Fill and Sign the Florida Family Law Rules of Procedure Form 12928 Cover

Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases (01/10) IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: ________________Judge: __________________ Petitioner and Respondent I. Type of Action/Proceeding. Place a check beside the proceeding you are initiating. If you are simultaneously filing more than one type of proceeding against the same opposing party, such as a modification and an enforcement proceeding, complete a separate cover sheet for each action being filed. If you are reopening a case, choose one of the three options below it. (A) _X_ Initial Action/Petition (B)___ Reopening Case 1.___ Modification/Supplemental Petition 2.___ Motion for Civil Contempt/Enforcement3.___ Other II.Type of Case. If the case fits more than one type of case, select the most definitive. (A)___ Simplified Dissolution of Marriage (B)___ Dissolution of Marriage (C) ___ Domestic Violence(D)___ Dating Violence (E)___ Repeat Violence (F)___ Sexual Violence (G)___ Support $8;, (Department of Revenue, Child Support Enforcement)(H)___ Support %1;$8;, (not Department of Revenue, Child Support Enforcement)(I)___ UIFSA $8;, (Department of Revenue, Child Support Enforcement)(J)___ UIFSA %1;$8;, (not Department of Revenue, Child Support Enforcement)(K)___ Other Family Court(L) ___ Adoption Arising Out Of Chapter 63 (M) _X_ Name Change(N) ___ Paternity/Disestablishment of Paternity(O) ___ Juvenile Delinquency (P)___ Petition for Dependency (Q) ___ Shelter Petition(R)___ Termination of Parental Rights Arising Out Of Chapter 39(S)___ Adoption Arising Out Of Chapter 39 Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases (01/10)(T)___ CINS/FINSIII.Rule of Judicial Administration 2.545(d) requires that a Notice of Related Cases Form, Family Law Form 12.900(h), be filed with the initial pleading/petition by the filing attorney or self- represented litigant in order to notify the court of related cases. Is Form 12.900(h) being filed with this Cover Sheet for Family Court Cases and initial pleading/petition?_X_ No, to the best of my knowledge, no related cases exist.___ Yes, all related cases are listed on Family Law Form 12.900(h). ATTORNEY OR PARTY SIGNATURE I CERTIFY that the information I have provided in this cover sheet is accurate to the best of my knowledge and belief. Signature________________________________________ FL Bar No.: _____________________ Attorney or party (Bar number,if attorney) (Type or print name) Date 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, whose address is {street} , {city} , {state} , {phone} , helped {name} , who is the [choose one only] _X_ petitioner or ___ respondent, fill out this form.