered separately
and as completely as the available information permits. The original of the answers to the
interrogatories is to be provided to the requesting party. Do not file the original or a copy with the clerk
of the circuit court except as provided by Florida Rule of Civil Procedure 1.340(e). The other party may
object to a question by writing the legal reason for the objection in the space provided. He or she may
also ask the court for a protective order granting him or her permission not to answer certain questions
and protecting him or her from annoyance, embarrassment, apprehension, or undue burden or
expense. If the other party fails to either answer or object to the questions within 30 days, he or she
may be subject to court sanctions.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out
these forms, that person must give you a copy of Disclosure from Nonlawyer, Florida Family Law Rules
of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms
also must put his or her name, address, and telephone number on the bottom of the last page of every
form he or she helps you complete.
Instructions for Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for
Modification Proceedings (10/08)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner
and
,
Respondent.
STANDARD FAMILY LAW INTERROGATORIES
FOR MODIFICATION PROCEEDINGS
TO BE COMPLETED BY THE PARTY SERVING THESE INTERROGATORIES
I am requesting that the following standard questions be answered: [ √ all that apply]
Background
Information
1 2
Education
3
Employment
In addition, I am requesting that the attached {#}
4
Assets
5
Liabilities
6
Miscellaneous
7
Long Form
Affidavit
questions be answered.
The answers to the following questions are intended to supplement the information provided in
the Financial Affidavits, Florida Family Law Rules of Procedure Form 12.902(b) or (c). You should answer
the group of questions indicated in the above shaded box. The questions should be answered in the
blank space provided below each separately numbered question. If sufficient space is not provided, you
may attach additional papers with the answers and refer to them in the space provided in the
interrogatories. You should be sure to make a copy for yourself. Each question must be answered
separately and as completely as the available information permits. All answers are to be made under
oath or affirmation as to their truthfulness.
I, {name of person answering interrogatories}
being sworn, certify that the following information is true:
1. BACKGROUND INFORMATION:
a. State your full legal name and any other name by which you have been known.
b. State your present residence and telephone numbers.
c. State your place and date of birth.
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
,
2. EDUCATION:
a. List all business, commercial, and professional licenses that you have obtained since the
entry of the Final Judgment sought to be modified.
b. List all of your education since the entry of the Final Judgment sought to be modified
including, but not limited to, vocational or specialized training, including the following:
(1) name and address of each educational institution.
(2) dates of attendance.
(3) degrees or certificates obtained or anticipated dates of same.
3. EMPLOYMENT:
a. For each place of your employment or self‐employment since the entry of the Final
Judgment sought to be modified, state the following:
(1) name, address, and telephone number of your employer.
(2) dates of employment.
(3) job title and brief description of job duties.
(4) starting and ending salaries.
(5) name of your direct supervisor.
(6) all benefits received, including, for example, health, life, and disability
insurance; expense account; use of automobile or automobile expense
reimbursement; reimbursement for travel, food, or lodging expenses;
payment of dues in any clubs or associations; and pension or profit sharing
plans.
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
b. Other than as an employee, if you have been engaged in or associated with any
business, commercial, or professional activity since the entry of the Final Judgment
sought to be modified that was not detailed above, state for each such activity the
following:
(1) name, address, and telephone number of each activity.
(2) dates you were connected with such activity.
(3) position title and brief description of activities.
(4) starting and ending compensation.
(5) name of all persons involved in the business, commercial, or professional
activity with you.
(6) all benefits and compensation received, including, for example, health, life,
and disability insurance; expense account; use of automobile or automobile
expense reimbursement; reimbursement for travel, food, or lodging expenses;
payment of dues in any clubs or associations; and pension or profit sharing
plans.
c. If you have been unemployed at any time since the entry of the Final Judgment sought
to be modified, state the dates of unemployment. If you have not been employed at
any time since the entry of the Final Judgment sought to be modified, give the
information requested above in question 3.a for your last period of employment.
4. ASSETS:
a. Real Estate. State the street address, if any, and if not, the legal description of all real
property that you own or owned during the last 3 years, or since the entry of the Final
Judgment sought to be modified, if shorter. For each property, state the following:
(1) the names and addresses of any other persons or entities holding any interest
and their percentage of interest.
(2) the present fair market value.
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
b. Tangible Personal Property. List all items of tangible personal property that are owned
by you or in which you have had any interest during the last 3 years, or since the entry
of the Final Judgment sought to be modified, if shorter, including, but not limited to,
motor vehicles, tools, furniture, boats, jewelry, art objects or other collections, and
collectibles whose fair market value exceeds $100. For each item, state the following:
(1) the percentage and type interest you hold.
(2) the names and addresses of any other persons or entities holding any interest.
(3) the present fair market value.
c. Intangible Personal Property. Other than the financial accounts (checking, savings,
money market, credit union accounts, retirement accounts, or other such cash
management accounts) listed in the answers to interrogatories 4.d and 4.e below, list all
items of intangible personal property that are owned by you or in which you have had
any ownership interest (including closed accounts) within the last 3 years, or since the
entry of the Final Judgment sought to be modified, if shorter, including, but not limited
to, partnership and business interests (including good will), deferred compensation
accounts unconnected with retirement, including but not limited to stock options, sick
leave, and vacation pay, stocks, stock funds, mutual funds, bonds, bond funds, real
estate investment trusts, receivables, certificates of deposit, notes, mortgages, and
debts owed to you by another entity or person. For each item, state the following:
(1) the percentage and type interest you hold.
(2) the names and addresses of any other persons or entities holding any interest
and the names and addresses of the persons and entities who are indebted to
you.
(3) the present fair market value or the amounts you claim are owned by or owed
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
to you, at the time of answering these interrogatories.
You may comply with this interrogatory (4.c) by providing copies of all periodic (monthly,
quarterly, semi‐annual, or annual) account statements for each such account for the preceding
3 years, or since the entry of the Final Judgment sought to be modified, if shorter. However, if
the date of acquisition, the purchase price, and the market valuations are not clearly reflected
in the periodic statements which are furnished, then these questions must be answered
separately. You do not have to resubmit any periodic statements previously furnished under
rule 12.285 (Mandatory Disclosure).
d. Retirement Accounts: List all information regarding each retirement account/plan,
including but not limited to defined benefit plans, 401k, 403B, IRA accounts, pension
plans, Florida Retirement System plans (FRS), Federal Government plans, money
purchase plans, HR10 (Keogh) plans, profit sharing plans, annuities, employee savings
plans, etc. that you have established and/or that have been established for you by you,
your employer or any previous employer. For each account, state the following:
(1) the name and account number of each account/plan and where it is located.
(2) the type of account/plan.
(3) the name and address of the fiduciary plan administrator/ service
representative
(4) the present fair market value of your interest in each account/plan.
(5) whether you are vested or not vested; and if vested, in what amount, as of a
certain date and the schedule of future vesting.
(6) the date at which you became/become eligible to receive some funds in this
account/plan.
(7) monthly benefits of the account/plan if no fair market value is ascertained.
(8) beneficiary(ies) and/or alternate payee(s).
e. Financial Accounts. For all financial accounts (checking, savings, money market, credit
union accounts, or other such cash management accounts) listed in your Financial
Affidavit, in which you have had any legal or equitable interest, regardless of whether
the interest is or was held in your own name individually, in your name with another
person, or in any other name, give the following:
(1)
name and address of each institution.
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
(2)
name in which the account is or was maintained.
(3)
account numbers.
(4)
names of each person authorized to make withdrawals from the accounts.
(5)
highest balance within each of the preceding 3 years, or since the entry of the
Final Judgment sought to be modified, if shorter.
(6)
lowest balance within each of the preceding 3 years, or since the entry of the
Final Judgment sought to be modified, if shorter.
You may comply with this interrogatory (4.e) by providing copies of all periodic (monthly,
quarterly, semi‐annual, or annual) account statements for each such account for the preceding
3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You do not
have to resubmit account statements previously furnished under rule 12.285 (Mandatory
Disclosure).
f.
Closed Financial Accounts. For all financial accounts (checking, savings, money market,
credit union accounts, or other such cash management accounts) closed within the last
3 years, or since the entry of the Final Judgment sought to be modified, if shorter, in
which you have had any legal or equitable interest, regardless of whether the interest is
or was held in your own name individually, in your name with another person, or in any
other name, give the:
(1)
name and address of each institution.
(2)
name in which the account is or was maintained.
(3)
account numbers.
(4)
name of each person authorized to make withdrawals from the accounts.
(5)
date account was closed.
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
g. Trust. For any interest in an estate, trust, insurance policy, or annuity, state the
following:
(1)
if you are the beneficiary of any estate, trust, insurance policy, or annuity, give
for each one the following:
(a) identification of the estate, trust, insurance policy, or annuity.
(b) the nature, amount, and frequency of any distributions of benefits.
(c) the total value of the beneficiaries’ interest in the benefit.
(d) whether the benefit is vested or contingent.
(2)
if you have established any trust or are the trustee of a trust, state the
following:
(a) the date the trust was established.
(b) the names and addresses of the trustees.
(c) the names and addresses of the beneficiaries.
(d) the names and addresses of the persons or entities who possess the
trust documents.
(e) each asset that is held in each trust, with its fair market value.
h. Name of Accountant, Bookkeeper, or Records Keeper. State the names, addresses, and
telephone numbers of your accountant, bookkeeper, and any other persons who
possess your financial records, and state which records each possesses.
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
5. LIABILITIES:
a. Loans, Liabilities, Debts, and Other Obligations. For all loans, liabilities, debts, and
other obligations (other than credit cards and charge accounts) listed in your Financial
Affidavit, indicate for each the following:
(1)
name and address of the creditor.
(2)
name in which the obligation is or was incurred.
(3)
loan or account number, if any.
(4)
nature of the security, if any.
(5)
payment schedule.
(6)
present balance and current status of your payments.
(7)
total amount of arrearage, if any.
You may comply with this interrogatory (5.a) by providing copies of all periodic (monthly,
quarterly, semi‐annual, or annual) account statements for each such account for the preceding
3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You do not
have to resubmit account statements previously furnished under rule 12.285 (Mandatory
Disclosure).
b. Credit Cards and Charge Accounts. For all financial accounts (credit cards, charge
accounts, or other such accounts) listed in your Financial Affidavit, in which you have
had any legal or equitable interest, regardless of whether the interest is or was held in
your own name individually, in your name with another person, or in any other name,
give the following:
(1)
name and address of the creditor.
(2)
name in which the account is or was maintained.
(3)
name of each person authorized to sign on the accounts.
(4)
account numbers.
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
(5)
present balance and current status of your payments.
(6)
total amount of arrearage, if any.
(7)
highest and lowest balance within each of the preceding 3 years, or since the
entry of the Final Judgment sought to be modified, if shorter.
You may comply with this interrogatory (5.b) by providing copies of all periodic (monthly,
quarterly, semi‐annual, or annual) account statements for each such account for the preceding
3 years, or since the entry of the Final Judgment sought to be modified, if shorter. You do not
have to resubmit account statements previously furnished under rule 12.285 (Mandatory
Disclosure).
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification
Proceedings (10/08)
c. Closed Credit Cards and Charge Accounts. As to all financial accounts (credit
card, charge accounts, or other such accounts) closed with no remaining
balance, within the last 3 years, or since the entry of the Final Judgment sought
to be modified, if shorter, in which you have had any legal or equitable interest,
regardless of whether the interest is or was held in your own name individually,
in your name with another person, or in any other name, give the following:
(1)
name and address of each creditor.
(2)
name in which the account is or was maintained.
(3)
account numbers.
(4)
name of each person authorized to sign on the accounts.
(5)
date the balance was paid off.
(6)
amount of final balance paid off.
You may comply with this interrogatory (5.c) by providing copies of all periodic
(monthly, quarterly, semi‐annual, or annual) account statements for each such
account for the preceding 3 years, or since the entry of the Final Judgment sought to
be modified, if shorter. You do not have to resubmit account statements previously
furnished under rule 12.285 (Mandatory Disclosure).
6. MISCELLANEOUS:
a. If you are claiming a diminished earning capacity since the entry of the Final
Judgment sought to be modified as grounds to modify alimony or deviate from
the child support established in your case, describe in detail how your earning
capacity is lowered and state all facts upon which you rely in your claim. If
unemployed, state how, why, and when you lost your job.
b. If you are claiming a change in a mental or physical condition since the entry of
the Final Judgment sought to be modified as grounds to modify alimony or
change the child support established in your case, describe in detail how your
mental and/or physical capacity has changed and state all facts upon which you
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for
Modification Proceedings (10/08)
rely in your claim. Identify the change in your mental and/or physical capacity,
and state the name and address of all health care providers involved in the
treatment of this mental or physical condition.
c. If you are requesting a change in shared or sole parental responsibility, the
parenting plan, or any combination thereof, for the minor child(ren), describe in
detail the change in circumstances since the entry of the Final Judgment sought
to be modified that you feel justify the requested change. State when the
change of circumstances occurred, how the change of circumstances affects the
child(ren), and why it is in the best interests of the child(ren) that the Court
make the requested change. Attach your proposed parenting plan.
d. If you do not feel the requested change in shared or sole parental responsibility,
the parenting plan, or any combination thereof, for the minor child(ren) is in
their best interests, describe in detail any facts since the entry of the Final
Judgment sought to be modified that you feel justify the Court denying the
requested change. State, in your opinion, what change, if any, in shared or sole
parental responsibility, or of the parenting plan is justified or agreeable to you
and why it is in the best interests of the child(ren).
7. LONG FORM AFFIDAVIT: If you filed the short form affidavit, Florida Family Law Rules of
Procedure Form 12.902(b), and you were specifically requested in the Notice of Service
of Standard Family Law Interrogatories to file the Long Form Affidavit, Form 12.902(c),
you must do so within the time to serve the answers to these interrogatories.
I certify that a copy of this document was [ √ one only] ( ) mailed ( ) faxed and mailed
.
( ) hand delivered to the person(s) listed below on {date}
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for
Modification Proceedings (10/08)
Other party or his/her attorney:
Name:
Address:
City, State, Zip:
Fax Number:
I understand that I am swearing or affirming under oath to the truthfulness of the
answers to these interrogatories and that the punishment for knowingly making a false
statement includes fines and/or imprisonment.
Dated:
Signature of Party
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
STATE OF FLORIDA
COUNTY OF
Sworn to or affirmed and signed before me on by
.
NOTARY PUBLIC or DEPUTY CLERK
[Print, type, or stamp commissioned name of
notary or clerk.]
Personally known
Produced identification
Type of identification produced
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS
BELOW: [fill in all blanks]
I, {full legal name and trade name of nonlawyer}
,
a nonlawyer, located at {street}
, {city}
,
{state} , {phone} , helped {name}
,
who is the [ √ one only] petitioner or respondent, fill out this form.
Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for
Modification Proceedings (10/08)
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