Fill and Sign the Consent Attorney Form

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.900(c), CONSENT TO LIMITED APPEARANCE BY ATTORNEY (09/12) 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 served on the other party or his or her attorney . Service must be in accordance with Florida Rule of Judicial Administration 2.516. Where can I look for more information? See Florida Family Law Rule of Procedure 12.040. Instructions to Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by Attorney (09/12) IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Petitioner, and , Respondent. CONSENT TO LIMITED APPEARANCE BY ATTORNEY {Name} _______________________________________ , the [ check one only ] ( ) Petitioner ( ) Respondent, consents to the limited representation by counsel, {attorney’s name} ___________________________________________, for the following limited purpose(s) [ check all that apply]: 1. ____The hearing set for {date} ___________________, at {time}________ on the issue(s) of {specify} ___________________________________________________________________. 2. ___To represent [ check one only ] ( ) Petitioner ( ) Respondent on the following issues throughout the proceedings: a. ___Parental responsibility and time-sharing. b. ___ Equitable distribution of marital assets and liabilities. c. ___ Alimony. d. ___ Child support. e. ___ Other {specify} : _______________________________________________________ The clerk of the above-styled court is requested to enter this notice of record. I certify that a copy of this consent to limited appearance was: [check all used] ( ) e-mailed ( ) mailed ( ) faxed ( ) hand delivered to the person(s) listed below on {date} _________. Other party or his/her attorney: Name: ________________________________ Address: _____________________________ City, State, Zip: _________________________ Telephone Number: _____________________ Fax Number: _____________________________ E-mail Address(es): _________________________ Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by Attorney (09/12) _______________________________________ Signature of Petitioner/Respondent Printed Name: ___________________________ Address: _______________________________ City, State, Zip: __________________________ Telephone Number: ______________________ Fax Number: ____________________________ E-mail Address(es):________________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] This form was prepared for the: {choose only one } ( ) Petitioner ( ) Respondent This form was completed with the assistance of: {name of individual} ____________________________________________________________, {name of business} _____________________________________________________________, {address} _____________________________________________________________________, {city} _____________________, {state} ______, {telephone number}______________________. Florida Family Law Rules of Procedure Form 12.900(c), Consent to Limited Appearance by Attorney (09/12)