INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED
FAMILY LAW
FORM 12.901(b)(1),
PETITION FOR DISSOLUTION OF MARRIAGE WITH
DEPENDENT OR MINOR CHILD(REN)
(02/18)
When should this form be used?
This form should be used when you are fling for a dissolution of marriage, and
you and your spouse have a dependent or minor child(ren) together, or a spouse is
pregnant. You or your spouse must have lived in Florida for at least 6 months
before fling for a dissolution in Florida. You must fle this form if the following is
true:
You and your spouse have a dependent or minor child(ren) together or a
spouse is pregnant.
This form should be typed or printed in black ink. After completing this form, you
should sign the form before a notary public or deputy clerk . You should fle the
original with the clerk of the circuit court in the county where you live and keep
a copy for your records. Because you are fling the petition in this proceeding, you
may also be referred to as the petitioner and your spouse as the respondent.
IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of Judicial Administration now require that all petitions, pleadings,
and documents be fled electronically except in certain circumstances. Self-
represented litigants may fle petitions or other pleadings or documents
electronically; however, they are not required to do so. If you choose to fle
your pleadings or other documents electronically, you must do so in accordance
with Florida Rule of Judicial Administration 2.525, and you must follow the
procedures of the judicial circuit in which you fle. The rules and procedures
should be carefully read and followed.
What should I do next?
For your case to proceed, you must properly notify your spouse of the petition . If
you know where your spouse lives, you should use personal service . If you
absolutely do not know where your spouse lives, you may use constructive
service . You may also be able to use constructive service if your spouse resides in
another state or country; however, if constructive service is used, other than
granting a divorce, the court may only grant limited relief, which cannot include
either spousal support (alimony) or child support. For more information on
constructive service, see Notice of Action for Family Cases with Minor
Child(ren) , Florida Supreme Court Approved Family Law Form 12.913(a)(2), and
Affidavit of Diligent Search and Inquiry , Florida Family Law Rules of Procedure
Instructions for Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for
Dissolution of Marriage with Dependent or Minor Child(ren) (02/18)
Form 12.913(c). If your spouse is in the military service of the United States,
additional steps for service may be required. See, for example, Memorandum for
Certifcate of Military Service , Florida Supreme Court Approved Family Law Form
12.912(a) and Affidavit of Military Service , Florida Supreme Court Approved
Family Law Form 12.912(b). In sum, the law regarding constructive service and
service on an individual in the military service is very complex and you may wish to
consult an attorney regarding these issues.
If personal service is used, your spouse has 20 days to answer after being served
with your petition. Your case will then generally proceed in one of the following
three ways:
DEFAULT . If after 20 days, your spouse has not fled an answer , you may fle a
Motion for Default , Florida Supreme Court Approved Family Law Form 12.922(a),
with the clerk of court. Then, if you have fled all of the required papers, you may
contact the clerk, family law intake staf , or judicial assistant to set a fnal
hearing . You must notify your spouse of the hearing by using a Notice of
Hearing (General) , Florida Supreme Court Approved Family Law Form 12.923, or
other appropriate notice of hearing form.
UNCONTESTED . If your spouse fles an answer that agrees with everything in your
petition or an answer and waiver, and you have complied with mandatory
disclosure and fled all of the required papers, you may contact the clerk, family
law intake staf, or judicial assistant to set a fnal hearing. You must notify your
spouse of the hearing by using a Notice of Hearing (General) , Florida Supreme
Court Approved Family Law Form 12.923, or other appropriate notice of hearing
form.
CONTESTED . If your spouse fles an answer or an answer and counterpetition ,
which disagrees with or denies anything in your petition, and you are unable to
settle the disputed issues, you should fle a Notice for Trial , Florida Supreme Court
Approved Family Law Form 12.924, after you have complied with mandatory
disclosure and fled all of the required papers. Some circuits may require the
completion of mediation before a fnal hearing may be set. You should contact the
clerk, family law intake staf, or judicial assistant for instructions on how to set your
case for trial (fnal hearing). If your spouse fles an answer and counterpetition, you
should answer the counterpetition within 20 days using an Answer to
Counterpetition , Florida Supreme Court Approved Family Law Form 12.903(d).
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 defned there. For further
information, see chapter 61, Florida Statutes.
IMPORTANT INFORMATION REGARDING E-SERVICE
ELECTION
Instructions for Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for
Dissolution of Marriage with Dependent or Minor Child(ren) (02/18)
After the initial service of process of the petition or supplemental petition by the
Sherif or certifed process server, the Florida Rules of Judicial Administration now
require that all documents required or permitted to be served on the other party
must be served by electronic mail (e-mail) except in certain circumstances. You
must strictly comply with the format requirements set forth in the Rules of
Judicial Administration. If you elect to participate in electronic service, which
means serving or receiving pleadings by electronic mail (e-mail), or through the
Florida Courts E-Filing Portal, you must review Florida Rule of Judicial
Administration 2.516. You may fnd this rule at www.flcourts.org through the link to
the Rules of Judicial Administration provided under either Family Law Forms: Getting
Started, or Rules of Court in the A-Z Topical Index.
SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL;
HOWEVER, THEY ARE NOT REQUIRED TO DO SO. If a self-represented litigant
elects to serve and receive documents by e-mail, the procedures must always be
followed once the initial election is made.
To serve and receive documents by e-mail, you must designate your e-mail
addresses by using the Designation of Current Mailing and E-mail Address ,
Florida Supreme Court Approved Family Law Form 12.915, and you must provide
your e-mail address on each form on which your signature appears. Please
CAREFULLY read the rules and instructions for: Certifcate of Service (General),
Florida Supreme Court Approved Family Law Form 12.914; Designation of
Current Mailing and E-mail Address , Florida Supreme Court Approved Family
Law Form 12.915; and Florida Rule of Judicial Administration 2.516.
Special notes...
If you do not have the money to pay the fling fee, you may obtain an Application for
Determination of Civil Indigent Status from the clerk, fll it out, and the clerk will
determine whether you are eligible to have fling fees deferred.
If you want to keep your address confdential 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, fle a Request for Confdential
Filing of Address , Florida Supreme Court Approved Family Law Form 12.980(h).
With this form, you must also fle the following:
Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA)
Affidavit , Florida Supreme Court Approved Family Law Form 12.902(d).
Child Support Guidelines Worksheet , Florida Family Law Rules of
Procedure Form 12.902(e), if you are asking that child support be ordered in
the fnal judgment. (If you do not know your spousess income, you may fle
this worksheet after your spousess fnancial afdavit has been served on
you.)
Affidavit of Corroborating Witness , Florida Supreme Court Approved
Family Law Form 12.902(i) OR photocopy of current Florida driverss license,
Florida identifcation card, or voterss registration card (issue date of copied
Instructions for Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for
Dissolution of Marriage with Dependent or Minor Child(ren) (02/18)
document must be at least six months before date case is actually fled with
the clerk of the circuit court).
Marital Settlement Agreement for Dissolution of Marriage with
Dependent or Minor Child(ren) , Florida Supreme Court Approved Family
Law Form 12.902(f)(1), if you and your spouse have reached an agreement
on any or all of the issues.
Notice of Social Security Number , Florida Supreme Court Approved
Family Law Form 12.902(j).
Family Law Financial Affidavit , Florida Family Law Rules of Procedure
Form 12.902(b) or (c). (This must be fled with the petition if the petitioner
seeks to establish child support. Otherwise, it must be fled within 45 days
of service of the petition on the respondent.)
Certifcate of Compliance with Mandatory Disclosure , Florida Family
Law Rules of Procedure Form 12.932. (This must be fled within 45 days of
service of the petition on the respondent, if not fled at the time of the
petition, unless you and your spouse have agreed not to exchange these
documents.)
Parenting Plan , Florida Supreme Court Approved Family Law Form
12.995(a), (b), or (c). If the parents have reached an agreement, a signed
and notarized Parenting Plan should be attached. If the parents have not
reached an agreement, a proposed Parenting Plan may be fled.
Parenting Plan and Time-Sharing. If you and your spouse are unable to agree
on parenting arrangements and a time-sharing schedule, a judge will decide for you
as part of establishing a Parenting Plan. The judge will decide the parenting
arrangements and time-sharing based on the child(ren)ss best interests. Regardless
of whether there is an agreement, the court reserves jurisdiction to modify issues
relating to the minor child(ren).
The judge may request a parenting plan recommendation or appoint a
guardian ad litem in your case. This means that a neutral person will review your
situation and report to the judge concerning parenting issues. The purpose of such
intervention is to be sure that the best interests of the child(ren) is (are) being
served. For more information, you may consult section 61.13, Florida Statutes.
A parenting course must be completed prior to entry of the fnal judgment. You
should contact the clerk, family law intake staf, or judicial assistant about
requirements for parenting courses where you live.
Listed below are some terms with which you should become familiar before
completing your petition. If you do not fully understand any of the terms
below or their implications, you should speak with an attorney before
going any further.
Shared Parental Responsibility
Sole Parental Responsibility
Supervised Time-Sharing
No contact
Parenting Plan
Parenting Plan Recommendation
Instructions for Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for
Dissolution of Marriage with Dependent or Minor Child(ren) (02/18)
Time-Sharing Schedule
Child Support. Both parents are required to provide fnancial support for
their minor or dependent child(ren) ; however, the court may order one parent
to pay child support to the other parent. Florida has adopted guidelines for
determining the amount of child support to be paid. These guidelines are based on
the combined income of both parents and take into account the fnancial
contributions of both parents and the number of overnights the child(ren) spend
with each parent. You must fle a Family Law Financial Affidavit , Florida Family
Law Rules of Procedure Form 12.902(b) or (c), and your spouse will be required to
do the same. From your fnancial afdavits, you should be able to calculate the
amount of child support that should be paid using the Child Support Guidelines
Worksheet , Florida Family Law Rules of Procedure Form 12.902(e). Because the
child support guidelines take several factors into consideration, change over time,
and vary from state to state, your child support obligation may be more or less than
that of other people in seemingly similar situations.
Alimony. Alimony may be awarded to a spouse if the judge fnds that one spouse
has an actual need for it and also fnds that the other spouse has the ability to pay.
If you want alimony, you must request it in writing in the original petition.
If you do not request alimony in writing before the fnal hearing, it is
waived (you may not request it later). You may request permanent alimony ,
bridge-the-gap alimony, durational alimony, , and/or rehabilitative alimony .
If alimony is awarded, the judge may order periodic payments, payments in lump
sum, or both.
Marital/Nonmarital Assets and Liabilities. Florida law requires an equitable
distribution of marital assets and marital liabilities . “Equitable” does not
necessarily mean “equal.” Many factors, including child support, time-sharing, and
alimony awards, may lead the court to make an unequal (but still equitable)
distribution of assets and liabilities. Nonmarital assets and nonmarital
liabilities are those assets and liabilities which the parties agree or the court
determines belong to, or are the responsibility of, only one of the parties. If the
parties agree or the court fnds an asset or liability to be nonmarital, the judge will
not consider it when distributing marital assets and liabilities.
Temporary Relief. If you need temporary relief regarding temporary use of
assets, temporary responsibility for liabilities, parental responsibility and time-
sharing with child(ren), temporary child support, or temporary alimony, you may fle
a Motion for Temporary Support and Time-Sharing with Dependent or
Minor Child(ren) , Florida Supreme Court Approved Family Law Form 12.947(a).
For more information, see the instructions for that form.
Marital Settlement Agreement. If you and your spouse are able to reach an
agreement on any or all of the issues, you should fle a Marital Settlement
Agreement for Dissolution of Marriage with Dependent or Minor Child(ren) ,
Florida Supreme Court Approved Family Law Form 12.902(f)(1). Both of you must
sign this agreement before a notary public or deputy clerk . Any issues on which
you are unable to agree will be considered contested and settled by the judge at
the fnal hearing.
Instructions for Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for
Dissolution of Marriage with Dependent or Minor Child(ren) (02/18)
Parenting Plan. In all cases involving minor or dependent child(ren), a Parenting
Plan shall be approved or established by the court. If you and your spouse have
reached an agreement, you should fle one of the following: Parenting Plan ,
Florida Supreme Court Approved Family Law Form 12.995(a), Safety-Focused
Parenting Plan , Florida Supreme Court Approved Family Law Form 12.995(b), or
Relocation/Long-Distance Parenting Plan , Florida Supreme Court Approved
Family Law Form 12.995(c), which addresses the time-sharing schedule for the
child(ren). If you have not reached an agreement, a proposed Parenting Plan may
be fled. If the parties are unable to agree, a Parenting Plan will be established
by the court.
Final Judgment Form. These family law forms contain a Final Judgment of
Dissolution of Marriage with Dependent or Minor Child(ren) , Florida Supreme
Court Approved Family Law Form 12.990(c)(1), which the judge may use if your
case is contested. If you and your spouse reach an agreement on all of the issues,
the judge may use a Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (Uncontested) , Florida Supreme Court
Approved Family Law Form 12.990(b)(1). You should check with the clerk, family
law intake staf, or judicial assistant to see if you need to bring a fnal judgment with
you to the hearing. If so, you should type or print the heading, including the circuit,
county, case number, division, and the partiess names, and leave the rest blank for
the judge to complete at your hearing or trial.
Nonlawyer. Remember, a person who is NOT an attorney is called a nonlawyer. If
a nonlawyer helps you fll 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 fll 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 Supreme Court Approved Family Law Form 12.901(b)(1), Petition for
Dissolution of Marriage with Dependent or Minor Child(ren) (02/18)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
In re: The Marriage of:
______________________________,
Petitioner,
and
_______________________________,
Respondent.
PETITION FOR DISSOLUTION OF MARRIAGE WITH
DEPENDENT OR MINOR CHILD(REN)
I, {full legal name} , the
Petitioner, being sworn, certify that the following statements are true:
1. JURISDICTION/RESIDENCE
_____Petitioner _____ Respondent _____ Both has (have) lived in Florida for at
least 6 months before the fling of this Petition for Dissolution of Marriage.
2. Petitioner _____ is or _____ is not a member of the military service.
Respondent _____ is or _____ is not a member of the military service.
3. MARRIAGE HISTORY
Date of marriage: {month, day, year} ___________________
Date of separation: {month, day, year} __________________ (___Please indicate
if approximate)
Place of marriage: {county, state, country}
__________________________________________
4. DEPENDENT OR MINOR CHILD(REN)
{Choose all that apply}
a. _____ Petitioner is pregnant. Baby is due on: {date} _____
b. _____ Respondent is pregnant. Baby is due on: {date}
________________________
c. _____ The minor (under 18) child(ren) common to both parties are:
Name Birth date
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of
Marriage with Dependent or Minor Child(ren) (02/18)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
d___The minor child(ren) born or conceived during the marriage who are not
common to both parties are:
Name Birth date
______________________________________________________________________________
______________________________________________________________________________
The birth parent (s) of the above minor child(ren) is (are): {name and
address}
______________________________________________________________________________
______________________________________________________________________________
e. ___ The child(ren) common to both parties who are 18 or older but who are
dependent upon the parties due to a mental or physical disability are:
Name Birth date
______________________________________________________________________________
______________________________________________________________________________
5. A completed Family Law Financial Afdavit, Florida Family Law Rules of
Procedure Form 12.902(b) or (c) {choose only one } _____ is fled with this
petition or _____ will be timely fled.
6. A completed Uniform Child Custody Jurisdiction and Enforcement Act
(UCCJEA) Afdavit, Florida Supreme Court Approved Family Law Form
12.902(d), is fled with this petition. (You must complete and attach this
form in a dissolution of marriage with minor child(ren)).
7. A completed Notice of Social Security Number, Florida Supreme Court
Approved Family Law Form 12.902(j), is fled with this petition.
8. This petition for dissolution of marriage should be granted because:
{Choose only one }
a. ____ The marriage is irretrievably broken.
OR
b. ____ One of the parties has been adjudged mentally incapacitated for a
period of 3 years prior to the fling of this petition. A copy of the Judgment
of Incapacity is attached.
SECTION I. MARITAL ASSETS AND LIABILITIES
1. ____ There are no marital assets or liabilities.
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of
Marriage with Dependent or Minor Child(ren) (02/18)
OR
2. ____ There are marital assets or liabilities. All marital and nonmarital assets
and liabilities are (or will be) listed in the fnancial afdavits, Florida Family
Law Rules of Procedure Form 12.902(b) or (c), fled in this case.
{Indicate all that apply}
a.____ All marital assets and liabilities have been divided by a written
agreement between the parties, which is attached, to be incorporated into
the fnal judgment of dissolution of marriage. (The parties may use Marital
Settlement Agreement for Dissolution of Marriage with Dependent or
Minor Child(ren), Florida Supreme Court Approved Family Law Form
12.902(f)(1).
b.____ The Court should determine how the assets and liabilities of this
marriage are to be distributed, under section 61.075, Florida Statutes.
c.____ Petitioner ____Respondent should be awarded an interest in the other
spousess property because:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SECTION II. SPOUSAL SUPPORT (ALIMONY)
1. ____ Petitioner ____Respondent forever gives up any right to
spousal support (alimony) from the other spouse.
OR
2. ____ Petitioner _____Respondent requests that the Court order the other
spouse to pay the following spousal support (alimony) and claims that he or
she has an actual need for the support that he or she is requesting and that
the other spouse has the ability to pay that support . Spousal support
(alimony) is requested in the amount of $________________ every: _____ week
_____ other week _____ month, or _________other ________________ beginning
{date} ________________ and continuing until {date or event}
___________________________.
Explain why the Court should order _____Petitioner _____Respondent to pay,
and any specifc request(s) for type of alimony (temporary, permanent,
bridge-the-gap, durational, rehabilitative, and/or lump sum):
.
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of
Marriage with Dependent or Minor Child(ren) (02/18)
3. _____Other provisions relating to alimony, including any tax treatment and
consequences:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
.
4. _____ Petitioner requests life insurance on the other spousess life, provided by
that spouse, to secure such support.
SECTION III. PARENTING PLAN ESTABLISHING PARENTAL RESPONSIBILITY
AND TIME-SHARING
1. The minor child(ren) currently reside(s) with _____ Petitioner _____
Respondent _____ Other: {explain}
___________________________________________________________
2. Parental Responsibility. It is in the child(ren)ss best interests that
parental responsibility be:
{ Choose only one }
a. ____ shared by both parents;
b. ____ awarded solely to _____ Petitioner _____ Respondent . Shared
parental responsibility would be detrimental to the child(ren)
because:________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.
3. Parenting Plan and Time-Sharing. It is in the best interests of the
child(ren) that the family be
ordered to comply with a Parenting Plan that _____ includes _____ does not
include parental
time- sharing with the child(ren). For purposes of a Parenting Plan, the
Petitioner will be referred to as {name or designation}_ ___________________,
and the Respondent will be referred to as { name or
designation}_________________________________. The Petitioner states that it is
in the best interests of the child(ren) that:
{Choose only one }
a.____ The attached proposed Parenting Plan should be adopted by the court.
The parties
{Choose only one} _____ have _____ have not agreed to the
Parenting Plan.
b. _____Each child will have time-sharing with both parents as follows:
__________________
_____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________________
(_____ Indicate if a separate sheet is attached.)
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of
Marriage with Dependent or Minor Child(ren) (02/18)
c. .____ The court should establish a Parenting Plan with the following
provisions for:
{Insert name or designation of the appropriate parent in the space
provided}
____ No time-sharing for Parent _____________
____ Limited time-sharing with Parent __________
____ Supervised Time-Sharing for Parent ___________Parent___________;
____ Supervised or third-party exchange of the child(ren).
____ Explain:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. Explain why this request is in the best interests of the child(ren):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.
SECTION IV. CHILD SUPPORT
{Choose all that apply}
1. _____Petitioner requests that the Court award child support as determined by
Floridass child support guidelines, section 61.30, Florida Statutes. A
completed Child Support Guidelines Worksheet, Florida Family Law Rules of
Procedure Form 12.902(e), _____ is, or _____ will be fled. Such support should
be ordered retroactive to:
a. ____ the date of separation {date} _________________________.
b. ____ the date of the fling of this petition.
c. ____ other {date} ____________ {explain}
___________________________________.
2. _____Petitioner requests that the Court award child support to be paid beyond
the age of 18 years because:
a.____ the following child(ren) {name(s)}
is (are) dependent because of a mental or physical incapacity which
began before the age of 18. {explain}
.
b.____ the following child(ren) {name(s)} ______________________________is (are)
dependent in fact, is (are) in high school, and are between the ages of 18
and 19; said child(ren) is (are) performing in good faith with reasonable
expectation of graduation before the age of 19.
3. _____Petitioner requests that the Court award a child support amount that is
more than or less than Floridass child support guidelines and understands
that a Motion to Deviate from Child Support Guidelines, Florida Supreme
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of
Marriage with Dependent or Minor Child(ren) (02/18)
Court Approved Family Law Form 12.943, must be fled before the Court will
consider this request.
4. _____Petitioner requests that medical/dental insurance for the minor
child(ren) be provided by:
{Choose only one }
a. ____ Petitioner
b. ____ Respondent.
5. _____Petitioner requests that uninsured medical/dental expenses for the
child(ren) be paid:
{Choose only one }
a. ____by Petitioner;
b. ____by Respondent;
c. ____equally by the spouses {each spouse pays one-half}.
d. ____according to the percentages in the Child Support Guidelines
Worksheet, Florida Family Law Rules of Procedure Form 12.902(e).
e. ____Other {explain} :
__________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6. _____Petitioner requests that life insurance to secure child support be
provided by the other spouse.
SECTION V. OTHER
1. Petitioner requests to be known by the following former legal name, which
was:
{former legal
name} : ___________________________________________________________.
2. Other relief {specify}
____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SECTION VI. REQUEST
{This section summarizes what you are asking the Court to include in the fnal
judgment of dissolution of marriage.}
Petitioner requests that the Court enter an order dissolving the marriage and :
{ Indicate all that apply}
1. ______distributing marital assets and liabilities as requested in Section I of this
petition;
2. ______awarding spousal support (alimony) as requested in Section II of this
petition;
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of
Marriage with Dependent or Minor Child(ren) (02/18)
3. ______ adopting or establishing a Parenting Plan containing provisions for
parental responsibility and time-sharing for the dependent or minor child(ren)
common to both parties, as requested in Section III of this petition;
4. ______establishing child support for the dependent or minor child(ren)
common to both parties, as requested in Section IV of this petition;
5. ______restoring Petitionerss former name as requested in Section V of this
petition;
6. ______awarding other relief as requested in Section V of this petition; and any
other terms the Court deems necessary.
I understand that I am swearing or affirming under oath to the
truthfulness of the claims made in this petition and that the punishment
for knowingly making a false statement includes fnes and/or
imprisonment.
Dated_________________________ _____________________________________________
Signature of Petitioner
Printed Name:
________________________________
Address:
______________________________________
City, State, Zip:
_________________________________
Telephone Number:
_____________________________
Fax Number:
__________________________________________
Designated E-mail Address(es):
____________________
_____________________________________________
STATE OF FLORIDA
COUNTY OF ____________________
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of
Marriage with Dependent or Minor Child(ren) (02/18)
Sworn to or afrmed 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 identifcation
Type of identifcation produced ________________________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN
THE BLANKS BELOW:
[fll in all blanks] This form was prepared for the Petitioner.
This form was completed with the assistance of:
{name of individual} _______________________________________________________________,
{name of business}
________________________________________________________________,
{address} ________________________________________________________________________,
{city} ________________ {state} _____, {zip code}________, {telephone number}
_______________.
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of
Marriage with Dependent or Minor Child(ren) (02/18)
