Fill and Sign the Of Name Change Form

IN THE CIRCUIT COURT OF THE __ JUDICIAL CIRCUIT, IN AND FOR ___ COUNTY, FLORIDA Case No.: Division: __ , Petitioner, and ____ , Respondent. AFFIDAVIT OF DILIGENT SEARCH AND INQUIRY I, {full legal name} , being sworn, certify that the following information is true: 1. I have made diligent search and inquiry to discover the name and current residence of Respondent: {Specify details of search} Refer to checklist below and identify all actions taken (any additional information included such as the date the action was taken and the person with whom you spoke is helpful) (attach additional sheet if necessary): [Check all that apply] ____ United States Post Ofce inquiry through Freedom of Information Act for current address or any relocations. ____ Last known employmentof Respondent, including name and address of employer. You should also ask for any addresses to which W-2 Forms were mailed, and, if a pension or proft-sharing plan exists, then for any addresses to which any pension or plan payment is and/or has been mailed. ____ Unions from which Respondent may have worked or that governed his or her particular trade or craft. ____ Regulatory agencies, including professional or occupational licensing. ____ Names and addresses of relatives and contacts with those relatives, and inquiry as to Respondent’s last known address. You are to follow up any leads of any addresses where Respondent may have moved. Relatives include, but are not limited to: parents, brothers, sisters, aunts, uncles, cousins, nieces, nephews, grandparents, great-grandparents, former in-laws, stepparents, stepchildren. ____ Information about the Respondent’s possible death and, if dead, the date and location of the death. ____ Telephone listings in the last known locations of Respondent’s residence. ____ Internet at http://www.switchboard.com or other Internet databank locator service. Please indicate if a public library assisted you in your search. ____ Law enforcement arrest and/or criminal records in the last known residential area of Respondent. ____ Highway Patrol records in the state of Respondent’s last known address. Florida Family Law Rules of Procedure Form 12.913(b), Afdavit of Diligent Search and Inquiry (11/12) ____ Department of Motor Vehicle records in the state of Respondent’s last known address. ____ Department of Corrections records in the state of Respondent’s last known address. ____ Title IV-D (child support enforcement) agency records in the state of Respondent’s last known address. ____ Hospitals in the last known area of Respondent’s residence. ____ Utility companies, which include water, sewer, cable TV, and electric, in the last known area of Respondent’s residence. ____ Letters to the Armed Forces of the U.S. and their response as to whether or not there is any information about Respondent. (See Memorandum for Certifcate of Military Service, Florida Supreme Court Approved Family Law Form 12.912(a).) ____ Tax Assessor’s and Tax Collector’s Ofce in the area where Respondent last resided. ____ Other: {explain} ______________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 2. The age of Respondent is [Choose only one ] ( ) known {enter age} _____ or ( ) unknown. 3. Respondent’s current residence [Choose only one ]] a. ____Respondent’s current residence is unknown to me. b. ____Respondent’s current residence is in some state or country other than Florida. _______________________________________________________________________ __ c. ____The Respondent, having residence in Florida, has been absent from Florida for more than 60 days prior to the date of this afdavit, or conceals him/her self so that process cannot be served personally upon him or her, and I believe there is no person in the state upon whom service of process would bind this absent or concealed Respondent. 4. Respondent’s last known address as of {date} ____________________________________, was: Address___________________________City_____________________State_________Zip ______ Telephone No. __________________Fax No._________________________. Respondent’s last known employment, as of {date} _________________________________, was Name of Employer________________________________________________________________ Florida Family Law Rules of Procedure Form 12.913(b), Afdavit of Diligent Search and Inquiry (11/12) Address_____________________________City_____________________State _____Zip_______ Telephone No.__________________ Fax No._________________________. I understand that I am swearing or afrming under oath to the truthfulness of the claims made in this afdadit 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: ____________________________ E-mail Address(es):________________________ STATE OF FLORIDA COUNTY OF Sworn to or afrmed and signed before me on ___________________ by______________________ _______________________________________ NOTARY PUBLIC or DEPUTY CLERK _______________________________________ Florida Family Law Rules of Procedure Form 12.913(b), Afdavit of Diligent Search and Inquiry (11/12) [Print, type, or stamp commissioned name of notary or 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: {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 12.913(b), Afdavit of Diligent Search and Inquiry (11/12)