IN THE CIRCUIT COURT OF THE ________________________JUDICIAL CIRCUIT,
IN AND FOR COUNTY, _______________________FLORIDA
Case No.:
Division:
_________________________________,
Petitioner,
and
_________________________________,
Respondent.
SUPPLEMENTAL FINAL JUDGMENT MODIFYING
PARENTAL
RESPONSIBILITY, VISITATION, OR PARENTING
PLAN/TIME-SHARING SCHEDULE AND OTHER RELIEF
This cause came before this Court on a Supplemental Petition to Modify Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief.
The Court, having reviewed the fle, having heard the testimony, and being
otherwise fully advised, makes these fndings of fact and reaches these conclusions
of law:
SECTION I. FINDINGS
1. The Court has jurisdiction over the subject matter and the parties.
2. The last order establishing or modifying parental responsibility, visitation, a
Parenting Plan, or time-sharing was entered on {date} ________________________.
3. There has been a substantial change in circumstances of the parties since the
entry of the last order, specifcally:
________________________________________________________________________
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment
Modifying Parental Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and
Other Relief (03/15)
_
_________________________________________________________________________________.
4. It is in the best interests of the minor child(ren) that the current parental
responsibility, visitation, time-sharing schedule or Parenting Plan be changed
because:________________________________
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________.
SECTION II. PARENTING PLAN ESTABLISHING PARENTAL RESPONSIBILITY
AND TIME-SHARING WITH DEPENDENT OR MINOR CHILD(REN)
1. Jurisdiction. The Court has jurisdiction to determine parental responsibility, to
establish or approve a Parenting Plan, and time-sharing with regard to the
parties’ minor child(ren) listed in paragraph 2 below.
2. The parties’ dependent or minor child(ren) is (are):
Name Birth date
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________
_
3. Parenting Plan. The parties shall comply with the Parenting Plan which is
attached and incorporated herein as Exhibit ______.
SECTION III. CHILD SUPPORT
1. Modifcation of Child Support.
{Choose one only}
a. ______The modifcation of parental responsibility or time-sharing entered
above does not necessitate a modifcation of child support. The previous
order or fnal judgment establishing or modifying child support shall remain in
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment
Modifying Parental Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and
Other Relief (03/15)
effect.
b. _____ _The Court fnds that there is a need for modifcation of child support
and that the ______ Mother ______ Father (hereinafter Obligor) has the
present ability to pay child support. The amounts in the Child Support
Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e),
fled by the ______ Mother ______ Father are correct OR the Court makes the
following fndings:
The Mother’s net monthly income is $____________, (Child Support Guidelines
_____%).
The Father’s net monthly income is $_____________, (Child Support Guidelines
_____%).
Monthly child care costs are $_______________.
Monthly health/dental insurance costs are $___________.
2. Amount.
Child support established at the rate of $_____________ per month for the
_______children {total number of parties’ minor or dependent children} shall be
paid commencing ____________________ {month, day, year} and terminating
_________________________________ {month, day, year}. Child support shall be paid
in the amount of $___________per ____________ {week, month, other} which is
consistent with the Obligor’s current payroll cycle.
Upon the termination of the obligation of child support for one of the parties’
children, child support in the amount of $_____________for the remaining _______
children {total number of remaining children} shall be paid
commencing___________________________________ {month, day, year} and
terminating_________________________________ {month, day, year}. This child
support shall be paid in the amount of $____________ per ____________ {week,
month, other} consistent with the Obligor’s current payroll cycle.
{Insert schedule for the child support obligation, including the amount,
and commencement and termination dates, for the remaining minor or
dependent children, which shall be payable as the obligation for each
child ceases. Please indicate whether the schedule ______appears below
or
_____ is attached as part of this form.}
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment
Modifying Parental Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and
Other Relief (03/15)
The Obligor shall pay child support until all of the minor or dependent child(ren):
reach the age of 18; become emancipated, marry, join the armed services, die,
or become self-supporting; or until further order of the court or agreement of the
parties. The child support obligation shall continue beyond the age of 18 and
until high school graduation for any child who is dependent in fact, between the
ages of 18 and 19, and is still in high school, performing in good faith with a
reasonable expectation of graduation before the age of 19.
If the child support ordered deviates from the guidelines by more than 5%, the
factual fndings which support that deviation are:
______________________________________________________
_________________________________________________________________________________
_
_________________________________________________________________________________
_
3. Arrearage/Retroactive Child Support.
{Choose one only}
a. _____There is no child support arrearage at the time of this Supplemental Final
Judgment.
OR
b. _____ The _____ Mother _____ Father shall pay to the other party the child
support arrearage of:
$_____________ for retroactive child support, as of
{date} _________________________________.
$_____________ for previously ordered unpaid child support, as of
{date} _____________________.
The total of $________________ in child support arrearage shall be repaid in the
amount of $________________, per month payable ______ in accordance with
Obligor’s employer’s payroll cycle, and in any event at least once a month _____
other {explain} ___________________beginning {date}
_____________________________ until paid in full including statutory interest.
4. Insurance.
[Indicate all that apply]
a. ______ Health/Dental Insurance. _____ Mother _____ Father shall be required
to maintain
_____health and/or _____ dental insurance for the parties’ minor child(ren), so
long as reasonable in cost and accessible to the child(ren) . The party
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment
Modifying Parental Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and
Other Relief (03/15)
providing insurance shall be required to convey insurance cards
demonstrating said coverage to the other party;
OR
______ health and/or ______ dental insurance is not reasonable in cost or
accessible to the child(ren) at this time.
b. _____ Reasonable and necessary uninsured medical/dental/prescription
drug costs for the minor child(ren) shall be assessed as follows:
_____ Shared equally by both parents.
_____ Prorated according to the child support guideline percentages.
_____ Other {explain} :
___________________________________________________________
___________________________________________________________________________
As to these uninsured medical/dental/prescription drug expenses, the party
who incurs the expense shall submit a request for reimbursement to the
other party within 30 days, and the other party, within 30 days of receipt,
shall submit the applicable reimbursement for that expense, according to the
schedule of reimbursement set out in this paragraph.
5. ______ Life Insurance (to secure payment of support). To secure the child
support obligations in this judgment, ______ Mother ______ Father ______Each
parent shall maintain life insurance, in an amount of at least $ ________ , on
______ his life ______ her life ______ his/her life naming the _____ minor child(ren)
as the benefciary(ies) OR naming the _____ Mother _____ Father
_____ other {name} _____________________________________as Trustee for the minor
child(ren), so long as reasonably available. The obligation to maintain the life
insurance shall continue until the youngest child turns 18, becomes
emancipated, marries, joins the armed services, dies, or becomes self-supporting.
6. ______ IRS Income Tax Exemption(s). The assignment of any tax exemption(s)
for the child(ren) shall be as follows:
______________________________________________________________________
_________________________________________________________________________________.
Further, each party shall execute any and all IRS forms necessary to effectuate
the provisions of this paragraph.
7. Other provisions relating to child support :
______________________________________________
_________________________________________________________________________________
_
_________________________________________________________________________________.
SECTION IV. METHOD OF PAYMENT
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment
Modifying Parental Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and
Other Relief (03/15)
Obligor shall pay court-ordered child support and arrears, if any, as follows:
1. Place of Payment.
a. _____Obligor shall pay court-ordered support directly to either the State
Disbursement Unit or the central depository, as required by statute, along
with any fee required by statute.
b. _____Both parties have requested and the court fnds that it is in the best
interests of the child(ren) that support payments need not be directed
through either the State Disbursement Unit or the central depository at this
time; however, either party may subsequently apply, pursuant to section
61.13(1)(d)3, Florida Statutes, to require payments through either the State
Disbursement Unit or the central depository.
2. Income Deduction.
a. ______ Immediate. Obligor shall pay through income deduction, pursuant to a
separate Income Deduction Order which shall be effective immediately.
Obligor is individually responsible for paying this support obligation until all of
said support is deducted from Obligor ’ s income. Until support payments are
deducted from Obligor ’ s paycheck, Obligor is responsible for making timely
payments directly to the State Disbursement Unit or the Obligee, as
previously set forth in this order.
b. ______ Deferred. Income deduction is ordered this day, but it shall not be
effective until a delinquency of $____________, or, if not specifed, an amount
equal to one month’s obligation occurs. Income deduction is not being
implemented immediately based on the following fndings: Income deduction
is not in the best interests of the child(ren) because: {explain}
______________________________________________________________________________
______________________________________________________________________________
,
AND
There is proof of timely payment of a previously ordered obligation without
an income deduction order,
AND
_____ There is an agreement by the Obligor to advise the Title IV-D agency,
the clerk of court, and the Obligee of any change in Payor and/or health insurance
OR
_____ there is a signed written agreement providing an alternative
arrangement between the Obligor and the Obligee and, at the option of the IV-D
agency, by the IV-D agency in IV-D cases in which there is an assignment of
support rights to the state, reviewed and entered in the record by the court .
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment
Modifying Parental Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and
Other Relief (03/15)
3. Bonus/one-time payments. _____All _________% _____No income paid in the
form of a bonus or other similar one-time payment, up to the amount of any
arrearage or the remaining balance thereof owed pursuant to this order, shall be
forwarded to the Obligee pursuant to the payment method prescribed above.
4. Other provisions relating to method of payment.
________________________________________
_________________________________________________________________________________
_
_________________________________________________________________________________.
SECTION V. ATTORNEY’S FEES, COSTS, AND SUIT MONEY
1. _____ Mother’s _____ Father’s request(s) for attorney’s fees, costs, and suit
money is (are) denied because
__________________________________________________________________________
_________________________________________________________________________________.
2. _____The Court fnds there is a need for and an ability to pay attorney’s fees,
costs, and suit money. _____ Mother _____ Father is hereby ordered to pay to the
other party $____________ in attorney’s fees, and $____________ in costs. The Court
further fnds that the attorney’s fees awarded are based on the reasonable rate
of $____________ per hour and ____________ reasonable hours. Other provisions
relating to attorney’s fees, costs, and suit money are as follows:
_________________________________________________________________________________
_________________________________________________________________________________
_
_________________________________________________________________________________.
SECTION VI. OTHER
1. Other Provisions.
___________________________________________________________________
_________________________________________________________________________________
_
_________________________________________________________________________________
_
_________________________________________________________________________________.
2. The Court reserves jurisdiction to modify and enforce this Supplemental Final
Judgment.
3. Unless specifcally modifed by this Supplemental Final Judgment, the provisions
of all fnal judgments or orders in effect remain the same.
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment
Modifying Parental Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and
Other Relief (03/15)
DONE AND ORDERED at __________________________, Florida, on _____________________.
_____________________________________________
CIRCUIT JUDGE
I certify that a copy of the { name of document(s)}
__________________________________________ was: ( ) mailed ( ) faxed and mailed
( ) e-mailed ( ) hand-delivered to the parties and any entities listed below on
{ date }____________________________.
by____________________________________
{Clerk of court or designee}
_____Petitioner (or his or her attorney)
_____Respondent (or his or her attorney)
_____Central Depository
_____State Disbursement Unit
Other: ________________________
Florida Supreme Court Approved Family Law Form 12.993(a), Supplemental Final Judgment
Modifying Parental Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and
Other Relief (03/15)