Fill and Sign the Florida Filing File Form

INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.980(h) REQUEST FOR CONFIDENTIAL FILING OF ADDRESS (06/18) When should this form be used? If you fear that disclosing your address would put you in danger because you are the victim of sexual battery, aggravated child abuse, stalking, aggravated stalking, harassment, aggravated battery, or domestic violence, you should complete this form and fle it with the clerk of the circuit court . This form should be typed or printed in black ink. After completing this form, you should fle the original with the clerk of the circuit court in the county where your petition was fled and keep a copy for your records. 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. Instructions for Florida Supreme Court Approved Family Law Form 12.980(h), Request for Confdential Filing of Address (06/18) IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: ___________________ , Petitioner, and __________________ , Respondent. REQUEST FOR CONFIDENTIAL FILING OF ADDRESS I, {full legal name} , request that the Court maintain and hold as confdential, the following address: Address City State Zip Telephone (area code and number) This request is being made for the purpose of keeping the location of my residence unknown for safety reasons pursuant to section 119.071(2)(j)1, section 741.30(3)(b) (a), section 784.046(4)(b)1, and section 784.0485(3)(b)1, Florida Statutes, or other statutory provision providing for the separate confdential fling for safety reasons. Dated: __________________________________________ Signature CLERK’S CERTIFICATE AS TO REQUEST FOR CONFIDENTIAL FILING OF ADDRESS I, , as Clerk of the Circuit Court, do hereby certify that I received and fled the above and will keep the above address confdential, subsequent to further order of the Court relative to such confdentiality. CLERK OF THE CIRCUIT COURT (SEAL) By: Florida Supreme Court Approved Family Law Form 12.980(h), Request for Confdential Filing of Address (06/18) {Deputy Clerk} Florida Supreme Court Approved Family Law Form 12.980(h), Request for Confdential Filing of Address (06/18)