In Re: Implementation Of Committee On Privacy And Court Records Recommendations Amendments To The Florida Rules Of Civil Procedure; The Florida Rules Of Judicial Administration; The Florida Rules Of Criminal Procedure; The Florida Probate Rules; The Florida Small Claims Rules; The Florida Rules Of Appellate Procedure; And The Florida Family Law Rules Of Procedure

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Supreme Court of Florida ____________ No. SC08-2443 ____________ IN RE: IMPLEMENTATION OF COMMITTEE ON PRIVACY AND COURT RECORDS RECOMMENDATIONS—AMENDMENTS TO THE FLORIDA RULES OF CIVIL PROCEDURE; THE FLORIDA RULES OF JUDICIAL ADMINISTRATION; THE FLORIDA RULES OF CRIMINAL PROCEDURE; THE FLORIDA PROBATE RULES; THE FLORIDA SMALL CLAIMS RULES; THE FLORIDA RULES OF APPELLATE PROCEDURE; AND THE FLORIDA FAMILY LAW RULES OF PROCEDURE. [January 19, 2012] PER CURIAM. In this case, the Court previously adopted rule and form amendments intended to minimize the amount of unnecessary personal information included in documents filed with the courts. See In re Implementation of Comm. on Privacy & Court Records Recommendations, 36 Fla. L. Weekly S642 (Fla. Nov. 3, 2011). Because the amendments to the Florida Supreme Court Approved Family Law Forms were not published for comment prior to their adoption, interested persons were given sixty days from the date of the opinion to “file comments with the Court addressing only the amendments to the approved forms.” In re Implementation of Comm. on Privacy & Court Records Recommendations, 36 Fla. L. Weekly S331, S334 (Fla. June 30, 2011), revised, 36 Fla. L. Weekly S642 (Fla. Nov. 3, 2011). Two comments were filed. One comment addresses an approved form that was amended. The other addresses rule amendments and an approved form that was not amended. We address only the comment on the amended form, which was filed by Judge Renee Goldenberg of the Seventeenth Judicial Circuit. Judge Goldenberg urges that the instructions for Form 12.932 (Certificate of Compliance with Mandatory Disclosure) be amended to provide better notice to self-represented litigants of the limitations on filing personal information unless it is absolutely essential. We agree. After considering the comments, we further amend Florida Supreme Court Approved Family Law Form 12.932 (Certificate of Compliance with Mandatory Disclosure) and the instructions for that form.1 We add the following caveats to Form 12.932 and the instructions for that form, respectively: ONLY THE ORIGINAL OF THIS COMPLETED FORM IS FILED WITH THE COURT. EXCEPT FOR THE FINANCIAL AFFIDAVIT AND CHILD SUPPORT GUIDELINES WORKSHEET, NO DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER. THE DOCUMENTS LISTED BELOW ARE TO BE GIVEN TO THE OTHER PARTY. 1. We have jurisdiction. See art. V, § 2(a), Fla. Const. -2- ONLY THE ORIGINAL OF THE COMPLETED FORM IS FILED WITH THE COURT. EXCEPT FOR THE FINANCIAL AFFIDAVIT AND CHILD SUPPORT GUIDELINES WORKSHEET, NO DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER. THE DOCUMENTS LISTED ON THE FORM ARE TO BE GIVEN TO THE OTHER PARTY. Including these caveats is consistent with the inclusion of similar caveats in other family law forms and instructions. See, e.g., Fla. Fam. L. R. P. Form 12.930(b) (Standard Family Law Interrogatories for Original or Enforcement Proceedings); Fla. Fam. L. R. P. Form 12.930(c) (Standard Family Law Interrogatories for Modification Proceedings); Fla. Fam. L. R. P. Form 12.930(d) (Notice of Service of Answers to Standard Family Law Interrogatories). Accordingly, we amend Florida Supreme Court Approved Family Law Form 12.932 and its instructions, as set forth in the appendix to this opinion, fully engrossed for immediate use. Also included in the appendix, fully engrossed for immediate use, is a corrected version of the Child Support Guidelines Chart contained in the Instructions for Florida Family Law Rules of Procedure Form 12.902(e) (Child Support Guidelines Worksheet). The forms also can be accessed and downloaded from this Court’s website at www.flcourts.org/gen_public/family/forms_rules/index.shtml. By amending the forms, we express no opinion as to their correctness or applicability. The amendments shall be effective immediately upon the release of this opinion. -3- It is so ordered. CANADY, C.J., and PARIENTE, LEWIS, QUINCE, POLSTON, LABARGA, and PERRY, JJ., concur. THE FILING OF A MOTION FOR REHEARING SHALL NOT ALTER THE EFFECTIVE DATE OF THESE AMENDMENTS. Original Proceedings – The Civil Procedure Rules Committee, The Rules of Judicial Administration Committee, Criminal Procedure Rules Committee, The Probate Rules Committee, The Small Claims Rules Committee, The Appellate Court Rules Committee, and The Family Law Rules Committee Judith L. Kreeger, Chair, the Florida Courts Technology Commission, Senior Judge, Eleventh Judicial Circuit, Miami, Florida, Paul Regensdorf, Chair, Subcommittee on Access to Court Records, and Judge Melanie G. May, Fourth District Court of Appeal, West Palm Beach, Florida; Ashley McCorvey Myers, Chair, McCorvey and Myers, Jacksonville, Florida and Steven Patrick Combs, Past Chair, Family Law Rules Committee, Jacksonville, Florida, for Petitioners Frank T. Pilotte, Past Chair, Florida Probate Rules Committee, and John F. Harkness, Jr., Executive Director, The Florida Bar, Tallahassee, Florida; Russell Robert Winer, St. Petersburg, Florida; Robyn L. Vines, Past Chair, Family Law Rules Committee, Fort Lauderdale, Florida; Carol Jean LoCicero and Deanna K. Shullman of Thomas, LoCicero and Bralow, PL, Tampa, Florida; John S. Mills, Past Chair, Appellate Court Rules Committee, Jacksonville, Florida; Judge Robert W. Lee, Past Chair, Small Claims Rules Committee, Seventeenth Judicial Circuit, Fort Lauderdale, Florida; Mark Romance, Past Chair, Civil Procedure Rules Committee, Miami, Florida; Jack A. Moring, Past Chair, Family Law Rules Committee, Crystal River, Florida; John G. Crabtree, Past Chair, Appellate Court Rules Committee, Key Biscayne, Florida; Fleur J. Lobree, Past Chair, Criminal Procedure Rules Committee; Dale R. Sanders of Lyons and Sanders, Fort Lauderdale, Florida; and Judge Renee Goldenberg, Seventeenth Judicial Circuit, Fort Lauderdale, Florida, Responding with comments -4- Robert T. Strain, Past Chair, Criminal Procedure Rules Committee, Tampa, Florida; Keith H. Park, on behalf of the Rules of Judicial Administration Committee, West Palm Beach, Florida, Donald E. Christopher, Chair, Civil Procedure Rules Committee, Orlando, Florida, and Jeffrey S. Goethe, Chair, Florida Probate Rules Committee, Bradenton, Florida, Also attended oral arguments -5- APPENDIX INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.902(e), CHILD SUPPORT GUIDELINES WORKSHEET (01/12) When should this form be used? You should complete this worksheet if child support is being requested in your case. If you know the income of the other party, this worksheet should accompany your financial affidavit. If you do not know the other party’s income, this form must be completed after the other party files his or her financial affidavit, and serves a copy on you. This form should be typed or printed in black ink. You should file the original with the clerk of the circuit court in the county where your case is filed and keep a copy for your records. What should I do next? A copy of this form must be mailed or hand delivered to the other party in your case, if it is not served on him or her with your initial papers. Where can I look for more information? Before proceeding, you should read “General Information for Self-Represented Litigants” found at the beginning of these forms. The words that are in “bold underline” in these instructions are defined there. For further information, see section 61.30, Florida Statutes. Special notes... If you want to keep your address confidential because you are the victim of sexual battery, aggravated child abuse, aggravated stalking, harassment, aggravated battery, or domestic violence, , do not enter the address, telephone, and fax information at the bottom of this form. Instead, file a Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h). Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) -6- 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 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 ÷ 2 = Monthly amount If you or the other parent request that the court award an amount that is different than the guideline amount, you must also complete and attach a Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943. Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete. Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) -7- CHILD SUPPORT GUIDELINES CHART Combined Monthly Available Income One Child Two Children Three Children Four Children Five Children Six Children 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 2550.00 202 213 224 235 246 258 269 280 290 300 310 320 330 340 350 360 370 380 390 400 410 421 431 442 452 463 473 484 494 505 515 526 536 547 557 257 302 347 365 382 400 417 435 451 467 482 498 513 529 544 560 575 591 606 622 638 654 670 686 702 718 734 751 767 783 799 815 831 847 864 259 305 351 397 443 489 522 544 565 584 603 623 642 662 681 701 720 740 759 779 798 818 839 859 879 899 919 940 960 980 1000 1020 1041 1061 1081 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 265 312 359 406 453 500 547 594 641 688 735 765 789 813 836 860 884 907 931 955 979 1004 1029 1054 1079 1104 1129 1154 1179 1204 1229 1254 1279 1304 1329 268 315 363 410 458 505 553 600 648 695 743 790 838 869 895 920 945 971 996 1022 1048 1074 1101 1128 1154 1181 1207 1234 1261 1287 1314 1340 1367 1394 1420 Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) -8- Combined Monthly Available Income One Child Two Children Three Children Four Children Five Children Six Children 2600.00 2650.00 2700.00 2750.00 2800.00 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 4350.00 568 578 588 597 607 616 626 635 644 654 663 673 682 691 701 710 720 729 738 748 757 767 776 784 793 802 811 819 828 837 846 854 863 872 881 889 880 896 912 927 941 956 971 986 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 1101 1121 1141 1160 1178 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 1242 1265 1287 1308 1328 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 1354 1379 1403 1426 1448 1471 1494 1517 1540 1563 1586 1608 1631 1654 1677 1700 1723 1745 1768 1791 1814 1837 1857 1878 1899 1920 1940 1961 1982 2002 2023 2044 2064 2085 2106 2127 1447 1473 1500 1524 1549 1573 1598 1622 1647 1671 1695 1720 1744 1769 1793 1818 1842 1867 1891 1915 1940 1964 1987 2009 2031 2053 2075 2097 2119 2141 2163 2185 2207 2229 2251 2273 Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) -9- Combined Monthly Available Income One Child Two Children Three Children Four Children Five Children Six Children 4400.00 4450.00 4500.00 4550.00 4600.00 4650.00 4700.00 4750.00 4800.00 4850.00 4900.00 4950.00 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 6150.00 898 907 916 924 933 942 951 959 968 977 986 993 1000 1006 1013 1019 1025 1032 1038 1045 1051 1057 1064 1070 1077 1083 1089 1096 1102 1107 1111 1116 1121 1126 1131 1136 1396 1409 1423 1436 1450 1463 1477 1490 1503 1517 1530 1542 1551 1561 1571 1580 1590 1599 1609 1619 1628 1638 1647 1657 1667 1676 1686 1695 1705 1713 1721 1729 1737 1746 1754 1762 1737 1754 1771 1788 1804 1821 1838 1855 1871 1888 1905 1927 1939 1952 1964 1976 1988 2000 2012 2024 2037 2049 2061 2073 2085 2097 2109 2122 2134 2144 2155 2165 2175 2185 2196 2206 1968 1987 2006 2024 2043 2062 2081 2100 2119 2138 2157 2174 2188 2202 2215 2229 2243 2256 2270 2283 2297 2311 2324 2338 2352 2365 2379 2393 2406 2418 2429 2440 2451 2462 2473 2484 2147 2168 2189 2209 2230 2251 2271 2292 2313 2334 2354 2372 2387 2402 2417 2432 2447 2462 2477 2492 2507 2522 2537 2552 2567 2582 2597 2612 2627 2639 2651 2663 2676 2688 2700 2712 2295 2317 2339 2361 2384 2406 2428 2450 2472 2494 2516 2535 2551 2567 2583 2599 2615 2631 2647 2663 2679 2695 2711 2727 2743 2759 2775 2791 2807 2820 2833 2847 2860 2874 2887 2900 Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 10 - Combined Monthly Available Income One Child Two Children Three Children Four Children Five Children Six Children 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 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 1141 1145 1150 1155 1160 1165 1170 1175 1179 1184 1189 1193 1196 1200 1204 1208 1212 1216 1220 1224 1228 1232 1235 1239 1243 1247 1251 1255 1259 1263 1267 1271 1274 1278 1282 1286 1770 1778 1786 1795 1803 1811 1819 1827 1835 1843 1850 1856 1862 1868 1873 1879 1885 1891 1897 1903 1909 1915 1921 1927 1933 1939 1945 1951 1957 1963 1969 1975 1981 1987 1992 1998 2216 2227 2237 2247 2258 2268 2278 2288 2299 2309 2317 2325 2332 2340 2347 2355 2362 2370 2378 2385 2393 2400 2408 2415 2423 2430 2438 2446 2453 2461 2468 2476 2483 2491 2498 2506 2495 2506 2517 2529 2540 2551 2562 2573 2584 2595 2604 2613 2621 2630 2639 2647 2656 2664 2673 2681 2690 2698 2707 2716 2724 2733 2741 2750 2758 2767 2775 2784 2792 2801 2810 2818 2724 2737 2749 2761 2773 2785 2798 2810 2822 2834 2845 2854 2863 2872 2882 2891 2900 2909 2919 2928 2937 2946 2956 2965 2974 2983 2993 3002 3011 3020 3030 3039 3048 3057 3067 3076 2914 2927 2941 2954 2967 2981 2994 3008 3021 3034 3045 3055 3064 3074 3084 3094 3103 3113 3123 3133 3142 3152 3162 3172 3181 3191 3201 3211 3220 3230 3240 3250 3259 3269 3279 3289 Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 11 - Combined Monthly Available Income One Child Two Children Three Children Four Children Five Children Six Children 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 9450.00 9500.00 9550.00 9600.00 9650.00 9700.00 9750.00 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 1403 1407 1411 1415 1419 1422 1425 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 2177 2183 2189 2195 2201 2206 2210 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 2732 2740 2748 2755 2763 2767 2772 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 3075 3083 3092 3100 3109 3115 3121 3085 3094 3104 3113 3122 3131 3141 3150 3159 3168 3178 3187 3196 3205 3215 3224 3233 3242 3252 3261 3270 3279 3289 3298 3307 3316 3326 3335 3344 3353 3363 3372 3381 3390 3396 3402 3298 3308 3318 3328 3337 3347 3357 3367 3376 3386 3396 3406 3415 3425 3435 3445 3454 3464 3474 3484 3493 3503 3513 3523 3532 3542 3552 3562 3571 3581 3591 3601 3610 3620 3628 3634 Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 12 - Combined Monthly Available Income One Child Two Children Three Children Four Children Five Children Six Children 9800.00 9850.00 9900.00 9950.00 10000.00 1427 1430 1432 1435 1437 2213 2217 2221 2225 2228 2776 2781 2786 2791 2795 3126 3132 3137 3143 3148 3408 3414 3420 3426 3432 3641 3647 3653 3659 3666 Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 13 - IN THE CIRCUIT COURT OF THE IN AND FOR JUDICIAL CIRCUIT, COUNTY, FLORIDA Case No.: Division: , Petitioner, and , Respondent. NOTICE OF FILING CHILD SUPPORT GUIDELINES WORKSHEET PLEASE TAKE NOTICE, that {name} , is filing his/her Child Support Guidelines Worksheet attached and labeled Exhibit 1. CERTIFICATE OF SERVICE I certify that a copy of this Notice of Filing with the Child Support Guidelines Worksheet was [check one only] ( ) mailed ( ) faxed and mailed ( ) hand delivered to the person(s) listed below on {date} . Other party or his/her attorney: Name: Address: City, State, Zip: Fax Number: Date: Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: Fax Number: Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 14 - CHILD SUPPORT GUIDELINES WORKSHEET A. FATHER 1. Present Net Monthly Income Enter the amount from line number 27, Section I of Florida Family Law Rules of Procedure Form 12.902(b) or (c), Financial Affidavit. 2. Basic Monthly Obligation There is (are) {number} ____ minor child(ren) common to the parties. Using the total amount from line 1, enter the appropriate amount from the child support guidelines chart. 3. Percent of Financial Responsibility Divide the amount on line 1A by the total amount on line 1 to get Father’s percentage financial responsibility. Enter answer on line 3A. Divide the amount on line 1B by the total amount on line 1 to get Mother’s percentage financial responsibility. Enter answer on line 3B. 4. Share of Basic Monthly Obligation Multiply the number on line 2 by the percentage on line 3A to get Father’s share of basic obligation. Enter answer on line 4A. Multiply the number on line 2 by the percentage on line 3B to get Mother’s share of basic obligation. Enter answer on line 4B. % B. MOTHER TOTAL % Additional Support — Health Insurance, Child Care & Other 5. a. 100% of Monthly Child Care Costs [Child care costs should not exceed the level required to provide quality care from a licensed source. See section 61.30(7), Fla. Stat. for more information.] Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 15 - CHILD SUPPORT GUIDELINES WORKSHEET A. FATHER B. MOTHER TOTAL b. Total Monthly Child(ren)’s Health Insurance Cost [This is only amounts actually paid for health insurance on the child(ren).] c. Total Monthly Child(ren)’s Noncovered Medical, Dental and Prescription Medication Costs d. Total Monthly Child Care & Health Costs [Add lines 5a+5b+5c] 6. Additional Support Payments Multiply the number on line 5d by the percentage on line 3A to determine the Father’s share. Enter answer on line 6A. Multiply the number on line 5d by the percentage on line 3B to determine the Mother’s share. Enter answer on line 6B. Statutory Adjustments/Credits 7. a. Monthly child care payments actually made b. Monthly health insurance payments actually made c. Other payments/credits actually made for any noncovered medical, dental and prescription medication expenses of the child(ren) not ordered to be separately paid on a percentage basis. [See § 61.30 (8), Florida Statutes] 8. Total Support Payments actually made [Add 7a through 7c] 9. MINIMUM CHILD SUPPORT OBLIGATION FOR EACH PARENT [Line 4 plus line 6; minus line 8] Substantial Time-Sharing (GROSS UP METHOD) If each parent exercises time-sharing at least 20 percent of the overnights in the year (73 overnights in the year), complete Nos. 10 through 21 Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 16 - CHILD SUPPORT GUIDELINES WORKSHEET A. FATHER 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.] B. MOTHER % TOTAL % Additional Support — Health Insurance, Child Care & Other 14. a. Total Monthly Child Care Costs [Child care costs should not exceed the level required to provide quality care from a licensed source. See section 61.30(7), Fla. Stat. for more information.] Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 17 - CHILD SUPPORT GUIDELINES WORKSHEET A. FATHER B. MOTHER TOTAL b. Total Monthly Child(ren)’s Health Insurance Cost. [This is only amounts actually paid for health insurance on the child(ren).] c. Total Monthly Child(ren)’s Noncovered Medical, Dental and Prescription Costs. d. Total Monthly Child Care & Health Costs [Add lines 14a+14b+14c] 15. Additional Support Payments Multiply the number on line 14d by the percentage on line 3A to determine the Father’s share. Enter answer on line 15A. Multiply the number on line 14d by the percentage on line 3B to determine the Mother’s share. Enter answer on line 15B. Statutory Adjustments/Credits 16. a. Monthly child care payments actually made b. Monthly health insurance payments actually made c. Other payments/credits actually made for any noncovered medical, dental and prescription medication expenses of the child(ren) not ordered to be separately paid on a percentage basis. [See § 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] Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 18 - CHILD SUPPORT GUIDELINES WORKSHEET A. FATHER 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] $ B. MOTHER TOTAL $ ADJUSTMENTS TO GUIDELINES AMOUNT. If you or the other parent is requesting the Court to award a child support amount that is more or less than the child support guidelines, you must complete and file Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943. [check one only] a. __ Deviation from the guidelines amount is requested. The Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is attached. b. __ Deviation from the guidelines amount is NOT requested. The Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is not attached. IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] I, {full legal name and trade name of nonlawyer} , a nonlawyer, located at {street} , {city} , {state} , {phone} , helped {name} , who is the [check one only] ____ petitioner or ____ respondent, fill out this form. Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/12) - 19 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.932, CERTIFICATE OF COMPLIANCE WITH MANDATORY DISCLOSURE (01/12) When should this form be used? Mandatory disclosure requires each party in a dissolution of marriage case to provide the other party with certain financial information and documents. These documents must be provided by mail or hand delivery to the other party within 45 days of service of the petition for dissolution of marriage or supplemental petition for modification on the respondent. The mandatory disclosure rule applies to all original and supplemental dissolution of marriage cases, except simplified dissolution of marriage cases and cases where the respondent is served by constructive service and does not answer. You should use this form to notify the court and the other party that you have complied with the mandatory disclosure rule. Each party must provide the other party with the documents listed in section 2 of this form if the relief being sought is permanent regardless of whether it is an initial or supplemental proceeding. ONLY THE ORIGINAL OF THE COMPLETED FORM IS FILED WITH THE COURT. EXCEPT FOR THE FINANCIAL AFFIDAVIT AND CHILD SUPPORT GUIDELINES WORKSHEET, NO DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER. THE DOCUMENTS LISTED ON THE FORM ARE TO BE GIVEN TO THE OTHER PARTY. If your individual gross annual income is under $50,000, you should complete the Family Law Financial Affidavit (Short Form), Florida Family Law Rules of Procedure Form 12.902(b). If your individual gross annual income is $50,000 or more, you should complete the Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(c). In addition, there are separate mandatory disclosure requirements that apply to temporary financial hearings, which are listed in section 1 of this form. The party seeking temporary financial relief must serve these documents on the other party with the notice of temporary financial hearing. The responding party must either deliver the required documents to the party seeking temporary relief on or before 5:00 p.m., 2 business days before the hearing on temporary relief, or mail (postmark) them to the other party seeking temporary relief 7 days before the hearing on temporary financial relief. Any documents that have already been served under the requirements for temporary or initial proceedings, do not need to be reserved again in the same proceeding. If a supplemental petition is filed, seeking modification, then the mandatory disclosure requirements begin again. This form should be typed or printed in black ink. After completing this form, you should file the original with the clerk of the circuit court in the county where your case is filed and keep a copy for your records. A copy of this form must be mailed or hand delivered to any other party in your case. What should I do next? Instructions for Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (01/12) - 20 - After you have provided the other party all of the financial information and documents and have filed this form certifying that you have complied with this rule, you are under a continuing duty to promptly give the other party any information or documents that change your financial status or that make the information already provided inaccurate. You should not file with the clerk any of the documents listed in the certificate of compliance other than the financial affidavit and child support guidelines worksheet. Refer to the instructions regarding the petition in your case to determine how you should proceed after filing this form. Where can I look for more information? Before proceeding, you should read “General Information for Self-Represented Litigants” found at the beginning of these forms. For further information, see rule 12.285, Florida Family Law Rules of Procedure. Special notes… You may provide copies of required documents; however, the originals must be produced for inspection if the other party requests to see them. Although the financial affidavits are based on individual gross income, either party may ask the other party to complete the Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(c), by serving the appropriate interrogatory form. (See Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(b) (original proceedings) or (c) (modification proceedings)). Any portion of the mandatory disclosure rule may be modified by order of the judge or agreement of the parties. Therefore, you and your spouse may agree that you will not require each other to produce the documents required under the mandatory disclosure rule. This exception does not apply to the Financial Affidavit, Family Law Rules of Procedure Form 12.902(b) or (c), which is required in all cases and cannot be waived. Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete. Instructions for Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (01/12) - 21 - IN THE CIRCUIT COURT OF THE IN AND FOR JUDICIAL CIRCUIT, COUNTY, FLORIDA Case No.: Division: , Petitioner, and , Respondent. CERTIFICATE OF COMPLIANCE WITH MANDATORY DISCLOSURE ONLY THE ORIGINAL OF THIS COMPLETED FORM IS FILED WITH THE COURT. EXCEPT FOR THE FINANCIAL AFFIDAVIT AND CHILD SUPPORT GUIDELINES WORKSHEET, NO DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER. THE DOCUMENTS LISTED BELOW ARE TO BE GIVEN TO THE OTHER PARTY. I, {full legal name} , certify that I have complied with the mandatory disclosure required by Florida Family Law Rule 12.285 as follows: 1. FOR TEMPORARY FINANCIAL RELIEF, ONLY: The date the following documents were served: . [Check all that apply] a. ___ Financial Affidavit ( ) Florida Family Law Rules of Procedure Form 12.902(b) (short form) ( ) Florida Family Law Rules of Procedure Form 12.902(c) (long form) b. ___( ) All personal (1040) federal tax, gift tax, and intangible personal property tax returns for the preceding year; or ( ) Transcript of tax return as provided by IRS form 4506-T; or ( ) IRS forms W-2, 1099, and K-1 for the past year because the income tax return for the past year has not been prepared. c. ___ Pay stubs or other evidence of earned income for the 3 months before the service of the financial affidavit. 2. FOR INITIAL, SUPPLEMENTAL, AND PERMANENT FINANCIAL RELIEF: The date the following documents were served: [Check all that apply] . Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (01/12) - 22 - a. ___ Financial Affidavit ( ) Florida Family Law Rules of Procedure Form 12.902(b) (short form) ( ) Florida Family Law Rules of Procedure Form 12.902(c) (long form) b. ___( ) All personal (1040) federal and state income tax returns, gift tax returns, and intangible personal property tax returns for the preceding 3 years; ( ) IRS forms W-2, 1099, and K-1 for the past year because the income tax return for the past year has not been prepared. c. ___ Pay stubs or other evidence of earned income for the 3 months before the service of the financial affidavit. d. ___ A statement identifying the source and amount of all income for the 3 months before the service of the financial affidavit, if not reflected on the pay stubs produced. e. ___ All loan applications and financial statements prepared for any purpose or used for any purpose within the 12 months preceding the service of the financial affidavit. f. ___ All deeds to real estate in which I presently own or owned an interest within the past 3 years. All promissory notes in which I presently own or owned an interest within the last 12 months. All present leases in which I own an interest. g. ___ All periodic statements for the last 3 months for all checking accounts and for the last year for all savings accounts, money market funds, certificates of deposit, etc. h. ___ All brokerage account statements for the last 12 months. i. ___ Most recent statement for any pension, profit sharing, deferred compensation, or retirement plan (for example, IRA, 401(k), 403(b), SEP, KEOGH, etc.) and summary plan description for any such plan in which I am a participant or alternate payee. j. ___ The declaration page, the last periodic statement, and the certificate for any group insurance for all life insurance policies insuring my life or the life of me or my spouse. k. ___ All health and dental insurance cards covering either me or my spouse and/or our dependent child(ren). l. ___ Corporate, partnership, and trust tax returns for the last 3 tax years, in which I have an ownership or interest greater than or equal to 30%. m. ___ All credit card and charge account statements and other records showing my (our) indebtedness as of the date of the filing of this action and for the prior 3 months. All promissory notes on which I presently owe or owned within the past year. All lease agreements I presently owe. n. ___ All premarital and marital agreements between the parties to this case. o. ___ If a modification proceeding, all written agreements entered into between the parties at any time since the order to be modified was entered. p. ___ All documents and tangible evidence relating to claims for an unequal distribution of marital property, enhancement or appreciation in nonmarital property, or nonmarital status of an asset or debt. q. ___ Any court order directing that I pay or receive spousal support (alimony) or child support. I certify that a copy of this document was [Check one only] ( ) mailed ( ) faxed and mailed ( ) hand delivered to the person(s) listed below on {date} Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (01/12) - 23 - . I understand that I am swearing or affirming under oath to the accuracy of my compliance with the mandatory disclosure requirements of Fla. Fam. L. R. P. 12.285 and that, unless otherwise indicated with specificity, this disclosure is complete. I further understand that the punishment for knowingly making a false statement or incomplete disclosure includes fines and/or imprisonment. Other party or his/her attorney: Name: Address: City, State, Zip: Fax Number: Dated: Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: Fax Number: STATE OF FLORIDA COUNTY OF Sworn to or affirmed and signed before me on by . NOTARY PUBLIC or DEPUTY CLERK [Print, type, or stamp commissioned name of notary or clerk.] Personally known Produced identification Type of identification produced IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] I, {full legal name and trade name of nonlawyer} a nonlawyer, located at {street}____________________________________, {city} {state}____________, {phone}____________, helped {name} who is the [Check one only] _ petitioner or _ respondent, fill out this form. Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (01/12) - 24 - , , ,

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