Supreme Court of Florida, 2025

In Re: Amendments to the Florida Family Law Rules of Procedure - Forms

Supreme Court of Florida · Decided June 26, 2025

Opinion

Supreme Court of Florida ____________ No. SC2024-0003 ____________ IN RE: AMENDMENTS TO THE FLORIDA FAMILY LAW RULES OF PROCEDURE – FORMS.

June 26, 2025 PER CURIAM.

The Florida Bar’s Family Law Rules Committee has filed a report proposing amendments to Florida Family Law Rules of Procedure Forms 12.900(a) (Disclosure from Nonlawyer), 12.900(b) (Notice of Limited Appearance), 12.900(c) (Consent to Limited Appearance by Attorney), 12.900(d) (Termination of Limited Appearance), 12.900(e) (Acknowledgment of Assistance by Attorney), 12.900(g) (Agreement Limiting Representation), 12.901(a) (Petition for Simplified Dissolution of Marriage), 12.902(c) (Family Law Financial Affidavit (Long Form)), 12.902(e) (Child Support Guidelines Worksheet), 12.930(a) (Notice of Service of Standard Family Law Interrogatories), 12.930(b) (Standard Family Law Interrogatories for Original or Enforcement Proceedings), 12.930(c) (Standard Family Law Interrogatories for Modification Proceedings), and 12.932 (Certificate of Compliance with Mandatory Disclosure).1 The Board of Governors of The Florida Bar unanimously recommends adopting the proposed amendments.

The Committee published its proposal for comment and received one comment. After the proposed amendments were filed, we re-published the proposal for comment and one comment was received. The Committee responded and revised its proposal in response to the comment. Having reviewed the Committee’s proposal, the comment, and the response, we adopt the Committee’s revised proposal with minor modifications. We discuss the more significant amendments below.

First, although the Committee has not proposed it, we note the suggestion of The Florida Bar Family Law Section and combine forms 12.900(b) and 12.900(c) into a single form, titled “Notice of and Consent to Limited Appearance.” We then delete form 12.900(c). As the Committee proposed, we amend paragraph 2 in

1. We have jurisdiction. See art. V, § 2(a), Fla. Const.; see also Fla. R. Gen. Prac. & Jud. Admin. 2.140(b)(1).

-2- form 12.900(b), which designates the types of issues for which the attorney will be making a limited appearance, to use language that mirrors Florida Family Law Rule of Procedure 12.040(c)(1) (Attorneys; Scope of Representation) by referring to “proceeding(s) or matter(s).” Also, on the list of issues, we make “parental responsibility” and “time-sharing” separate types of issues and add “mediation” as a new type of issue.

Next, in form 12.900(e), we delete the reference to the specific attorney who assists the pro se litigant. Now, the form simply reads that the litigant “certifies that this document was prepared with the assistance of counsel.”

Further, while we revise form 12.901(a) to improve clarity and readability, we decline to implement some of the Committee’s proposed changes related to minor and dependent children, and instead keep the language in the instructions and form consistent with the language of Florida Family Law Rule of Procedure 12.105(a)(1) (Simplified Dissolution Procedure; Requirements for Use).

-3- In form 12.902(e), we add the case caption at the beginning of the form worksheet and a separate table before the Child Support Guidelines Worksheet titled “Gross Income Calculation.”

Additionally, in the instructions to forms 12.930(a) and 12.930(b), we decline to implement the Committee’s suggested changes advising that a party may take action to compel a response. We instead retain the prior language indicating that a failure to respond may result in sanctions.

Accordingly, the Florida Family Law Rules of Procedure Forms are amended as reflected in the appendix to this opinion, with the forms fully engrossed and ready for use. The forms may be accessed and downloaded from the Florida State Courts’ website at http://www.flcourts.org/resources-and-services/court- improvement/family-courts/family-law-forms.stml. The amendments shall take effect immediately upon the release of this opinion. We thank the Committee for its attention to this important task.

It is so ordered.

MUÑIZ, C.J., and CANADY, LABARGA, COURIEL, GROSSHANS, FRANCIS, and SASSO, JJ., concur.

-4- THE FILING OF A MOTION FOR REHEARING SHALL NOT ALTER THE EFFECTIVE DATE OF THESE AMENDMENTS.

Original Proceeding – Florida Family Law Rules of Procedure Jeffrey Paul Battista, Chair, Family Law Rules Committee, Vero Beach, Florida, Hon. Howard Ogle McGillin, Jr., Past Chair, Family Law Rules Committee, St. Augustine, Florida, Joshua E. Doyle, Executive Director, The Florida Bar, Tallahassee, Florida, and Kelly Noel Smith, Bar Liaison, The Florida Bar, Tallahassee, Florida, for Petitioner Christopher William Rumbold, Chair, Family Law Section of The Florida Bar, Fort Lauderdale, Florida, Sarah E. Kay, Past Chair, Family Law Section of The Florida Bar, Tampa, Florida, Lindsay Agranoff Gunia, Co-Chair, Rules and Forms Committee, Family Law Section of The Florida Bar, Miami, Florida, Jaime Rodriguez Girgenti, Co-Chair, Rules and Forms Committee, Family Law Section of The Florida Bar, Clearwater, Florida, Temi N. Zeitenberg, Past Co-Chair, Rules and Forms Committee, Family Law Section of The Florida Bar, Boca Raton, Florida, and Marck K. Joseph, Jr., Past Co-Chair, Rules and Forms Committee, Family Law Section of The Florida Bar, Miami, Florida, Responding with comments

-5- APPENDIX INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.900(a) DISCLOSURE FROM NONLAWYER (06/25) When should this form be used?

This form must be used when anyone who is not a lawyer in good standing with The Florida Bar helps you complete any Florida Family Law Form. Atorneys who are licensed to prac�ce in other states but not Florida, or who have been disbarred or suspended from the prac�ce of law in Florida, are nonlawyers for the purposes of the Florida Family Law Forms and instruc�ons.

The nonlawyer must complete this form and both of you are to sign it before the nonlawyer assists you in comple�ng any Family Law Form.

In addi�on, on any other form with which a nonlawyer helps you, the nonlawyer shall complete the nonlawyer sec�on located at the botom of the form unless otherwise speciﬁed in the instruc�ons to the form. This is to protect you and be sure that you are informed in advance of the nonlawyer’s limita�ons.

What should I do next?

A copy of this disclosure, signed by both the nonlawyer and the person on whose behalf the forms will be completed, must be given to the person to retain and the nonlawyer must keep a copy in the person’s ﬁle. The nonlawyer must also keep copies for at least 6 years of all forms given to the person being assisted.

Special Notes . . .

This disclosure form does NOT act as or cons�tute a waiver, disclaimer, or limita�on of liability.

Instructions for Florida Family Law Rules of Procedure Form 12.900(a), Disclosure from Nonlawyer (06/25) of 1 -6- IN THE CIRCUIT COURT OF THE _________ JUDICIAL CIRCUIT, IN AND FOR ___________________________________ COUNTY, FLORIDA Case No.: ________________________ Division: ________________________ _______________________________, Pe��oner, and _______________________________, Respondent.

DISCLOSURE FROM NONLAWYER {Name} __________________________________________ told me that he/she is a nonlawyer and may not give legal advice, cannot tell me what my rights or remedies are, cannot tell me how to tes�fy in court, and cannot represent me in court.

Rule 10-2.1(b) of the Rules Regula�ng The Florida Bar deﬁnes a paralegal as a person who works under the supervision of a member of The Florida Bar and who performs speciﬁcally delegated substan�ve legal work for which a member of The Florida Bar is responsible. Only persons who meet the deﬁni�on may call themselves paralegals. {Name} ______, informed me that he/she is not a paralegal as deﬁned by the rule and cannot call himself/herself a paralegal.

{Name} , told me that he/she may only type the factual informa�on provided by me in wri�ng into the blanks on the form. Except for typing, {name} ____, may not tell me what to put in the form and may not complete the form for me. However, if using a form approved by the Supreme Court of Florida, {name} ________________________, may ask me factual ques�ons to ﬁll in the blanks on the form and may also tell me how to ﬁle the form. {Choose one only} ____ I can read English. ____ I cannot read English, but this disclosure was read to me [ﬁll in both blanks] by {name} _ in {language} ________, which I understand.

Dated: Signature of Party

Signature of NONLAWYER Printed Name: Name of Business: Address: Telephone:

Florida Family Law Rules of Procedure Form 12.900(a), Disclosure from Nonlawyer (06/25) of 1 -7- INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.900(b) NOTICE OF AND CONSENT TO LIMITED APPEARANCE (06/25) When should this form be used?

This form should be used to provide no�ce to the court and the other atorney or party when an atorney is making a limited appearance for which a client has consented under Florida Family Law Rule of Procedure 12.040(e).

This form should be typed or printed in black ink. A�er comple�ng and signing this form, the atorney should ﬁle this document with the clerk of the circuit court in the county in which the ac�on is pending and keep a copy for his or her records.

What should I do next?

A copy of this form must be ﬁled with the court and served on the other party or his or her atorney. The copy you are serving on the other party must be either mailed, e-mailed, or hand-delivered to the opposing party or his or her atorney on the same day indicated on the cer�ﬁcate of service. If it is mailed, it must be postmarked on the date indicated in the cer�ﬁcate of service. Service must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

IMPORTANT INFORMATION REGARDING E-FILING The Florida Rules of General Prac�ce and Judicial Administra�on require that all pe��ons, pleadings, and documents be ﬁled electronically except in certain circumstances. Self-represented li�gants may ﬁle pe��ons or other pleadings or documents electronically; however, they are not required to do so. If you choose to ﬁle your pleadings or other documents electronically, you must do so in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.525, and you must follow the procedures of the judicial circuit in which you ﬁle. The rules and procedures should be carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION A�er the ini�al service of process of the pe��on or supplemental pe��on by the Sheriﬀ or cer�ﬁed process server, the Florida Rules of General Prac�ce and Judicial Administra�on require that all documents required or permited 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 Florida Rules of General Prac�ce and Judicial Administra�on. If you elect to par�cipate 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 General Prac�ce and Judicial Administra�on 2.516. You may ﬁnd this rule at www.ﬂcourts.org through the link to the Rules of General Prac�ce and Judicial Administra�on provided under either Family Law Forms: Ge�ng Started, or Rules of Court in the A-Z Topical Index.

Instructions for Florida Family Law Rules of Procedure Form 12.900(b), Notice of and Consent to Limited Appearance (06/25) of 2 -8- SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT REQUIRED TO DO SO. If a self-represented li�gant elects to serve and receive documents by email, the procedures must always be followed once the ini�al elec�on is made.

To serve and receive documents by e-mail, you must designate your e-mail addresses by using the Designa�on 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 instruc�ons for: Cer�ﬁcate of Service (General), Florida Supreme Court Approved Family Law Form 12.914; Designa�on of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form 12.915; and Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

Where can I look for more information?

See Florida Family Law Rule of Procedure 12.040.

Instructions for Florida Family Law Rules of Procedure Form 12.900(b), Notice of and Consent to Limited Appearance (06/25) of 2 -9- IN THE CIRCUIT COURT OF THE _______________________________ JUDICIAL CIRCUIT, IN AND FOR ___________________________________ COUNTY, FLORIDA Case No.: ________________________ Division: ________________________ _______________________________, Pe��oner, and _______________________________, Respondent.

NOTICE OF AND CONSENT TO LIMITED APPEARANCE {Attorney’s name} __________________________________________ ﬁles this No�ce of Limited Appearance on behalf of {name} _____________________________________, [choose one only] ( ) Pe��oner ( ) Respondent, for the following limited purpose(s). [choose all that apply]: 1. ___ The hearing set for {date} _____________________________, at {time} ___________on the issue(s) of {specify} ______________________________________________________ _.

2. ___ To represent [check one only] ( ) Pe��oner ( ) Respondent on the following issues throughout the proceeding(s) or mater(s): a. ___ Parental responsibility. b. ___ Time-sharing. c. ___ Equitable distribu�on of marital assets and marital liabili�es. d. ___ Alimony. e. ___ Child support. f. ___ Media�on. g. ___ Other {specify}: The clerk of the above-styled court is requested to enter this no�ce of record.

3. The party noted above consents to this limited representa�on by counsel.

4. Copies of all future court papers should be served on the undersigned atorney at the address listed and on the [choose one only] ( ) Pe��oner ( ) Respondent at {name, address, e-mail address(es), and telephone number}

Florida Family Law Rules of Procedure Form 12.900(b), Notice of and Consent to Limited Appearance (06/25) of 2 - 10 - I cer�fy that a copy of this no�ce of limited appearance was: [check all used] ( ) e-mailed ( ) mailed ( ) hand delivered to the person(s) listed below on {date} _______________________.

Other party or his/her atorney: Name: Address: City, State, Zip: Telephone Number: E-mail Address(es):

Signature of Atorney Printed Name: Address: City, State, Zip: Telephone Number: E-mail Address(es): Florida Bar Number:

______________________________________ Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: E-mail Address(es):

Florida Family Law Rules of Procedure Form 12.900(b), Notice of and Consent to Limited Appearance (06/25) of 2 - 11 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.900(d) TERMINATION OF LIMITED APPEARANCE (06/25) When should this form be used?

This form should be used by an atorney who is termina�ng a limited appearance for a client under Florida Family Law Rule of Procedure 12.040(e).

This form should be typed or printed in black ink. A�er comple�ng this form, the atorney should sign this document and then ﬁle this document with the clerk of the circuit court in the county in which the ac�on is pending. The atorney should keep a copy for his or her records.

What should I do next?

Instructions for Florida Family Law Rules of Procedure Form 12.900(d), Termination of Limited Appearance (06/25) of 2 - 12 - SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT REQUIRED TO DO SO. If a self-represented li�gant elects to serve and receive documents by email, the procedures must always be followed once the ini�al elec�on is made.

Where can I look for more information?

See Florida Family Law Rule of Procedure 12.040.

Instructions for Florida Family Law Rules of Procedure Form 12.900(d), Termination of Limited Appearance (06/25) of 2 - 13 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Pe��oner, and , Respondent.

TERMINATION OF LIMITED APPEARANCE {Attorney’s name} , ﬁles this Termina�on of Limited Appearance on behalf of the [check one only] ( ) Pe��oner ( ) Respondent, {name}, _____________ ______________________________________, and cer�ﬁes that the proceeding or mater is concluded.

The clerk of the above-styled court is requested to enter this No�ce of Termina�on of Limited Appearance of record. Copies of all future court papers should be served on the [check one only] ( ) Pe��oner ( ) Respondent at: {name, address, e-mail address(es), and telephone number} _____________________________________________________________________________________ .

I cer�fy that a copy of this termina�on of limited appearance was: [check all used] ( ) e-mailed ( ) mailed ( ) hand delivered to the person(s) listed below on {date} _________________.

Other party or his/her atorney: Name: Address: City, State, Zip: Telephone Number: E-mail Address(es): Client Party: Name: Address: City, State, Zip: Telephone Number: E-mail Address(es): _______________________________________ Signature of Atorney Printed Name: Address: City, State, Zip:

Florida Family Law Rules of Procedure Form 12.900(d), Termination of Limited Appearance (06/25) of 2 - 14 - Telephone Number: E-mail Address(es): Florida Bar Number:

Florida Family Law Rules of Procedure Form 12.900(d), Termination of Limited Appearance (06/25) of 2 - 15 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.900(e) ACKNOWLEDGMENT OF ASSISTANCE BY ATTORNEY (06/25) When should this form be used?

This form, when added to the signature page of any pe��on, pleading, or mo�on, should be ﬁled with the court when an atorney not making a limited appearance under Florida Family Law Rule of Procedure 12.040(e) has assisted the pe��oner or respondent in the prepara�on of the document. The pe��oner or respondent should then sign the pleading and include his/her name and address.

What should I do next?

A copy of this form must be ﬁled with the court and served on the other party or his or her atorney. The copy you are serving to the other party must be either mailed, e-mailed, or hand-delivered to the opposing party or his or her atorney on the same day indicated on the cer�ﬁcate of service. If it is mailed, it must be postmarked on the date indicated in the cer�ﬁcate of service. Service must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

Instructions for Florida Family Law Rules of Procedure Form 12.900(e), Acknowledgment of Assistance by Attorney (06/25) 1 of 2 - 16 - SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT REQUIRED TO DO SO. If a self-represented li�gant elects to serve and receive documents by email, the procedures must always be followed once the ini�al elec�on is made.

Where can I get more information?

See the instruc�ons to Florida Family Law Rules of Procedure Forms 12.900(b) and (d) and Rule 12.040.

Before proceeding, you should read General Informa�on for Self-Represented Li�gants found at the beginning of these forms. For more informa�on, see rule 12.080, Florida Family Law Rules of Procedure.

Instructions for Florida Family Law Rules of Procedure Form 12.900(e), Acknowledgment of Assistance by Attorney (06/25) 2 of 2 - 17 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Pe��oner, and , Respondent.

ACKNOWLEDGMENT OF ASSISTANCE BY ATTORNEY {Name}, , [check one only] ( ) Pe��oner ( ) Respondent, cer�ﬁes that this document was prepared with the assistance of counsel.

CERTIFICATE OF SERVICE I cer�fy that a copy of this Acknowledgement of Assistance By Atorney was [check all used]: ( ) e-mailed ( ) mailed ( ) hand delivered to the person(s) listed below on {date} .

Other party or his/her atorney: Name: Address: City, State, Zip: Telephone Number: E-mail Address(es): ___________________

Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: E-mail Address(es):

Florida Family Law Rules of Procedure Form 12.900(e), Acknowledgment of Assistance by Attorney (06/25) of 1 - 18 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.900(g) AGREEMENT LIMITING REPRESENTATION (06/25) When should this form be used?

This form should be used as a “rider” or supplemental agreement, in addi�on to an Atorney-Client fee agreement, between the atorney and client when the atorney is making a limited appearance under Rules Regula�ng The Florida Bar 4-1.2(c), 4-4.2(b), and 4-4.3(b) and Florida Family Law Rule of Procedure 12.040(e). A limited appearance means the atorney is not handling the whole case for the client, but is only being retained to do a speciﬁc part of the case. This form is not to be ﬁled with the clerk of the court.

Where can I look for more information?

See Rules Reg. Fla. Bar 4-1.2(c), 4-4.2(b), and 4-4.3(b) and Florida Family Law Rule of Procedure 12.040(e).

Instructions for Florida Family Law Rules of Procedure Form 12.900(g), Agreement Limiting Representation (06/25) of 1 - 19 - AGREEMENT LIMITING REPRESENTATION (This agreement is supplemental to the Atorney-Client fee agreement and is limited to addressing the consequences of Limited Legal Representa�on by an atorney in Florida) TO THE CLIENT: THIS IS A LEGALLY BINDING CONTRACT. PLEASE READ IT CAREFULLY AND MAKE CERTAIN THAT YOU UNDERSTAND ALL OF THE TERMS AND CONDITIONS. YOU MAY TAKE THIS CONTRACT HOME WITH YOU, REVIEW IT WITH ANOTHER ATTORNEY IF YOU WISH, AND ASK ANY QUESTIONS YOU MAY HAVE BEFORE SIGNING.

EMPLOYMENT OF AN ATTORNEY FOR LIMITED REPRESENTATION REQUIRES THAT THE ATTORNEY AND CLIENT CAREFULLY AND THOROUGHLY REVIEW THE DUTIES AND RESPONSIBILITIES EACH WILL ASSUME.

ANY LIMITED REPRESENTATION AGREEMENT SHOULD DESCRIBE, IN DETAIL, THE ATTORNEY’S DUTIES IN THE CLIENT’S INDIVIDUAL CASE.

1. SERVICES/LIMITED SCOPE OF REPRESENTATION: Client, {name} ______________________, employs Atorney, {name} _________________________________________________________ to provide representa�on only in the limited proceeding(s) or mater(s) described as follows: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 2. COMPLIANCE WITH CHAPTER 4 OF THE RULES REGULATING THE FLORIDA BAR: Although legal assistance is limited, an atorney-client rela�onship exists, and the client is en�tled to the standards of professional responsibility established by Chapter 4 of the Rules Regula�ng the Florida Bar, including conﬁden�ality, competence, and diligence.

3. COMPLIANCE WITH FLORIDA FAMILY LAW RULE OF PROCEDURE 12.040: An Atorney hired to provide limited representa�on in court must comply with Florida Family Law Rule of Procedure 12.040, as follows: a. The atorney will ﬁle with the court a No�ce of Limited Appearance, Florida Family Law Rules of Procedure Form 12.900(b), signed by the client, speciﬁcally limi�ng the atorney's appearance to the par�cular proceeding or mater in which the atorney appears. b. If the atorney seeks to withdraw from representa�on before the conclusion of a limited appearance, the atorney must: (1) File a mo�on with the court se�ng forth the reasons and serve that mo�on on the client and interested persons, and (2) Obtain approval of the court. c. At the conclusion of the proceeding or mater, the atorney’s role terminates without the necessity of leave of court, on the atorney ﬁling Termina�on of Limited Appearance, Florida Family Law Rules of Procedure Form 12.900(d). The no�ce shall include the names and last known addresses of the person(s) represented by the withdrawing atorney. d. THE CLIENT IS ADVISED THAT ANY OBJECTION TO THE ATTORNEY’S “TERMINATION OF LIMITED APPEARANCE” MUST BE MADE IN WRITING BY THE CLIENT BY PROVIDING THE COURT, THE ATTORNEY, AND EACH OTHER INTERESTED PERSON (OR THEIR ATTORNEY) A COPY AND FILING THE ORIGINAL WITH THE CLERK OF COURT e. Representa�on regarding any other mater or proceeding requires a separate No�ce of Limited Florida Family Law Rules of Procedure Form 12.900(g), Agreement Limiting Representation (06/25) of 2 - 20 - Appearance and must comply with Florida Family Law Rule of Procedure 12.040.

4. ADDITIONAL SERVICES/REPRESENTATION: The atorney and client may later determine that the atorney should provide addi�onal limited services or assume full representa�on. The atorney may decline to provide addi�onal services. a. If the atorney agrees to provide addi�onal services, those addi�onal services should be speciﬁcally listed in an amendment to this agreement, signed and dated by both the atorney and the client. b. If the atorney and client agree that the atorney shall serve as the client’s atorney of record on all maters related to handling the client’s case, the client and the atorney should indicate that agreement in an amendment to this agreement, signed and dated by both the atorney and the client. c. In either case, addi�onal compliance with the no�ce requirement of Rule 12.040 will be required by the atorney. d. THE ATTORNEY AND THE CLIENT SHOULD NOT RELY ON VERBAL DISCUSSIONS OR VERBAL AGREEMENTS WHEN CHANGING THE TERMS OF THE ATTORNEY’S RESPONSIBILITY FOR REPRESENTATION.

5. ATTORNEYS’ FEES AND COURT COSTS: The atorney and the client have made a separate agreement in wri�ng as to payment of atorneys’ fees and all costs associated with the case and the atorney’s representa�on.

BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT YOU HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL OF THE FOREGOING TERMS, AND YOU INTEND TO BE LEGALLY BOUND BY THEM.

Atorney Client Name: Name: Address: Address: City, State, Zip: City, State, Zip: Telephone Number: Telephone Number: E-mail Address(es): E-mail Address(es): Florida Bar Number: Date: Date: I HAVE BEEN PROVIDED A FULLY EXECUTED COPY OF THIS AGREEMENT LIMITING REPRESENTATION. _______________________________ Client

Florida Family Law Rules of Procedure Form 12.900(g), Agreement Limiting Representation (06/25) of 2 - 21 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.901(a) JOINT PETITION FOR SIMPLIFIED DISSOLUTION OF MARRIAGE (06/25) When should this form be used?

This form should be used when a married couple is ﬁling for a simpliﬁed dissolu�on of marriage.

You or your spouse must have lived in Florida for at least 6 months before ﬁling for a dissolu�on in Florida. You may ﬁle a simpliﬁed dissolu�on of marriage in Florida if all of the following are true. • You and your spouse agree that the marriage cannot be saved. • You and your spouse have no minor or dependent child(ren) together, the wife does not have any minor or dependent children born during the marriage, and the wife is not now pregnant. • You and your spouse have worked out how the two of you will divide the things that you both own (your assets) and who will pay what part of the money you both owe (your liabili�es), and you both agree with this division. • You and your spouse are not seeking support (alimony) from the other. • You and your spouse are willing to give up your right to trial and appeal. • You and your spouse have both signed the pe��on. • You and your spouse are both willing to atend the ﬁnal hearing (at the same �me).

If you do not meet all of the criteria above, you must ﬁle a regular pe��on for dissolu�on of marriage.

This pe��on should be typed or printed in black ink. Each of you must sign the pe��on.

What should I do next?

1. A�er comple�ng this form, you should ﬁle it with the clerk of the circuit court in the county where you live and keep a copy for your records.

You may document your agreement by signing a Marital Setlement Agreement, Florida Family Law Rules of Procedure Form 12.902(f)(3) and ﬁling it with the clerk of the circuit court or you may agree that all of your assets (what you own) and liabili�es (what you owe) have been disposed of by oral agreement.

2. You must prove to the court that either party has lived in Florida for more than 6 months before ﬁling the pe��on for simpliﬁed dissolu�on of marriage. Residence can be proven by

Instructions for Florida Family Law Rules of Procedure Form 12.901(a), Joint Petition for Simplified Dissolution of Marriage (06/25) 1 of 3 - 22 - • a valid Florida driver’s license, Florida iden�ﬁca�on card, or voter registra�on card issued to one of you at least 6 months prior to ﬁling for dissolu�on of marriage; • the tes�mony of another person who knows that either you or your spouse has resided in Florida for more than 6 months and is available to tes�fy in court; or • an aﬃdavit. To prove residence by aﬃdavit, use an Aﬃdavit of Corrobora�ng Witness, Florida Supreme Court Approved Family Law Form 12.902(i). This form must be signed by a person who knows that either you or your spouse has lived in Florida for more than months before the date that you ﬁled the pe��on for simpliﬁed dissolu�on of marriage.

This aﬃdavit may be signed in the presence of the clerk of the court or in the presence of a notary public, who must aﬃx his or her seal at the proper place on the aﬃdavit.

3. You must pay the appropriate ﬁling fees to the clerk of the circuit court. If you and your spouse cannot aﬀord to pay the ﬁling fees, you may ﬁll out an Applica�on for Determina�on of Civil Indigent Status, and ﬁle it with your pe��on for dissolu�on of marriage. You may obtain this form from the clerk and the clerk will determine whether you are eligible to have ﬁling fees waived.

4. You will need to complete a Family Court Cover Sheet, Florida Family Law Rules of Procedure Form 12.928. The clerk’s oﬃce can provide this form to you.

5. Depending on your jurisdic�on, you may either obtain a date and �me for a ﬁnal hearing with the court from the clerk of court, or a date and �me will be provided to you by the court. On that date, you and your spouse must atend the simpliﬁed dissolu�on of marriage ﬁnal hearing. Depending on your jurisdic�on, you will either complete a Final Judgment of Simpliﬁed Dissolu�on of Marriage, Florida Family Law Rules of Procedure Form 12.990(a), and bring it with you to the hearing, or the court will prepare it at the hearing. At that �me, if all of the papers are in order, the court may grant a ﬁnal judgment dissolving your marriage under the simpliﬁed dissolu�on of marriage procedures by signing the ﬁnal judgment.

6. If you fail to complete this procedure, the court may dismiss the case.

Where can I look for more information?

Before proceeding, you should read “General Informa�on for Self-Represented Li�gants” found at the beginning of these forms. The words that are in “bold and underlined” in these instruc�ons are deﬁned there. For further informa�on, see chapter 61, Florida Statutes, and Rule 12.105, Florida Family Law Rules of Procedure.

Instructions for Florida Family Law Rules of Procedure Form 12.901(a), Joint Petition for Simplified Dissolution of Marriage (06/25) 2 of 3 - 23 - Special notes . . .

Remember, a person who is NOT an atorney is called a nonlawyer. If a nonlawyer helps you ﬁll 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 helping you. A nonlawyer helping you ﬁll out these forms also must put their name, address, and telephone number on the botom of the last page of every form they help you complete.

Instructions for Florida Family Law Rules of Procedure Form 12.901(a), Joint Petition for Simplified Dissolution of Marriage (06/25) 3 of 3 - 24 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA In re the Marriage of: Case No.: Division: , Pe��oner, and , Respondent.

JOINT PETITION FOR SIMPLIFIED DISSOLUTION OF MARRIAGE We, {full legal name} , Pe��oner, and {full legal name} , Respondent, being sworn, cer�fy that the following informa�on is true: [ﬁll in all blanks] 1. We are both asking the Court for a dissolu�on of our marriage.

2. Pe��oner lives in {name} County, {state} , and has lived there since {date} . Respondent lives in {name} County, {state} , and has lived there since {date} .

3. We were married to each other on {date} in the city of {city} _________________ in state of {state} , or country of {country} __________________________.

4. Our marriage is irretrievably broken.

5. We do not have any minor or dependent children together, the wife does not have any minor or dependent children born during the marriage, and the wife is not pregnant.

6. We have divided our assets (what we own) and our liabili�es (what we owe) by agreement.

We are sa�sﬁed with this agreement. {Check one only} ( ) Our marital setlement agreement, Florida Family Law Rules of Procedure Form 12.902(f)(3), is atached. This agreement was signed freely and voluntarily by each of us and we intend to be bound by it. ( ) Our marital setlement agreement is not in wri�ng. {Check only one} Florida Family Law Rules of Procedure Form 12.901(a), Joint Petition for Simplified Dissolution of Marriage (06/25) of 3 - 25 - ( ) Our Financial Aﬃdavits are being ﬁled with this Joint Pe��on for Simpliﬁed Dissolu�on of Marriage pursuant to Rule 12.285. ( ) We have executed the Florida Family Law Form 12.902(k), No�ce of Joint Veriﬁed Waiver of Filing Financial Aﬃdavits, pursuant to Rule 12.285.

7. {Check all that apply} ( ) Pe��oner wants to be known by the Pe��oner’s former name, which was {full legal name}___________________________________________________. ( ) Respondent wants to be known by the Respondent’s former name, which was {full legal name}_____________________________________________________________________.

8. We each cer�fy that we have not been threatened or pressured into signing this pe��on.

We each understand that the result of signing this pe��on may be a ﬁnal judgment ending our marriage and allowing no further relief.

9. We each understand that we both must come to the hearing to tes�fy about the things we are asking for in this pe��on.

10. We understand that we each may have legal rights as a result of our marriage and that by signing this pe��on, we may be giving up those rights.

11. We ask the Court to end our marriage and approve our marital setlement agreement if ﬁled therein.

Under penal�es of perjury, I declare that I have read this document and the facts stated in it are true.

Dated: Signature of Pe��oner Printed Name: Address: City, State, Zip: Telephone Number: E-mail Address(es):__________________________

Under penal�es of perjury, I declare that I have read this document and the facts stated in it are true.

Dated: Signature of Respondent Florida Family Law Rules of Procedure Form 12.901(a), Joint Petition for Simplified Dissolution of Marriage (06/25) of 3 - 26 - Printed Name: Address: City, State, Zip: Telephone Number: E-mail Address(es):__________________________

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, THE NONLAWYER MUST FILL IN THE BLANKS BELOW: [ﬁll in all blanks] This form was prepared for: [choose one or both] ( ) Pe��oner ( ) 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 12.901(a), Joint Petition for Simplified Dissolution of Marriage (06/25) of 3 - 27 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.902(c) FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM) (06/25) When should this form be used?

This form should be used when you are involved in a family law case which requires a ﬁnancial aﬃdavit and your individual gross income is $50,000 OR MORE per year unless: (1) You are ﬁling a simpliﬁed dissolu�on of marriage under rule 12.105 and both par�es have waived the ﬁling of ﬁnancial aﬃdavits; (2) you have no minor children, no support issues, and have ﬁled a writen setlement agreement disposing of all ﬁnancial issues; or (3) the court lacks jurisdic�on to determine any ﬁnancial issues.

This form should be typed or printed in black ink. A�er comple�ng this form, you should sign the form.

You should then ﬁle this document with the clerk of the circuit court in the county where the pe��on was ﬁled and keep a copy for your records.

What should I do next?

A copy of this form must be served on the other party, or the part’s atorney if the party is represented, in your case within 45 days of being served with the pe��on, if it is not served on him or her with your ini�al papers. Service must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

Where can I look for more information?

Before proceeding, you should read “General Informa�on for Self-Represented Li�gants” found at the beginning of these forms. The words that are in “bold underline” in these instruc�ons are deﬁned there.

For further informa�on, see Florida Family Law Rule of Procedure 12.285.

Instructions for Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) 1 of 3 - 28 - IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION A�er the ini�al service of process of the pe��on or supplemental pe��on by the Sheriﬀ or cer�ﬁed process server, the Florida Rules of General Prac�ce and Judicial Administra�on require that all documents required or permited 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 Florida Rules of General Prac�ce and Judicial Administra�on. If you elect to par�cipate 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 General Prac�ce and Judicial Administra�on 2.516. You may ﬁnd this rule at www.ﬂcourts.org through the link to the Rules of General Prac�ce and Judicial Administra�on provided under either Family Law Forms: Ge�ng 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 li�gant elects to serve and receive documents by email, the procedures must always be followed once the ini�al elec�on is made.

Please CAREFULLY read the rules and instruc�ons for: Cer�ﬁcate of Service (General), Florida Supreme Court Approved Family Law Form 12.914; Designa�on of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form 12.915; and Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

Special notes . . .

If you want to keep your address conﬁden�al because you have been found by a judge to be the vic�m of sexual batery, aggravated child abuse, aggravated stalking, harassment, aggravated batery, or domes�c violence do not enter the address and telephone informa�on at the botom of this form. Instead, ﬁle Request for Conﬁden�al Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h).

The aﬃdavit must be completed using monthly income and expense amounts. If you are paid or your bills are due on a schedule which is not monthly, you must convert those to monthly amounts. Hints are provided below for making these conversions.

Instructions for Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) 2 of 3 - 29 - Hourly - If you are paid by the hour, you may convert your income to monthly as follows: Hourly amount x Hours worked per week = Weekly amount Weekly amount x 52 Weeks per year = Yearly amount Yearly amount ÷ 12 Months per year = Monthly Amount Daily - If you are paid by the day, you may convert your income to monthly as follows: Daily amount x Days worked per week = Weekly amount Weekly amount x 52 Weeks per year = Yearly amount Yearly amount ÷ 12 Months per year = Monthly Amount Weekly - If you are paid by the week, you may convert your income to monthly as follows: Weekly amount x 52 Weeks per year = Yearly amount Yearly amount ÷ 12 Months per year = Monthly Amount Bi-weekly - If you are paid every two weeks, you may convert your income to monthly as follows: Bi-weekly amount x 26 = Yearly amount Yearly amount ÷ 12 Months per year = Monthly Amount Semi-monthly - If you are paid twice per month, you may convert your income to monthly as follows: Semi-monthly amount x 2 = Monthly Amount Expenses may be converted in the same manner.

Remember, a person who is NOT an atorney is called a nonlawyer. If a nonlawyer helps you ﬁll 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 ﬁll out these forms also must put his or her name, address, and telephone number on the botom of the last page of every form he or she helps you complete.

Instructions for Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) 3 of 3 - 30 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA

Case No.: Division: , Pe��oner, and , Respondent.

FAMILY LAW FINANCIAL AFFIDAVIT (LONG FORM) ($50,000 or more Individual Gross Annual Income) I, {full legal name} , being sworn, cer�fy that the following informa�on is true: SECTION I. INCOME 1. My age is: ___________________ 2. My occupa�on is: 3. I am currently [Check all that apply] a.____ Unemployed Describe why you are unemployed, your eﬀorts to ﬁnd employment, how soon you expect to be employed, the pay you expect to receive, and your highest gross earned income in the past ﬁve years: __________________________________________________________ b.____ Employed by: _____________________________________________________________ Address: _______________________________________________________________________ City, State, Zip code: ________________________________ Telephone Number: ____________ Pay rate: $ ______ ( ) every week ( ) every other week ( ) twice a month ( ) monthly ( ) other: ___________________________________________________________ If you are expec�ng to become unemployed or change jobs soon, explain why, describe the change you expect, and explain why and how it will aﬀect your income:

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 31 - ____ Check here if you currently have more than one job. List the informa�on above for the second job(s) on a separate sheet and atach it to this aﬃdavit. c.____ Re�red. Date of re�rement: Employer from whom re�red: Address: City, State, Zip code: Telephone Number: If you have an an�cipated re�rement date, please provide the date: _______________________ ______ Check here if you are in or planning to enter the DROP program or any other deferred compensa�on plan or an�cipated re�rement plan.

LAST YEAR’S GROSS INCOME: Your Income Other Party’s Income (if known) YEAR _____ $ _______ $ _______ PRESENT MONTHLY GROSS INCOME: All amounts must be MONTHLY. See the instruc�ons with this form to ﬁgure out money amounts for anything that is NOT paid monthly. Atach more paper, if needed. Items included under “other” should be listed separately with separate dollar amounts.

1. $______ Gross salary or wages 2. _______ Bonuses, commissions, allowances, over�me, �ps, and similar payments 3. _______ Business income from sources such as self-employment, partnerships, close corpora�ons, and/or independent contracts (Gross receipts minus ordinary and necessary expenses required to produce income.) (Atach sheet itemizing such income and expenses.)

4. _______ Disability beneﬁts/SSI for you 5. _______ Workers’ compensa�on 6. _______ Reemployment assistance 7. _______ Pension, re�rement, or annuity payments 8. _______ Social Security beneﬁts 9. _______ Alimony actually received (Add 9a and 9b) 9a. From this case: ________ 9b. From other case(s): ________ 10. _______ Interest and dividends 11. _______ Rental income (gross receipts minus ordinary and necessary expenses required to produce income) (Atach sheet itemizing such income and expenses for each property.)

12. _______ Income from royal�es, trusts, or estates 13. _______ Reimbursed expenses and in-kind payments to the extent that they reduce personal living expenses (Atach sheet itemizing such income and expenses.)

14. _______ Gains derived from dealing in property (not including nonrecurring gains) Any other income of a recurring nature (iden�fy source): 15. _______________________________________________________________________________ 16. _______________________________________________________________________________ 17. $_________ TOTAL PRESENT MONTHLY GROSS INCOME (Add lines 1 through 16).

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 32 - PRESENT MONTHLY DEDUCTIONS: All amounts must be MONTHLY. See the instruc�ons with this form to ﬁgure out money amounts for anything that is NOT paid monthly.

18. $_______ Federal, state, and local income tax (corrected for ﬁling status and allowable dependents and income tax liabili�es) 18a. Filing Status 18b. Number of dependents claimed 19. _______ FICA or self-employment taxes 20. _______ Medicare payments 21. _______ Mandatory union dues 22. _______ Mandatory re�rement payments 23. _______ Health insurance payments for you only (including medical, dental, and vision), excluding por�on paid for any third party or minor children of this rela�onship 24. _______ Court-ordered child support actually paid for children from another rela�onship 25. _______ Court-ordered alimony actually paid (Add 25a and 25b) 25a. From this case: _________ 25b. From other case(s): _________ 26. $______ TOTAL DEDUCTIONS ALLOWABLE UNDER SECTION 61.30, FLORIDA STATUTES (Add lines 18 through 25).

27. $______ PRESENT NET MONTHLY INCOME (Subtract line 26 from line 17).

SECTION II. AVERAGE MONTHLY EXPENSES Expenses. If your expenses as listed below do not reﬂect what you actually pay currently, you should write “es�mate” next to each amount that is es�mated.

PRIMARY HOUSEHOLD: List the number of addi�onal households for which you incur expenses: (If more than one household, please iden�fy the household for which the listed expenses are incurred and atach a separate sheet lis�ng expenses for each addi�onal household.

1. $______ Mortgage or rent payments 2. _______ Property taxes (if not included in mortgage) 3. _______ Insurance on residence (if not included in mortgage) 4. _______ Condominium maintenance fees and homeowner’s associa�on fees 5. _______ Electricity 6. _______ Water, garbage, and sewer 7. _______ Telephone 8. _______ Fuel oil or natural gas 9. _______ Repairs and maintenance 10. _______ Lawn care 11. _______ Pool maintenance 12. _______ Pest control 13. _______ Misc. household 14. _______ Food and home supplies 15. _______ Meals outside home 16. _______ Cable t.v./internet Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 33 - 17. _______ Subscrip�on streaming services 18. _______ Alarm service contract 19. _______ Service contracts on appliances 20. _______ Housekeeping service 21. _______ Communica�on technology/remote working subscrip�ons Other: 22. ________________________________________________________________________________ 23. ________________________________________________________________________________ 24. ________________________________________________________________________________ 25. ________________________________________________________________________________ 26. ________________________________________________________________________________ 27. $_______ SUBTOTAL (add lines 1 through 26).

AUTOMOBILES: List the number of automobiles for which you incur expenses: _____.

28. $______ Gasoline and oil 29. _______ Electric car charging (outside of the home) 30. _______ Repairs 31. _______ Auto tags 32. _______ Insurance 33. _______ Payments (lease or ﬁnancing) 34. _______ Rental 35. _______ Alterna�ve transporta�on (bus, rail, carpool, taxi, ridesharing, etc.) 36. _______ Tolls and parking 37. _______ Automobile subscrip�ons and roadside services 38. _______ Other: _________________________________________________ 39. $_______ SUBTOTAL (add lines 28 through 35) MONTHLY EXPENSES FOR MINOR OR DEPENDENT CHILDREN COMMON TO BOTH PARTIES: List the number of minor or dependent children as deﬁned in Sec�on 743.07 (2), Florida Statutes common to both par�es: _______.

40. $______ Childcare 41. _______ School tui�on 42. _______ School supplies, books, and fees 43. _______ Extracurricular ac�vi�es 44. _______ School uniforms 45. _______ Lunch money 46. _______ Private lessons or tutoring 47. _______ Allowances 48. _______ Clothing 49. _______ Entertainment (movies, par�es, video games etc.) 50. _______ Health insurance (including dental and vision) 51. _______ Medical, dental, prescrip�ons (nonreimbursed only) 52. _______ Psychiatric/psychological/counselor 53. _______ Orthodon�c 54. _______ Grooming 55. _______ Nonprescrip�on medica�ons, supplements, and vitamins Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 34 - 56. _______ Cosme�cs, toiletries, and sundries 57. _______ Gi�s from child(ren) to others (other children, rela�ves, teachers, etc.) 58. _______ Camp or summer ac�vi�es 59. _______ Clubs (Boy/Girl Scouts, etc.) 60. _______ Cost required to exercise �me-sharing (supervised visita�on, travel and lodging expenses, etc.) 61. _______ Religious training 62. _______ Remote learning 63. _______ Subscrip�on service (if not listed on line 17 above) 64. _______ Other 65. $_______ SUBTOTAL (add lines 40 through 64) MONTHLY EXPENSES FOR MINOR OR DEPENDENT CHILD(REN) FROM ANOTHER RELATIONSHIP List the number of minor or dependent children as deﬁned in Florida Statutes Sec�on 743.07 (2) from another rela�onship: _______. (other than court-ordered child support) 66. $________________________________________________________________________________ 67. _________________________________________________________________________________ 68. _________________________________________________________________________________ 69. _________________________________________________________________________________ 70. $_______ SUBTOTAL (add lines 66 through 69) MONTHLY INSURANCE: 71. $______ Health insurance (if not listed on lines 23 of deduc�ons or 50 of expenses) 72. _______ Life insurance 73. _______ Dental insurance (if not listed on lines 23 of deduc�ons or 50 of expenses) 74. _______ Vision insurance (if not listed on lines 23 of deduc�ons or 50 of expenses) 75. _______ Long term care insurance 76. _______ Disability insurance Other: 77. _________________________________________________________________________________ 78. _________________________________________________________________________________ 79. $_______ SUBTOTAL (add lines 71 through 78) OTHER MONTHLY EXPENSES NOT LISTED ABOVE: 80. $______ Dry cleaning and laundry 81. _______ Clothing 82. _______ Medical, dental, and prescrip�on (unreimbursed only) 83. _______ Psychiatric, psychological, or counselor (unreimbursed only) 84. _______ Non-prescrip�on medica�ons, cosme�cs, toiletries, and sundries 85. _______ Grooming 86. _______ Gi�s 87. _______ Pet care 88. _______ Club dues and membership 89. _______ Sports and hobbies 90. _______ Entertainment Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 35 - 91. _______ Periodicals/books/other subscrip�on service 92. _______ Charitable dona�ons 93. _______ Gambling and lotery 94. _______ Tobacco, alcohol, and vaping 95. _______ Atorney fees and court costs 95a. _______ Related to this case 95b. _______ Other 96. _______ Professional training fees (unreimbursed only) 97. _______ Vaca�ons 98. _______ Religious organiza�ons 99. _______ Bank charges/credit card fees 100. _______ Educa�on expenses (unreimbursed only) 101. _______ Other: (include any regular and recurring expenses not otherwise men�oned in the items listed above) __________________________________________________________________________ 102. ________________________________________________________________________________ 103. ________________________________________________________________________________ 104. ________________________________________________________________________________ 105. $_______ SUBTOTAL (add lines 80 through 104) MONTHLY PAYMENTS TO CREDITORS: List only when payments are currently made by you on outstanding balances and not listed elsewhere on this aﬃdavit. For student loans listed below, list each student loan together with its date of origina�on. List only last 4 digits of account numbers.

MONTHLY PAYMENT AND NAME OF CREDITOR(s): 106. $______________________________________________________________________________ 107. _______________________________________________________________________________ 108. _______________________________________________________________________________ 109. _______________________________________________________________________________ 110. _______________________________________________________________________________ 111. _______________________________________________________________________________ 112. _______________________________________________________________________________ 113. _______________________________________________________________________________ 114. _______________________________________________________________________________ 115. _______________________________________________________________________________ 116. ________________________________________________________________________________ 117. _______________________________________________________________________________ 118. _______________________________________________________________________________ 119. $_______ SUBTOTAL (add lines 106 through 118) 120. $_______ TOTAL MONTHLY EXPENSES: (add lines 27, 39, 65, 70, 79, 105, and 119 of Sec�on II, Expenses) SUMMARY 121. $_______ TOTAL PRESENT MONTHLY NET INCOME (from line 27 of SECTION I. INCOME) 122. $_______ TOTAL MONTHLY EXPENSES (from line 120 above) 123. $_______ SURPLUS (If line 121 is more than line 122, subtract line 122 from line 121. This is the amount of your surplus. Enter that amount here.)

124. ($______) (DEFICIT) (If line 122 is more than line 121, subtract line 121 from line 122. This is the amount of your deﬁcit. Enter that amount here.)

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 36 - SECTION III. ASSETS AND LIABILITIES A. ASSETS If you have an equitable distribu�on schedule or balance sheet that includes the informa�on below, you may atach the document instead of ﬁlling out Sec�on III.

INSTRUCTIONS: STEP 1: Describe the Asset. In column A, list a descrip�on of each separate item owned by you (or your spouse, if this is an original ac�on for dissolu�on). Include items held in a revocable trust. List only the last 4 digits of account numbers. Blank spaces are provided if you need to list more than one of a certain type of asset. If you need to list more assets than blank spaces provided, please atach a separate sheet lis�ng addi�onal assets.

STEP 2: Select Assets. (Ini�al Dissolu�on Mater ONLY) If this is an original ac�on for dissolu�on, check the box to the le� of the descrip�on in column A next to any asset that you are reques�ng the judge award to you. Disregard this step in all other domes�c rela�ons maters and proceed to step 4.

STEP 3: State the Value of Marital Assets and Non-Marital Assets (Ini�al Dissolu�on Mater ONLY) If this is an original ac�on for dissolu�on, in column B, place the current fair market value of all marital assets. If you believe that the asset described in column A is your non-marital asset, write what you believe its fair market value to be in column C under “Pe��oner” if you are the Pe��oner, or under “Respondent” if you are the Respondent. If the asset has a marital and non-marital component, write what you believe the fair market value of the marital por�on is in column B and what you believe the fair market value of the non-marital por�on is in the appropriate column in column C. The total of column B and column C must equal the asset value on the appropriate valua�on date. Disregard this step in all other domes�c rela�on maters and proceed to step 4.

STEP 4: State the Value of Non-marital Assets. (OTHER THAN Ini�al Dissolu�on Maters ONLY) If this is a mater OTHER THAN an original dissolu�on, write what you believe the fair market value to be in column C under Pe��oner if you are the Pe��oner, or under Respondent if you are the Respondent. DO NOT USE COLUMN B in any domes�c rela�ons mater that is NOT an original dissolu�on; use only column C. See the “General Informa�on for Self-Represented Li�gants” found at the beginning of these forms and sec�on 61.075(1), Florida Statutes, for deﬁni�ons of “marital” and “nonmarital” assets and liabili�es.

A B C ASSETS: DESCRIPTION OF ITEM(S) Marital Nonmarital Assets – Assets – Current Fair Market Value LIST ONLY LAST FOUR DIGITS OF ACCOUNT NUMBERS. Current Check the box on the le� in column A next to any asset(s) Fair which you are reques�ng be awarded to you. Market Value Pe��oner Respondent Reques�ng Title to be Owner Awarded Cash (on hand) $ Cash (in banks and credit unions, including checking, savings and money market accounts, cer�ﬁcates of deposit, and in safe deposit boxes) Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 37 - Cash (in digital wallets, including but not limited to Venmo, Apple Wallet, and PayPal)

Virtual currency and cryptocurrency (atach a schedule that shows number of units held of virtual currency or cryptocurrency and unit value at �me of prepara�on of this form)

Non-Fungible Tokens (NFT) and the like

Stocks/Bonds, investment/brokerage accounts

Notes (money owed to you in wri�ng)

Money owed to you (not evidenced by a note)

Real estate: (Home) Real estate (Other)

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 38 - Business interests (also indicate % of ownership interest next to each en�ty listed)

Automobiles

Boats

Other vehicles

Re�rement plans (Proﬁt Sharing, Pension, IRA, 401(k)s, etc.)

Furniture & furnishings in home

Furniture & furnishings elsewhere

Collec�bles and commodi�es (including but not limited to cards, precious metals, coins, stamps, and art)

Jewelry

Life insurance (cash surrender value)

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 39 - Spor�ng, hobby, and entertainment (T.V., stereo, etc.) equipment Tools Firearms and ammuni�on

Judgments (owed to you)

Patents, trademarks, copyrights

Other assets:

Total Fair Market Value of Marital Assets (add column B) $ Total Fair Market Value of Nonmarital Assets (add $ column C) B. LIABILITIES/DEBTS INSTRUCTIONS: STEP 1: Describe the Liability/Debt. In column A, list a descrip�on of each separate debt owed by you (or your spouse, if this is an original ac�on for dissolu�on) and iden�fy the �tle owner/obligor of the debt. List only the last 4 digits of account numbers. Blank spaces are provided if you need to list more than one of a certain type of debt. If you need to list more debts than blank spaces provided, please atach a separate sheet lis�ng addi�onal debts.

STEP 2: Select Debts (Ini�al Dissolu�on Mater ONLY). If this is an original ac�on for dissolu�on, check the box to the le� of the descrip�on in column A next to any debt(s) for which you believe you should be responsible. Disregard this step in all other domes�c rela�ons maters and proceed to step 4.

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 40 - STEP 3: State the Value of Marital Debts and Non-Marital Debts (Ini�al Dissolu�on Mater ONLY).

If this is an original ac�on for dissolu�on, in column B, write what you believe the current amount owed for each marital debts listed.

If you believe that the debt described in column A is a non-marital debt, write what you believe the current amount owed is in column C under Pe��oner if you believe the Pe��oner should be responsible for the debt, or under Respondent if you believe the Respondent should be responsible for the debt.

If the debt has a marital and non-marital component, write what you believe the current amount owed of the marital por�on is in column B and what you believe the current amount owed of the non-marital por�on in the appropriate column in column C. The total of column B and column C must equal the total debt value on the appropriate valua�on date. Disregard this step in all other domes�c rela�ons maters and proceed to step 4.

STEP 4: State Value of Non-Marital Debts (OTHER THAN Ini�al Dissolu�on Maters ONLY). If this is a mater OTHER THAN an original dissolu�on, write what you believe the current amount owed to be in column C under Pe��oner, if you are the Pe��oner or under Respondent, if you are the Respondent. DO NOT USE COLUMN B in any domes�c rela�ons mater that is NOT an original dissolu�on; use only column C. See the “General Informa�on for Self-Represented Li�gants” found at the beginning of these forms and sec�on 61.075(1), Florida Statutes, for deﬁni�ons of “marital” and “nonmarital” assets and liabili�es.

A B C LIABILITIES: DESCRIPTION OF ITEM(S) Marital Nonmarital Liabili�es – Liabili�es Current Amount Owed LIST ONLY LAST FOUR DIGITS OF ACCOUNT – Current NUMBERS. Amount Check the box on the le� of column A next to any Owed debt(s) for which you believe you should be responsible.

Pe��oner Respondent Reques�ng Debtor/ Creditor to be Obligor/ Responsible Title for Holder Mortgages on real estate $

Charge/credit card accounts

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 41 - Student loans (list each loan individually)

Medical liabili�es

Auto loans

Bank/Credit Union loans

Tax liabili�es

Notes (money you owe in wri�ng)

Money you owe (not evidenced by a note)

Judgments (against you)

Other liabili�es:

Total Amount Owed on Marital Liabili�es (add $ column B) Total Amount Owed on Nonmarital Liabili�es (add $ column C) Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 42 - C. NET WORTH (excluding con�ngent assets and liabili�es) $_______Total Assets (enter total of Column B in Asset Table; Sec�on A) $_______Total Liabili�es (enter total of Column B in Liabili�es Table; Sec�on B) $_______TOTAL NET WORTH (Total Assets minus Total Liabili�es) (excluding con�ngent assets and liabili�es) D. CONTINGENT ASSETS AND LIABILITIES INSTRUCTIONS: If you have any POSSIBLE assets (possible lawsuits, income poten�al, accrued vaca�on or sick leave, bonus, inheritance, etc.) or POSSIBLE liabili�es (possible lawsuits, future unpaid taxes, con�ngent tax liabili�es, debts assumed by another), you must list them here.

A B C Con�ngent Assets Marital Nonmarital Con�ngent Con�ngent Assets – Check the box in column A next to any con�ngent Assets – Possible Value Possible Value asset(s) which you are reques�ng the court assign to you. Pe��oner Respondent Reques�ng to Title $ be Awarded Owner Stock Op�ons Other

Total Possible Value of Marital Con�ngent Assets $ (add column B) Total Possible Value of Nonmarital Con�ngent $ Assets (add column C)

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 43 - A B C Con�ngent Liabili�es Marital Nonmarital Con�ngent Con�ngent Liabili�es – Liabili�es – Possible Amount Owed Check the box in column A next to any Possible con�ngent debt(s) for which you believe Amount Owed you should be responsible.

Pe��oner Respondent Reques�ng to Debtor/ Creditor $ $ $ be Responsible Obligor For / Title Holder

Atorney Fees

Total Possible Amount Owed on $ $ $ Con�ngent Liabili�es E. CHILD SUPPORT GUIDELINES WORKSHEET. Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet, MUST be ﬁled with the court at or prior to a hearing to establish or modify child support. This requirement cannot be waived by the par�es. [Check one only] ____A Child Support Guidelines Worksheet IS or WILL BE ﬁled in this case. This case involves the establishment or modiﬁca�on of child support. ____A Child Support Guidelines Worksheet IS NOT being ﬁled in this case. The establishment or modiﬁca�on of child support is not an issue in this case.

I cer�fy that a copy of this ﬁnancial aﬃdavit was [check all used]: ( ) e-mailed, ( ) mailed, ( ) hand delivered to the person(s) listed below on {date} ____________________.

Other party or his/her atorney: Name: __________________________________ Address: ________________________________ City, State, Zip: ___________________________ E-mail Address(es): ________________________ Under penal�es of perjury, I declare that I have read this document and the facts stated in it are true.

Florida Family Law Rules of Procedure Form 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 44 - Dated: ______________________ __________________________________________ Signature of Party Printed Name: ______________________________ Address: ___________________________________ City, State, Zip: ______________________________ E-mail Address(es): ____________________________

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [ﬁll in all blanks] This form was prepared for the: {choose only one} ( ) Pe��oner ( ) 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 12.902(c), Family Law Financial Affidavit (Long Form) (06/25) of 15 - 45 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.902(e) CHILD SUPPORT GUIDELINES WORKSHEET (06/25) When should this form be used?

You should complete this worksheet if child support is being requested in your case. If you know the income of the other party, this worksheet should accompany your ﬁnancial aﬃdavit. If you do not know the other party’s income, this form must be completed a�er the other party ﬁles his or her ﬁnancial aﬃdavit, and serves a copy on you.

This form should be typed or printed in black ink. You should ﬁle this document with the clerk of the circuit court in the county where your case is ﬁled and keep a copy for your records.

What should I do next?

A copy of this form must be ﬁled with the court and served on the other party or his or her atorney. The copy you are serving to the other party must be either mailed, emailed, or hand-delivered to the opposing party or his or her atorney on the same day indicated on the cer�ﬁcate of service. If it is mailed, it must be postmarked on the date indicated in the cer�ﬁcate of service. Service must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 8 - 46 - SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT REQUIRED TO DO SO. If a self-represented li�gant elects to serve and receive documents by email, the procedures must always be followed once the ini�al elec�on is made.

Where can I look for more information?

Special notes . . .

If you want to keep your address conﬁden�al because you have been found by a court to be the vic�m of sexual batery, aggravated child abuse, aggravated stalking, harassment, aggravated batery or domes�c violence, do not enter the address and telephone informa�on at the botom of this form. Instead, ﬁle Request for Conﬁden�al Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h).

The chart below contains the guideline amounts that you should use when calcula�ng child support. This amount is based on the number of children and the combined income of the parents, and it is divided between the parents in direct propor�on to their income or earning capacity. From �me to �me, some of the amounts in the child support guidelines chart will change. Be sure you have the most recent version of the chart before using it.

If the par�es’ combined monthly net income is not listed on the below chart, then calculate child support as provided by law in sec�on 61.30(6), Florida Statutes.

Because the guidelines are based on monthly amounts, it may be necessary to convert some income and expense ﬁgures from other frequencies to monthly. You should do this as follows: If payment is twice per month Payment amount x 2 = Monthly amount If payment is every two weeks Payment amount x 26 = Yearly amount due Yearly amount ÷ 12 = Monthly amount If payment is weekly Weekly amount x 52 = Yearly amount due Yearly amount ÷ 12 = Monthly amount Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 8 - 47 - If you or the other parent request that the court award an amount that is diﬀerent than the guideline amount, you must also complete and atach a Mo�on to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943.

Remember, a person who is NOT an atorney is called a nonlawyer. If a nonlawyer helps you ﬁll 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 ﬁll out these forms also must put his or her name, address, and telephone number on the botom of the last page of every form he or she helps you complete.

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 8 - 48 - CHILD SUPPORT GUIDELINES CHART Combined One Two Three Four Five Six Monthly Child Children Children Children Children Children Available Income 800.00 190 211 213 216 218 220 850.00 202 257 259 262 265 268 900.00 213 302 305 309 312 315 950.00 224 347 351 355 359 363 1000.00 235 365 397 402 406 410 1050.00 246 382 443 448 453 458 1100.00 258 400 489 495 500 505 1150.00 269 417 522 541 547 553 1200.00 280 435 544 588 594 600 1250.00 290 451 565 634 641 648 1300.00 300 467 584 659 688 695 1350.00 310 482 603 681 735 743 1400.00 320 498 623 702 765 790 1450.00 330 513 642 724 789 838 1500.00 340 529 662 746 813 869 1550.00 350 544 681 768 836 895 1600.00 360 560 701 790 860 920 1650.00 370 575 720 812 884 945 1700.00 380 591 740 833 907 971 1750.00 390 606 759 855 931 996 1800.00 400 622 779 877 955 1022 1850.00 410 638 798 900 979 1048 1900.00 421 654 818 923 1004 1074 1950.00 431 670 839 946 1029 1101 2000.00 442 686 859 968 1054 1128 2050.00 452 702 879 991 1079 1154 2100.00 463 718 899 1014 1104 1181 2150.00 473 734 919 1037 1129 1207 2200.00 484 751 940 1060 1154 1234 2250.00 494 767 960 1082 1179 1261 2300.00 505 783 980 1105 1204 1287 2350.00 515 799 1000 1128 1229 1314 2400.00 526 815 1020 1151 1254 1340 2450.00 536 831 1041 1174 1279 1367 2500.00 547 847 1061 1196 1304 1394 2550.00 557 864 1081 1219 1329 1420

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 8 - 49 - Combined One Two Three Four Five Six Monthly Child Children Children Children Children Children Available Income 2600.00 568 880 1101 1242 1354 1447 2650.00 578 896 1121 1265 1379 1473 2700.00 588 912 1141 1287 1403 1500 2750.00 597 927 1160 1308 1426 1524 2800.00 607 941 1178 1328 1448 1549 2850.00 616 956 1197 1349 1471 1573 2900.00 626 971 1215 1370 1494 1598 2950.00 635 986 1234 1391 1517 1622 3000.00 644 1001 1252 1412 1540 1647 3050.00 654 1016 1271 1433 1563 1671 3100.00 663 1031 1289 1453 1586 1695 3150.00 673 1045 1308 1474 1608 1720 3200.00 682 1060 1327 1495 1631 1744 3250.00 691 1075 1345 1516 1654 1769 3300.00 701 1090 1364 1537 1677 1793 3350.00 710 1105 1382 1558 1700 1818 3400.00 720 1120 1401 1579 1723 1842 3450.00 729 1135 1419 1599 1745 1867 3500.00 738 1149 1438 1620 1768 1891 3550.00 748 1164 1456 1641 1791 1915 3600.00 757 1179 1475 1662 1814 1940 3650.00 767 1194 1493 1683 1837 1964 3700.00 776 1208 1503 1702 1857 1987 3750.00 784 1221 1520 1721 1878 2009 3800.00 793 1234 1536 1740 1899 2031 3850.00 802 1248 1553 1759 1920 2053 3900.00 811 1261 1570 1778 1940 2075 3950.00 819 1275 1587 1797 1961 2097 4000.00 828 1288 1603 1816 1982 2119 4050.00 837 1302 1620 1835 2002 2141 4100.00 846 1315 1637 1854 2023 2163 4150.00 854 1329 1654 1873 2044 2185 4200.00 863 1342 1670 1892 2064 2207 4250.00 872 1355 1687 1911 2085 2229 4300.00 881 1369 1704 1930 2106 2251 4350.00 889 1382 1721 1949 2127 2273 4400.00 898 1396 1737 1968 2147 2295 4450.00 907 1409 1754 1987 2168 2317 4500.00 916 1423 1771 2006 2189 2339

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 8 - 50 - Combined One Two Three Four Five Six Monthly Child Children Children Children Children Children Available Income 4550.00 924 1436 1788 2024 2209 2361 4600.00 933 1450 1804 2043 2230 2384 4650.00 942 1463 1821 2062 2251 2406 4700.00 951 1477 1838 2081 2271 2428 4750.00 959 1490 1855 2100 2292 2450 4800.00 968 1503 1871 2119 2313 2472 4850.00 977 1517 1888 2138 2334 2494 4900.00 986 1530 1905 2157 2354 2516 4950.00 993 1542 1927 2174 2372 2535 5000.00 1000 1551 1939 2188 2387 2551 5050.00 1006 1561 1952 2202 2402 2567 5100.00 1013 1571 1964 2215 2417 2583 5150.00 1019 1580 1976 2229 2432 2599 5200.00 1025 1590 1988 2243 2447 2615 5250.00 1032 1599 2000 2256 2462 2631 5300.00 1038 1609 2012 2270 2477 2647 5350.00 1045 1619 2024 2283 2492 2663 5400.00 1051 1628 2037 2297 2507 2679 5450.00 1057 1638 2049 2311 2522 2695 5500.00 1064 1647 2061 2324 2537 2711 5550.00 1070 1657 2073 2338 2552 2727 5600.00 1077 1667 2085 2352 2567 2743 5650.00 1083 1676 2097 2365 2582 2759 5700.00 1089 1686 2109 2379 2597 2775 5750.00 1096 1695 2122 2393 2612 2791 5800.00 1102 1705 2134 2406 2627 2807 5850.00 1107 1713 2144 2418 2639 2820 5900.00 1111 1721 2155 2429 2651 2833 5950.00 1116 1729 2165 2440 2663 2847 6000.00 1121 1737 2175 2451 2676 2860 6050.00 1126 1746 2185 2462 2688 2874 6100.00 1131 1754 2196 2473 2700 2887 6150.00 1136 1762 2206 2484 2712 2900 6200.00 1141 1770 2216 2495 2724 2914 6250.00 1145 1778 2227 2506 2737 2927 6300.00 1150 1786 2237 2517 2749 2941 6350.00 1155 1795 2247 2529 2761 2954 6400.00 1160 1803 2258 2540 2773 2967 6450.00 1165 1811 2268 2551 2785 2981

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 8 - 51 - Combined One Two Three Four Five Six Monthly Child Children Children Children Children Children Available Income 6500.00 1170 1819 2278 2562 2798 2994 6550.00 1175 1827 2288 2573 2810 3008 6600.00 1179 1835 2299 2584 2822 3021 6650.00 1184 1843 2309 2595 2834 3034 6700.00 1189 1850 2317 2604 2845 3045 6750.00 1193 1856 2325 2613 2854 3055 6800.00 1196 1862 2332 2621 2863 3064 6850.00 1200 1868 2340 2630 2872 3074 6900.00 1204 1873 2347 2639 2882 3084 6950.00 1208 1879 2355 2647 2891 3094 7000.00 1212 1885 2362 2656 2900 3103 7050.00 1216 1891 2370 2664 2909 3113 7100.00 1220 1897 2378 2673 2919 3123 7150.00 1224 1903 2385 2681 2928 3133 7200.00 1228 1909 2393 2690 2937 3142 7250.00 1232 1915 2400 2698 2946 3152 7300.00 1235 1921 2408 2707 2956 3162 7350.00 1239 1927 2415 2716 2965 3172 7400.00 1243 1933 2423 2724 2974 3181 7450.00 1247 1939 2430 2733 2983 3191 7500.00 1251 1945 2438 2741 2993 3201 7550.00 1255 1951 2446 2750 3002 3211 7600.00 1259 1957 2453 2758 3011 3220 7650.00 1263 1963 2461 2767 3020 3230 7700.00 1267 1969 2468 2775 3030 3240 7750.00 1271 1975 2476 2784 3039 3250 7800.00 1274 1981 2483 2792 3048 3259 7850.00 1278 1987 2491 2801 3057 3269 7900.00 1282 1992 2498 2810 3067 3279 7950.00 1286 1998 2506 2818 3076 3289 8000.00 1290 2004 2513 2827 3085 3298 8050.00 1294 2010 2521 2835 3094 3308 8100.00 1298 2016 2529 2844 3104 3318 8150.00 1302 2022 2536 2852 3113 3328 8200.00 1306 2028 2544 2861 3122 3337 8250.00 1310 2034 2551 2869 3131 3347 8300.00 1313 2040 2559 2878 3141 3357 8350.00 1317 2046 2566 2887 3150 3367 8400.00 1321 2052 2574 2895 3159 3376

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 8 - 52 - Combined One Two Three Four Five Six Monthly Child Children Children Children Children Children Available Income 8450.00 1325 2058 2581 2904 3168 3386 8500.00 1329 2064 2589 2912 3178 3396 8550.00 1333 2070 2597 2921 3187 3406 8600.00 1337 2076 2604 2929 3196 3415 8650.00 1341 2082 2612 2938 3205 3425 8700.00 1345 2088 2619 2946 3215 3435 8750.00 1349 2094 2627 2955 3224 3445 8800.00 1352 2100 2634 2963 3233 3454 8850.00 1356 2106 2642 2972 3242 3464 8900.00 1360 2111 2649 2981 3252 3474 8950.00 1364 2117 2657 2989 3261 3484 9000.00 1368 2123 2664 2998 3270 3493 9050.00 1372 2129 2672 3006 3279 3503 9100.00 1376 2135 2680 3015 3289 3513 9150.00 1380 2141 2687 3023 3298 3523 9200.00 1384 2147 2695 3032 3307 3532 9250.00 1388 2153 2702 3040 3316 3542 9300.00 1391 2159 2710 3049 3326 3552 9350.00 1395 2165 2717 3058 3335 3562 9400.00 1399 2171 2725 3066 3344 3571 9450.00 1403 2177 2732 3075 3353 3581 9500.00 1407 2183 2740 3083 3363 3591 9550.00 1411 2189 2748 3092 3372 3601 9600.00 1415 2195 2755 3100 3381 3610 9650.00 1419 2201 2763 3109 3390 3620 9700.00 1422 2206 2767 3115 3396 3628 9750.00 1425 2210 2772 3121 3402 3634 9800.00 1427 2213 2776 3126 3408 3641 9850.00 1430 2217 2781 3132 3414 3647 9900.00 1432 2221 2786 3137 3420 3653 9950.00 1435 2225 2791 3143 3426 3659 10000.00 1437 2228 2795 3148 3432 3666

Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 8 - 53 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Pe��oner, and , Respondent.

NOTICE OF FILING CHILD SUPPORT GUIDELINES WORKSHEET PLEASE TAKE NOTICE, that {name} _______, is ﬁling the Child Support Guidelines Worksheet atached and labeled Exhibit 1.

CERTIFICATE OF SERVICE I cer�fy that a copy of this No�ce of Filing with the Child Support Guidelines Worksheet was [check all used]: ( ) e-mailed ( ) mailed ( ) hand delivered to the person(s) listed below on {date} __________.

Other party or his/her atorney: Name: _____________________________ Address: ____________________________ City, State, Zip: _______________________ Telephone Number: ___________________ E-mail Address(es): ____________________

Signature of Party Printed Name: _________________________ Address: ______________________________ City, State, Zip: _________________________ Telephone Number: _____________________ E-mail Address(es): ______________________

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 7 - 54 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Pe��oner, and , Respondent.

CHILD SUPPORT GUIDELINES WORKSHEET GROSS INCOME CALCULATION A. PETITIONER B. RESPONDENT TOTAL Present Gross Monthly Income Enter the amount from line 17, Section I of Florida Family Law Rules of Procedure Form 12.902(b) or (c), Financial Affidavit.

CHILD SUPPORT GUIDELINES WORKSHEET A. PETITIONER B. RESPONDENT TOTAL 1. Present Net Monthly Income Enter the amount from line 27, Sec�on I of Florida Family Law Rules of Procedure Form 12.902(b) or (c), Financial Aﬃdavit.

2. Basic Monthly Obligation There is (are) {number}_____ minor child(ren) common to the parties. Using the total amount from line 1, enter the appropriate amount from the child support guidelines chart.

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 7 - 55 - A. PETITIONER B. RESPONDENT TOTAL 3. Percent of Financial Responsibility % % Divide the amount on line 1A by the total amount on line 1 to get Pe��oner’s percentage of ﬁnancial responsibility. Enter answer on line 3A. Divide the amount on line 1B by the total amount on line 1 to get Respondent’s percentage of ﬁnancial responsibility. Enter answer on line 3B.

4. Share of Basic Monthly Obliga�on Mul�ply the number on line 2 by the percentage on line 3A to get Pe��oner’s share of basic obliga�on. Enter answer on line 4A. Mul�ply the number on line 2 by the percentage on line 3B to Respondent’s share of basic obliga�on. Enter answer on line 4B.

Addi�onal Support — Health Insurance, Child Care & Other 5. a. 100% of Monthly Child Care Costs [Child care costs should not exceed the level required to provide quality care from a licensed source. See section 61.30(7), Florida Statutes, for more information.]

b. Total Monthly Child(ren)’s Health Insurance Cost [This is only amounts actually paid for health insurance on the child(ren).]

c. Total Monthly Child(ren)’s Noncovered Medical, Dental and Prescrip�on Medica�on Costs d. Total Monthly Child Care & Health Costs [Add lines 5a + 5b +5c.]

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 7 - 56 - 6. Addi�onal Support Payments Mul�ply the number on line 5d by the percentage on line 3A to determine the Pe��oner’s share. Enter answer on line 6A.

Mul�ply the number on line 5d by the percentage on line 3B to determine the Respondent’s share.

Enter answer on line 6B.

Statutory Adjustments/Credits 7. a. Monthly child care payments actually made.

b. Monthly health insurance payments actually made.

c. Other payments/credits actually made for any noncovered medical, dental and prescrip�on medica�on expenses of the child(ren) not ordered to be separately paid on a percentage basis. (See sec�on 61.30 (8), Florida Statutes.)

8. Total Support Payments actually made (Add 7a though 7c.)

9. MINIMUM CHILD SUPPORT OBLIGATION FOR EACH PARENT [Line 4 plus line 6; minus line 8.]

Substan�al Time-Sharing (GROSS UP METHOD) If each parent exercises �me-sharing at least 20 percent of the overnights in the year (73 overnights in the year), complete Nos. 10 through 21.

10. Basic Monthly Obligation x 150% [Multiply line 2 by 1.5]

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 7 - 57 - 11. Increased Basic Obliga�on for each parent.

Mul�ply the number on line 10 by the percentage on line 3A to determine the Pe��oner’s share. Enter answer on line 11A. Mul�ply the number on line 10 by the percentage on line 3B to determine the Respondent’s share.

Enter answer on line 11B.

12. Percentage of overnight stays with each % % parent. The child(ren) spend(s) ____overnight stays with the Pe��oner each year. Using the number on the above line, mul�ply it by 100 and divide by 365.

Enter this number on line 12A. The child(ren) spend(s) _____ overnight stays with the Respondent each year. Using the number on the above line, mul�ply it by and divide by 365.

Enter this number on line 12B.

13. Parent’s support mul�plied by other Parent’s percentage of overnights. [Mul�ply line 11A by line 12B. Enter this number in 13A. Mul�ply line 11B by line 12A. Enter this number in 13B.]

Addi�onal Support — Health Insurance, Child Care & Other 14. a. Total Monthly Child Care Costs [Child care costs should not exceed the level required to provide quality care from a licensed source. See sec�on 61.30(7), Florida Statutes, for more informa�on.]

b. Total Monthly Child(ren)’s Health Insurance Cost. [This is only amounts actually paid for health insurance on the child(ren).]

c. Total Monthly Child(ren)’s Noncovered Medical, Dental and Prescrip�on Medica�on Costs.

d. Total Monthly Child Care & Health Costs [Add lines 14a + 14b + 14c.]

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 7 - 58 - 15. Addi�onal Support Payments.

Mul�ply the number on line 14d by the percentage on line 3A to determine the Pe��oner’s share. Enter answer on line 15A.

Mul�ply the number on line 14d by the percentage on line 3B to determine the Respondent’s share. Enter answer on line 15B.

Statutory Adjustments/Credits 16. a. Monthly child care payments actually made. b. Monthly health insurance payments actually made. c. Other payments/credits actually made for any noncovered medical, dental and prescrip�on medica�on expenses of the child(ren) not ordered to be separately paid on a percentage basis. [See sec�on 61.30(8), Florida Statutes.]

17. Total Support Payments actually made [Add 16a though 16c.]

18. Total Addi�onal Support Transfer Amount [Line 15 minus line 17; enter any nega�ve number as zero.]

19. Total Child Support Owed from Pe��oner to Respondent [Add line 13A plus 18A.]

20. Total Child Support Owed from Respondent to Pe��oner [Add line 13B plus line 18B.]

21. Presump�ve Child Support to Be Paid. [Comparing lines 19 and 20, subtract the $ smaller amount owed from the larger amount owed and enter the result in the column for the parent that owes the larger amount of support.]

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 7 - 59 - ADJUSTMENTS TO GUIDELINES AMOUNT. If you or the other parent is reques�ng the Court to award a child support amount that is more or less than the child support guidelines, you must complete and ﬁle Mo�on to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943.

[check one only] a. ____ Devia�on from the guidelines amount is requested. The Mo�on to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is atached. b. ____ Devia�on from the guidelines amount is NOT requested. The Mo�on to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is not atached.

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [ﬁll in all blanks] This form was prepared for the: {choose only one} ____ Pe��oner ____ Respondent This form was completed with the assistance of: {name of individual} , {name of business} ____________________________________________________________, {address} ____________________________________________________________________, {city} __________________, {state} ____, {zip code} ______, {telephone number} _________

Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (06/25) of 7 - 60 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.930(a) NOTICE OF SERVICE OF STANDARD FAMILY LAW INTERROGATORIES (06/25) When should this form be used?

You should use this form to tell the court that you are asking the other party in your case to answer certain standard ques�ons in wri�ng. These ques�ons are called interrogatories, and they must relate to your case. The standard family law interrogatories are designed to supplement the informa�on provided in the Financial Aﬃdavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c). You should carefully read the standard interrogatory forms, Florida Family Law Rules of Procedure Form 12.930(b) and (c), to determine which ques�ons, if any, the other party should answer to provide you with informa�on not covered by the ﬁnancial aﬃdavit forms.

This form should be typed or printed in black ink. You must indicate whether you are sending the interrogatories for original and enforcement proceedings or for modiﬁca�on proceedings. You must also indicate which ques�ons you are asking the other party to answer. A�er comple�ng this form, you should ﬁle this document with the clerk of the circuit court in the county where your case was ﬁled and keep a copy for your records.

What should I do next?

You must serve the other party with a copy of this form along with an original and a copy of the appropriate interrogatories, Florida Family Law Rules of Procedure Form 12.930(b) or (c), if service is by mail or hand delivery. You must serve a copy of this form and a copy of the interrogatories if service is by email. Service must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

You may want to inform the other party of the following information: As a general rule, within 30 days a�er service of interrogatories, the other party must answer the ques�ons in wri�ng and serve you with the answers. Service of the answers must be in compliance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516. His or her answers may be writen on as many separate sheets of paper as necessary. He or she should number each page and indicate which ques�on(s) he or she is answering, and be sure to make a copy for him/herself. All answers to these ques�ons must be signed under penal�es of perjury as to their truthfulness. Each ques�on must be answered separately and as completely as the available informa�on permits. The original of the answers to the interrogatories is to be provided to the reques�ng party. Do not ﬁle the original or a copy with the clerk of the circuit court except as provided in Florida Family Law Rule of Procedure 12.340(d).

The other party may object to a ques�on by wri�ng the legal reason for the objec�on in the space provided. He or she may also ask the court for a protec�ve order gran�ng him or her permission not to answer certain ques�ons and protec�ng him or her from annoyance, embarrassment, apprehension, or undue burden or expense. If the other party fails to either answer or object to the ques�ons within 30 days, he or she may be subject to court sanc�ons.

Instructions for Florida Family Law Rules of Procedure Form 12.930(a), Notice of Service of Standard Family Law Interrogatories (06/25) of 3 - 61 - Where can I look for more information?

Before proceeding, you should read General Informa�on for Self-Represented Li�gants found at the beginning of these forms. The words that are bold and underlined in these instruc�ons are deﬁned there.

For further informa�on, see Florida Family Law Rules of Procedure 12.280, 12.285, 12.340, and 12.380.

A copy of this form must be ﬁled with the court and served on the other party or his or her atorney. The copy you are serving to the other party must be either mailed, e-mailed, or hand-delivered to the opposing party or his or her atorney on the same day indicated on the cer�ﬁcate of service. If it is mailed, it must be postmarked on the date indicated in the cer�ﬁcate of service. Service must be in accordance with Florida Rules of General Prac�ce and Judicial Administra�on 2.516.

Instructions for Florida Family Law Rules of Procedure Form 12.930(a), Notice of Service of Standard Family Law Interrogatories (06/25) of 3 - 62 - Special notes . . .

Remember, a person who is NOT an atorney is called a nonlawyer. If a nonlawyer helps you ﬁll out these forms, that person must give you a copy of Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you ﬁll out these forms also must put his or her name, address, and telephone number on the botom of the last page of every form he or she helps you complete.

Instructions for Florida Family Law Rules of Procedure Form 12.930(a), Notice of Service of Standard Family Law Interrogatories (06/25) of 3 - 63 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Pe��oner, and , Respondent.

NOTICE OF SERVICE OF STANDARD FAMILY LAW INTERROGATORIES I, {full legal name} , have on {date} , served upon {name of person served} , to be answered under oath within 30 days a�er service, the Standard Family Law Interrogatories for [check one only] ( ) Original or Enforcement Proceedings ( ) Modiﬁca�on Proceedings I am reques�ng that the following standard ques�ons be answered: [check all that apply] ______ 1 ____ 2 ____ 3 _ __ 4 _ ___ 5 _____ 6 ____ 7 Background Educa�on Employment Assets Liabili�es Miscellaneous Long Form Informa�on Aﬃdavit In addi�on, I am reques�ng that the atached {#} ques�ons be answered.

I cer�fy that a copy of this document was [check all used]: ( ) emailed ( ) mailed ( ) hand delivered to the person(s) listed below on {date} ______________.

Other party or his/her atorney: Name: Address: City, State, Zip: Telephone Number: Email Address(es): _ _____ ____________________________________ Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: Email Address(es): Florida Family Law Rules of Procedure Form 12.930(a), Notice of Service of Standard Family Law Interrogatories (06/25) of 2 - 64 - IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [ﬁll in all blanks] This form was prepared for: {choose only one} _____ Pe��oner _____ Respondent This form was completed with the assistance of: {name of individual} , {name of business} , {address} , {city} __________________, {state} ____, {zip code} ______, {telephone number} .

Florida Family Law Rules of Procedure Form 12.930(a), Notice of Service of Standard Family Law Interrogatories (06/25) of 2 - 65 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.930(b) STANDARD FAMILY LAW INTERROGATORIES FOR ORIGINAL OR ENFORCEMENT PROCEEDINGS (06/25) When should this form be used?

This form should be used to ask the other party in your case to answer certain standard ques�ons in wri�ng. These ques�ons are called interrogatories, and they must relate to your case. If the other party fails to answer the ques�ons, you may ask the court to order the other party to answer the ques�ons. (You cannot ask these ques�ons before the pe��on has been ﬁled.)

The ques�ons in this form should be used in original proceedings or enforcement proceedings and are meant to supplement the informa�on provided in the Financial Aﬃdavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c). You should read all of the ques�ons in this form to determine which ques�ons, if any, the other party should answer to provide you with informa�on not covered in the ﬁnancial aﬃdavit forms. If there are ques�ons to which you already know the answer, you may choose not to ask them.

This form should be typed or printed in black ink. You must complete the box at the beginning of this form to indicate which ques�ons you are reques�ng that the other party answer.

You must serve the other party with this document and a copy of these interrogatories and a copy of the No�ce of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a), if by mail or hand delivery. You must serve these interrogatories and a copy of the No�ce, if by email. Service must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

You should also keep a copy for your records. You should not ﬁle this form with the clerk of the circuit court. However, you must ﬁle the No�ce of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure 12.930(a), to tell the court that you have sent this form to the other party.

Where can I look for more information?

Before proceeding, you should read General Informa�on for Self-Represented Li�gants found at the beginning of these forms. The words that are in bold and underlined in these instruc�ons are deﬁned there. For further informa�on, see the instruc�ons for No�ce of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a) and Florida Family Law Rules of Procedure 12.280, 12.285, 12.340, and 12.380.

Instructions for Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 3 - 66 - IMPORTANT INFORMATION REGARDING E-FILING The Florida Rules of General Prac�ce and Judicial Administra�on require that all pe��ons, pleadings, and documents be ﬁled electronically except in certain circumstances. Self- represented li�gants may ﬁle pe��ons or other pleadings or documents electronically; however, they are not required to do so. If you choose to ﬁle your pleadings or other documents electronically, you must do so in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.525, and you must follow the procedures of the judicial circuit in which you ﬁle.

The rules and procedures should be carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION A�er the ini�al service of process of the pe��on or supplemental pe��on by the Sheriﬀ or cer�ﬁed process server, the Florida Rules of General Prac�ce and Judicial Administra�on require that all documents required or permited 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 Florida Rules of General Prac�ce and Judicial Administra�on. If you elect to par�cipate 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 General Prac�ce and Judicial Administra�on 2.516. You may ﬁnd this rule at www.ﬂcourts.org through the link to the Rules of General Prac�ce and Judicial Administra�on provided under either Family Law Forms: Ge�ng Started, or Rules of Court in the A-Z Topical Index.

Special notes . . .

In addi�on to the standard ques�ons in this form, you may ask up to 10 addi�onal ques�ons. You should type or print legibly your addi�onal ques�ons on a separate sheet of paper and atach it to this form. If you want to ask more than 10 addi�onal ques�ons, you will need to get permission from the court.

You may want to inform the other party of the following informa�on: As a general rule, within days a�er service of interrogatories, the other party must answer the ques�ons in wri�ng and Instructions for Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 3 - 67 - serve you with the answers. Service of the answers must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516. His or her answers may be writen in the blank space provided a�er each separately numbered interrogatory. If suﬃcient space is not provided, the answering party may atach addi�onal papers with the answers and refer to them in the space provided in the interrogatories. He or she should be sure to make a copy for him/herself. All answers to these ques�ons must be made under penal�es of perjury as to their truthfulness. Each ques�on must be answered separately and as completely as the available informa�on permits.

The answers to the interrogatories are to be provided to the reques�ng party. DO NOT FILE THIS DOCUMENT WITH THE CLERK OF THE COURT EXCEPT AS PROVIDED BY FLORIDA FAMILY LAW RULE OF PROCEDURE 12.340(d) AND IN ACCORDANCE WITH THE REQUIREMENTS OF FLORIDA RULE OF GENERAL PRACTICE AND JUDICIAL ADMINISTRATION 2.425. The other party may object to a ques�on by wri�ng the legal reason for the objec�on in the space provided. He or she may also ask the court for a protec�ve order gran�ng him or her permission not to answer certain ques�ons and protec�ng him or her from annoyance, embarrassment, apprehension, or undue burden or expense. If the other party fails to either answer or object to the ques�ons within 30 days, he or she may be subject to court sanc�ons.

Instructions for Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 3 - 68 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA

Case No.: Division: , Pe��oner, and , Respondent.

STANDARD FAMILY LAW INTERROGATORIES FOR ORIGINAL OR ENFORCEMENT PROCEEDINGS TO BE COMPLETED BY THE PARTY SERVING THESE INTERROGATORIES I am reques�ng that the following standard ques�ons be answered: [check all that apply] ____1 ____2 ____3 ____4 ____ 5 _____6 _____7 Background Educa�on Employment Assets Liabili�es Miscellaneous Long Form Informa�on Aﬃdavit In addi�on, I am reques�ng that the atached {#} _________________ ques�ons be answered.

The answers to the following ques�ons are intended to supplement the informa�on provided in the Financial Aﬃdavits, Florida Family Law Rules of Procedure Form 12.902(b) or (c). You should answer the group of ques�ons indicated in the above shaded box. The ques�ons should be answered in the blank space provided below each separately numbered ques�on. If suﬃcient space is not provided, you may atach addi�onal papers with the answers and refer to them in the space provided in the interrogatories. You should be sure to make a copy for yourself. Each ques�on must be answered separately and as completely as the available informa�on permits. All answers are to be made under oath or aﬃrma�on as to their truthfulness.

AFTER YOU ANSWER THE INTERROGATORIES, DO NOT FILE THIS DOCUMENT WITH THE CLERK OF THE COURT. ALL PERSONAL INFORMATION CONTAINED IN THE COURT FILE BECOMES PUBLIC RECORD.

INSTEAD, SERVE THE ANSWERS TO THE INTERROGATORIES ON THE OTHER PARTY AND FILE FORM 12.930(d), NOTICE OF SERVICE OF ANSWERS TO INTERROGATORIES, WITH THE CLERK.

I, {name of person answering interrogatories} , being sworn, cer�fy that the following informa�on is true:

Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 8 - 69 - 1. BACKGROUND INFORMATION: a. State your full legal name and any other name by which you have been known. b. State your present residence and telephone numbers.

2. EDUCATION: a. List all business, commercial, and professional licenses that you have obtained. b. List all of your educa�on including, but not limited to, voca�onal or specialized training, including the following: (1) name and address of each educa�onal ins�tu�on. (2) dates of atendance. (3) degrees or cer�ﬁcates obtained or an�cipated dates of same.

3. EMPLOYMENT: a. For each place of your employment or self-employment during the last 3 years, state the following: (1) name, address, and telephone number of your employer. (2) dates of employment. (3) job �tle and brief descrip�on of job du�es. (4) star�ng and ending salaries. (5) name of your direct supervisor. (6) all beneﬁts received, including, for example, health, life, and disability insurance; expense account; use of automobile or automobile expense reimbursement; reimbursement for travel, food, or lodging expenses; payment of dues in any clubs or associa�ons; and pension or proﬁt sharing plans.

b. Other than as an employee, if you have been engaged in or associated with any business, commercial, or professional ac�vity within the last 3 years that was not detailed above, state for each such ac�vity the following: (1) name, address, and telephone number of each ac�vity. (2) dates you were connected with such ac�vity. (3) posi�on �tle and brief descrip�on of ac�vi�es. (4) star�ng and ending compensa�on. (5) name of all persons involved in the business, commercial, or professional ac�vity with you. (6) all beneﬁts and compensa�on received, including, for example, health, life, and disability insurance; expense account; use of automobile or automobile expense reimbursement; reimbursement for travel, food, or lodging expenses; payment of dues in any clubs or associa�ons; and pension or proﬁt sharing plans.

c. If you have been unemployed at any �me during the last 3 years, state the dates of unemployment. If you have not been employed at any �me in the last 3 years, give the informa�on requested above in ques�on 3.a for your last period of employment.

4. ASSETS: a. Real Estate. State the street address, if any, and if not, the legal descrip�on of all real property that you own or owned during the last 3 years. For each property, state the following: Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 8 - 70 - (1) the names and addresses of any other persons or entities holding any interest and their percentage of interest. (2) the purchase price, the cost of any improvements made since it was purchased, and the amount of any deprecia�on taken. (3) the fair market value on the date of your separa�on from your spouse. (4) the fair market value on the date of the ﬁling of the pe��on for dissolu�on of marriage.

b. Tangible Personal Property. List all items of tangible personal property that are owned by you or in which you have had any interest during the last 3 years including, but not limited to, motor vehicles, tools, furniture, boats, jewelry, art objects or other collec�ons, and collec�bles whose fair market value exceeds $100. For each item, state the following: (1) the percentage and type interest you hold. (2) the names and addresses of any other persons or en��es holding any interest. (3) the date you acquired your interest. (4) the purchase price. (5) the present fair market value. (6) the fair market value on the date of your separa�on from your spouse. (7) the fair market value on the date of the filing of the petition for dissolution of marriage.

c. Intangible Personal Property. Other than the financial accounts (checking, savings, money market, credit union accounts, retirement accounts, or other such cash management accounts) listed in the answers to interrogatories 4.d and 4.e below, list all items of intangible personal property that are owned by you or in which you have had any ownership interest (including closed accounts) within the last 3 years, including but not limited to, partnership and business interests (including good will), deferred compensation accounts unconnected with retirement, including but not limited to stock options, sick leave, and vacation pay, stocks, stock funds, mutual funds, bonds, bond funds, real estate investment trust, receivables, certificates of deposit, notes, mortgages, and debts owed to you by another entity or person. For each item, state the following: (1) the percentage and type interest you hold. (2) the names and addresses of any other persons or en��es holding any interest and the names and addresses of the persons and en��es who are indebted to you. (3) the date you acquired your interest. (4) the purchase price, acquisi�on cost, or loaned amount. (5) the fair market value or the amounts you claim are owned by or owed to you: (a) presently, at the �me of answering these interrogatories. (b) on the date of your separa�on from your spouse. (c) on the date of the ﬁling of the pe��on for dissolu�on of marriage.

You may comply with this interrogatory (4.c) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding years. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. However, if the date of acquisi�on, the purchase price and the market valua�ons are not clearly reﬂected in the periodic statements which are furnished then these ques�ons must be answered separately.

You do not have to resubmit any periodic statements previously furnished under rule 12.285 (Mandatory Disclosure).

Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 8 - 71 - d. Re�rement Accounts: List all informa�on regarding each re�rement account/plan, including but not limited to deﬁned beneﬁt plans, 401k, 403B, IRA accounts, pension plans, Florida Re�rement System plans (FRS), Federal Government plans, money purchase plans, HR10 (Keogh) plans, proﬁt sharing plans, annui�es, employee savings plans, etc. that you have established and/or that have been established for you by you, your employer, or any previous employer. For each account, state the following: (1) the name and last 4 digits of the account number of each account/plan and where it is located. (2) the type of account/plan. (3) the name and address of the ﬁduciary plan administrator/service representa�ve. (4) the fair market value of your interest in each account/plan. (a) present value. (b) value on the date of separa�on. (c) value on the date of ﬁling of the pe��on for dissolu�on of marriage (5) whether you are vested or not vested; and if vested, in what amount, as of a certain date and the schedule of future ves�ng. (6) the date at which you became/become eligible to receive some funds in this account/plan. (7) monthly beneﬁts of the account/plan if no fair market value is ascertained. (8) beneﬁciary(ies) and/or alternate payee(s).

e. Financial Accounts. For all ﬁnancial accounts (checking, savings, money market, credit union accounts, or other such cash management accounts) listed in your Financial Aﬃdavit, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of each ins�tu�on. (2) name in which the account is or was maintained. (3) the last 4 digits of account numbers. (4) name of each person authorized to make withdrawals from the accounts. (5) highest balance within each of the preceding 3 years. (6) lowest balance within each of the preceding 3 years.

You may comply with this interrogatory (4.e) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding years. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. You do not have to resubmit account statements previously furnished pursuant to rule 12.285 (Mandatory Disclosure).

f. Closed Financial Accounts. For all ﬁnancial accounts (checking, savings, money market, credit union accounts, or other such cash management accounts) closed within the last 3 years, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of each ins�tu�on. (2) name in which the account is or was maintained.

Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 8 - 72 - (3) the last 4 digits of account numbers. (4) name of each person authorized to make withdrawals from the accounts. (5) date account was closed.

g. Trust. For any interest in an estate, trust, insurance policy, or annuity, state the following: (1) If you are the beneﬁciary of any estate, trust, insurance policy, or annuity, give for each one the following: (a) iden�ﬁca�on of the estate, trust, insurance policy, or annuity. (b) the nature, amount, and frequency of any distribu�ons of beneﬁts. (c) the total value of the beneﬁciaries’ interest in the beneﬁt. (d) whether the beneﬁt is vested or con�ngent. (2) If you have established any trust or are the trustee of a trust, state the following: (a) the date the trust was established. (b) the names and addresses of the trustees. (c) the names and addresses of the beneﬁciaries. (d) the names and addresses of the persons or en��es who possess the trust documents. (e) each asset that is held in each trust, with its fair market value.

h. Canceled Life Insurance Policies. For all policies of life insurance within the preceding 3 years that you no longer hold, own, or have any interest in, state the following: (1) name of company that issued the policy and last 4 digits of policy number. (2) name, address, and telephone number of agent who issued the policy. (3) amount of coverage. (4) name of insured. (5) name of owner of policy. (6) name of beneﬁciaries. (7) premium amount. (8) date the policy was surrendered. (9) amount, if any, of monies distributed to the owner.

i. Name of Accountant, Bookkeeper, or Records Keeper. State the names, addresses, and telephone numbers of your accountant, bookkeeper, and any other persons who possess your ﬁnancial records, and state which records each possesses.

j. Safe Deposit Boxes, Lock Boxes, Vaults, Etc. For all safe deposit boxes, lock boxes, vaults, or similar types of depositories, state the following: (1) The names and addresses of all banks, depositories, or other places where, at any �me during the period beginning 3 years before the ini�a�on of the ac�on, un�l the date of your answering this interrogatory, you did any of the following: (a) had a safe deposit box, lock box, or vault. (b) were a signatory or co-signatory on a safe deposit box, lock box, or vault. (c) had access to a safe deposit box, lock box, or vault. (d) maintained property. (2) The box or iden�ﬁca�on numbers and the name and address of each person who has had access to any such depository during the same �me period. (3) All persons who have possession of the keys or combina�on to the safe deposit box, lock box, or vault.

Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 8 - 73 - (4) Any items removed from any safe deposit boxes, lock boxes, vaults, or similar types of depositories by you or your agent during that time, together with the present location and fair market value of each item. (5) All items in any safe deposit boxes, lock boxes, vaults, or similar types of depositories and fair market value of each item.

5. LIABILITIES: a. Loans, Liabili�es, Debts, and Other Obliga�ons. For all loans, liabili�es, debts, and other obliga�ons (other than credit cards and charge accounts) listed in your Financial Aﬃdavit, indicate for each the following: (1) name and address of the creditor. (2) name in which the obliga�on is or was incurred. (3) last 4 digits of the loan or account number, if any. (4) nature of the security, if any. (5) payment schedule. (6) present balance and current status of your payments. (7) total amount of arrearage, if any. (8) balance on the date of your separa�on from your spouse. (9) balance on the date of the ﬁling of the pe��on for dissolu�on of marriage.

You may comply with this interrogatory (5.a) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding years. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure).

b. Credit Cards and Charge Accounts. For all ﬁnancial accounts (credit cards, charge accounts, or other such accounts) listed in your Financial Aﬃdavit, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of the creditor. (2) name in which the account is or was maintained. (3) names of each person authorized to sign on the accounts. (4) last 4 digits of account numbers. (5) present balance and current status of your payments. (6) total amount of arrearage, if any. (7) balance on the date of your separa�on from your spouse. (8) balance on the date of the ﬁling of the pe��on for dissolu�on of marriage. (9) highest and lowest balance within each of the preceding 3 years.

You may comply with this interrogatory (5.b) by providing copies of all periodic (monthly quarterly, semi-annual, or annual) account statements for each such account for the preceding 3 years. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure).

c. Closed Credit Cards and Charge Accounts. For all ﬁnancial accounts (credit cards, charge accounts, or other such accounts) closed with no remaining balance, within the last 3 years, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 8 - 74 - (1) name and address of each creditor. (2) name in which the account is or was maintained. (3) last 4 digits of account numbers. (4) names of each person authorized to sign on the accounts. (5) date the balance was paid oﬀ. (6) amount of ﬁnal balance paid oﬀ.

You may comply with this interrogatory (5.c) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding years. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure).

6. MISCELLANEOUS: a. If you are claiming an unequal distribu�on of marital property or enhancement or apprecia�on of nonmarital property, state the amount claimed and all facts upon which you rely in your claim. b. If you are claiming an asset or liability is nonmarital, list the asset or liability and all facts upon which you rely in your claim. c. If the mental or physical condi�on of a spouse or child is an issue, iden�fy the person and state the name and address of all health care providers involved in the treatment of that person for said mental or physical condi�on. d. Detail your proposed paren�ng plan for the minor child(ren), including your proposed �me-sharing schedule. Alterna�vely, atach a copy of your proposed paren�ng plan. e. If you are claiming that the other parent’s �me-sharing with the minor child(ren) should be limited, supervised, or otherwise restricted, or that you should have sole parental responsibility for the minor child(ren), with or without �me-sharing with the other parent, or that you should have ul�mate responsibility over speciﬁc aspects of the child(ren)’s welfare or that these responsibili�es should be divided between you and the other parent, state your reasons and all facts which you rely upon to support your claim.

7. LONG FORM AFFIDAVIT: If you ﬁled the short form aﬃdavit, Florida Family Law Rules of Procedure Form 12.902(b), and you were speciﬁcally requested in the No�ce of Service of Standard Family Law Interrogatories to ﬁle the Long Form Aﬃdavit, Form12.902(c), you must do so within the �me to serve the answers to these interrogatories.

Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 8 - 75 - I cer�fy that a copy of this document was [check all used]: ( ) emailed ( ) mailed ( ) hand delivered to the person(s) listed below on {date} ______________.

Other party or his/her atorney: Name: Address: City, State, Zip: Telephone Number: _______________________ Email Address(es): ________________________ Under penal�es of perjury, I declare that I have read this document and the facts stated in it are true.

Dated: Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: Email Address(es): ___________________________

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [ﬁll in all blanks] This form was prepared for the: {choose only one} _____ Pe��oner _____Respondent This form was completed with the assistance of: {name of individual} ____________________________________________________________________, {name of business} _____________________________________________________________________, {address} ____________________________________________________________________________, {city} ___________________, {state} _____, {zip code} __________, {telephone number} ____________.

Florida Family Law Rules of Procedure Form 12.930(b), Standard Family Law Interrogatories for Original or Enforcement Proceedings (06/25) of 8 - 76 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.930(c) STANDARD FAMILY LAW INTERROGATORIES FOR MODIFICATION PROCEEDINGS (06/25) When should this form be used?

The ques�ons in this form should be used in modiﬁca�on proceedings and are meant to supplement the informa�on provided in the Financial Aﬃdavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c). You should read all of the ques�ons in this form to determine which ques�ons, if any, the other party should answer to provide you with informa�on not covered in the ﬁnancial aﬃdavit forms. If there are ques�ons to which you already know the answer, you may choose not to ask them.

This form should be typed or printed in black ink. You must complete the box at the beginning of this form to indicate which ques�ons you are reques�ng that the other party answer.

You should also keep a copy for your records. You should not ﬁle this form with the clerk of the circuit court. However, you must ﬁle the No�ce of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a), to tell the court that you have sent this form to the other party.

A�er you receive the completed answers to the interrogatories, DO NOT FILE THIS DOCUMENT WITH THE CLERK OF THE COURT UNLESS THE ANSWERS ARE ADMITTED INTO EVIDENCE BY THE COURT AND ARE IN COMPLIANCE WITH FLORIDA RULE OF GENERAL PRACTICE AND JUDICIAL ADMINISTRATION 2.425.

Instructions for Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 3 - 77 - Where can I look for more information?

For further informa�on, see the instruc�ons for No�ce of Service of Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(a) and Florida Family Law Rules of Procedure 12.280, 12.285, 12.340, and 12.380.

IMPORTANT INFORMATION REGARDING E-FILING The Florida Rules of General Prac�ce and Judicial Administra�on require that all pe��ons, pleadings, and documents be ﬁled electronically except in certain circumstances. Self- represented li�gants may ﬁle pe��ons or other pleadings or documents electronically; however, they are not required to do so. If you choose to ﬁle your pleadings or other documents electronically, you must do so in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.525, and you must follow the procedures of the judicial circuit in which you ﬁle.

The rules and procedures should be carefully read and followed.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION A�er the ini�al service of process of the pe��on or supplemental pe��on by the Sheriﬀ or cer�ﬁed process server, the Florida Rules of General Prac�ce and Judicial Administra�on require that all documents required or permited 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 Florida Rules of General Prac�ce and Judicial Administra�on. If you elect to par�cipate 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 General Prac�ce and Judicial Administra�on 2.516. You may ﬁnd this rule at www.ﬂcourts.org through the link to the Rules of General Prac�ce and Judicial Administra�on provided under either Family Law Forms: Ge�ng Started, or Rules of Court in the A-Z Topical Index.

Instructions for Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 3 - 78 - Special notes . . .

You may want to inform the other party of the following informa�on: As a general rule, within days a�er service of interrogatories, the other party must answer the ques�ons in wri�ng and serve you with the answers. Service of the answers must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516. His or her answers may be writen in the blank space provided a�er each separately numbered interrogatory. If suﬃcient space is not provided, the answering party may atach addi�onal papers with the answers and refer to them in the space provided in the interrogatories. He or she should be sure to make a copy for him/herself. All answers to these ques�ons must be made under penal�es of perjury as to their truthfulness. Each ques�on must be answered separately and as completely as the available informa�on permits.

The answers to the interrogatories are to be provided to the reques�ng party. DO NOT FILE THIS DOCUMENT WITH THE CLERK OF THE CIRCUIT COURT UNLESS THE ANSWERS ARE ADMITTED INTO EVIDENCE BY THE COURT AND ARE IN COMPLIANCE WITH THE REQUIREMENTS OF FLORIDA RULE OF GENERAL PRACTICE AND JUDICIAL ADMINISTRATION 2.425. The other party may object to a ques�on by wri�ng the legal reason for the objec�on in the space provided. He or she may also ask the court for a protec�ve order gran�ng him or her permission not to answer certain ques�ons and protec�ng him or her from annoyance, embarrassment, apprehension, or undue burden or expense. If the other party fails to either answer or object to the ques�ons within days, he or she may be subject to court sanc�ons.

Instructions for Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 3 - 79 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA

Case No.: Division: , Pe��oner, and , Respondent.

STANDARD FAMILY LAW INTERROGATORIES FOR MODIFICATION PROCEEDINGS TO BE COMPLETED BY THE PARTY SERVING THESE INTERROGATORIES I am reques�ng that the following standard ques�ons be answered: [check all that apply] ____1 ____2 ____3 ____4 ____ 5 ____6 ____7 Background Educa�on Employment Assets Liabili�es Miscellaneous Long Form Informa�on Aﬃdavit In addi�on, I am reques�ng that the atached {#} _________________ ques�ons be answered.

You should be sure to make a copy for yourself. Each ques�on must be answered separately and as completely as the available informa�on permits. All answers are to be made under oath or aﬃrma�on as to their truthfulness.

AFTER YOU ANSWER THE INTERROGATORIES, DO NOT FILE THIS DOCUMENT WITH THE CLERK OF THE COURT. ALL PERSONAL INFORMATION CONTAINED IN THE COURT FILE BECOMES PUBLIC RECORD.

INSTEAD, SERVE THE ANSWERS TO THE INTERROGATORIES ON THE OTHER PARTY AND FILE FORM 12.930(d), NOTICE OF SERVICE OF ANSWERS TO INTERROGATORIES, WITH THE CLERK.

I, {name of person answering interrogatories} , being sworn, cer�fy that the following informa�on is true:

Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 8 - 80 - 1. BACKGROUND INFORMATION: a. State your full legal name and any other name by which you have been known. b. State your present residence and telephone numbers.

2. EDUCATION: a. List all business, commercial, and professional licenses that you have obtained since the entry of the Final Judgment sought to be modiﬁed.

b. List all of your educa�on since the entry of the Final Judgment sought to be modiﬁed including, but not limited to, voca�onal or specialized training, including the following: (1) name and address of each educa�onal ins�tu�on. (2) dates of atendance. (3) degrees or cer�ﬁcates obtained or an�cipated dates of same.

3. EMPLOYMENT: a. For each place of your employment or self-employment since the entry of the Final Judgment sought to be modiﬁed, state the following: (1) name, address, and telephone number of your employer. (2) dates of employment. (3) job �tle and brief descrip�on of job du�es. (4) star�ng and ending salaries. (5) name of your direct supervisor. (6) all beneﬁts received, including, for example, health, life, and disability insurance; expense account; use of automobile or automobile expense reimbursement; reimbursement for travel, food, or lodging expenses; payment of dues in any clubs or associa�ons; and pension or proﬁt sharing plans.

b. Other than as an employee, if you have been engaged in or associated with any business, commercial, or professional ac�vity since the entry of the Final Judgment sought to be modiﬁed that was not detailed above, state for each such ac�vity the following: (1) name, address, and telephone number of each ac�vity. (2) dates you were connected with such ac�vity. (3) posi�on �tle and brief descrip�on of ac�vi�es. (4) star�ng and ending compensa�on. (5) name of all persons involved in the business, commercial, or professional ac�vity with you. (6) all beneﬁts and compensa�on received, including, for example, health, life, and disability insurance; expense account; use of automobile or automobile expense reimbursement; reimbursement for travel, food, or lodging expenses; payment of dues in any clubs or associa�ons; and pension or proﬁt sharing plans.

Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 8 - 81 - c. If you have been unemployed at any �me since the entry of the Final Judgment sought to be modiﬁed, state the dates of unemployment. If you have not been employed at any �me since the entry of the Final Judgment sought to be modiﬁed, give the informa�on requested above in ques�on 3.a for your last period of employment.

4. ASSETS: a. Real Estate. State the street address, if any, and if not, the legal descrip�on of all real property that you own or owned during the last 3 years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter. For each property, state the following: (1) the names and addresses of any other persons or en��es holding any interest and their percentage of interest. (2) the present fair market value.

b. Tangible Personal Property. List all items of tangible personal property that are owned by you or in which you have had any interest during the last 3 years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter, including, but not limited to, motor vehicles, tools, furniture, boats, jewelry, art objects or other collec�ons, and collec�bles whose fair market value exceeds $100. For each item, state the following: (1) the percentage and type interest you hold. (2) the names and addresses of any other persons or en��es holding any interest. (3) the present fair market value.

c. Intangible Personal Property. Other than the financial accounts (checking, savings, money market, credit union accounts, retirement accounts, or other such cash management accounts) listed in the answers to interrogatories 4.d and 4.e below, list all items of intangible personal property that are owned by you or in which you have had any ownership interest (including closed accounts) within the last 3 years, or since the entry of the Final Judgment sought to be modified, if shorter, including but not limited to, partnership and business interests (including good will), deferred compensation accounts unconnected with retirement, including but not limited to stock options, sick leave, and vacation pay, stocks, stock funds, mutual funds, bonds, bond funds, real estate investment trust, receivables, certificates of deposit, notes, mortgages, and debts owed to you by another entity or person. For each item, state the following: (1) the percentage and type interest you hold. (2) the names and addresses of any other persons or en��es holding any interest and the names and addresses of the persons and en��es who are indebted to you (3) the present fair market value or the amounts you claim are owned by or owed to you, at the �me of answering these interrogatories.

You may comply with this interrogatory (4.c) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. However, if the date of acquisi�on, the purchase price and the market valua�ons are not clearly reﬂected in the periodic statements which are furnished, then these ques�ons must be answered separately. You do not have to resubmit any periodic statements previously furnished under rule 12.285 (Mandatory Disclosure).

Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 8 - 82 - d. Re�rement Accounts: List all informa�on regarding each re�rement account/plan, including but not limited to deﬁned beneﬁt plans, 401k, 403B, IRA accounts, pension plans, Florida Re�rement System plans (FRS), Federal Government plans, money purchase plans, HR10 (Keogh) plans, proﬁt sharing plans, annui�es, employee savings plans, etc. that you have established and/or that have been established for you by you, your employer, or any previous employer. For each account, state the following: (1) the name and last 4 digits of the account number of each account/plan and where it is located. (2) the type of account/plan. (3) the name and address of the ﬁduciary plan administrator/service representa�ve. (4) the present fair market value of your interest in each account/plan. (5) whether you are vested or not vested; and if vested, in what amount, as of a certain date and the schedule of future ves�ng. (6) the date at which you became/become eligible to receive some funds in this account/plan. (7) monthly beneﬁts of the account/plan if no fair market value is ascertained. (8) beneﬁciary(ies) and/or alternate payee(s).

e. Financial Accounts. For all ﬁnancial accounts (checking, savings, money market, credit union accounts, or other such cash management accounts) listed in your Financial Aﬃdavit, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of each ins�tu�on. (2) name in which the account is or was maintained. (3) last 4 digits of account numbers. (4) name of each person authorized to make withdrawals from the accounts. (5) highest balance within each of the preceding 3 years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter. (6) lowest balance within each of the preceding 3 years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter.

You may comply with this interrogatory (4.e) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. You do not have to resubmit account statements previously furnished pursuant to rule 12.285 (Mandatory Disclosure).

f. Closed Financial Accounts. For all ﬁnancial accounts (checking, savings, money market, credit union accounts, or other such cash management accounts) closed within the last 3 years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter, in which you have had Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 8 - 83 - any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of each ins�tu�on. (2) name in which the account is or was maintained. (3) last 4 digits of account numbers. (4) name of each person authorized to make withdrawals from the accounts. (5) date account was closed.

g. Trust. For any interest in an estate, trust, insurance policy, or annuity, state the following: (1) If you are the beneficiary of any estate, trust, insurance policy, or annuity, give for each one the following: (a) iden�ﬁca�on of the estate, trust, insurance policy, or annuity. (b) the nature, amount, and frequency of any distribu�ons of beneﬁts. (c) the total value of the beneﬁciaries’ interest in the beneﬁt. (d) whether the beneﬁt is vested or con�ngent. (2) If you have established any trust or are the trustee of a trust, state the following: (a) the date the trust was established. (b) the names and addresses of the trustees. (c) the names and addresses of the beneﬁciaries. (d) the names and addresses of the persons or en��es who possess the trust documents. (e) each asset that is held in each trust, with its fair market value.

h. Name of Accountant, Bookkeeper, or Records Keeper. State the names, addresses, and telephone numbers of your accountant, bookkeeper, and any other persons who possess your ﬁnancial records, and state which records each possesses.

5. LIABILITIES: a. Loans, Liabili�es, Debts, and Other Obliga�ons. For all loans, liabili�es, debts, and other obliga�ons (other than credit cards and charge accounts) listed in your Financial Aﬃdavit, indicate for each the following: (1) name and address of the creditor. (2) name in which the obliga�on is or was incurred. (3) last 4 digits of loan or account number, if any. (4) nature of the security, if any. (5) payment schedule. (6) present balance and current status of your payments. (7) total amount of arrearage, if any.

You may comply with this interrogatory (5.a) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure).

Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 8 - 84 - b. Credit Cards and Charge Accounts. For all ﬁnancial accounts (credit cards, charge accounts, or other such accounts) listed in your Financial Aﬃdavit, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of the creditor. (2) name in which the account is or was maintained. (3) names of each person authorized to sign on the accounts. (4) last 4 digits of account numbers. (5) present balance and current status of your payments. (6) total amount of arrearage, if any. (7) highest and lowest balance within each of the preceding 3 years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter.

You may comply with this interrogatory (5.b) by providing copies of all periodic (monthly quarterly, semi-annual, or annual) account statements for each such account for the preceding years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure).

c. Closed Credit Cards and Charge Accounts. For all ﬁnancial accounts (credit cards, charge accounts, or other such accounts) closed with no remaining balance, within the last 3 years, or since the entry of the Final Judgment sought to be modiﬁed, in which you have had any legal or equitable interest, regardless of whether the interest is or was held in your own name individually, in your name with another person, or in any other name, give the following: (1) name and address of each creditor. (2) name in which the account is or was maintained. (3) last 4 digits of account numbers. (4) name of each person authorized to sign on the accounts. (5) date the balance was paid oﬀ. (6) amount of ﬁnal balance paid oﬀ.

You may comply with this interrogatory (5.c) by providing copies of all periodic (monthly, quarterly, semi-annual, or annual) account statements for each such account for the preceding years, or since the entry of the Final Judgment sought to be modiﬁed, if shorter. DO NOT FILE THESE DOCUMENTS IN THE COURT FILE. You do not have to resubmit account statements previously furnished under rule 12.285 (Mandatory Disclosure).

6. MISCELLANEOUS: a. If you are claiming a diminished earning capacity since the entry of the Final Judgment sought to be modiﬁed as grounds to modify alimony or deviate from the child support established in your case, describe in detail how your earning capacity is lowered and state all facts upon which you rely in your claim. If unemployed, state how, why, and when you lost your job.

b. If you are claiming a change in mental or physical condi�on since the entry of the Final Judgment sought to be modiﬁed as grounds to modify alimony or change the child support established in your case, describe in detail how your mental and/or physical capacity has changed and state all facts on which you rely in your claim. Iden�fy the change in your mental Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (--/--) of 8 - 85 - and/or physical capacity, and state the name and address of all health care providers involved in the treatment of this mental or physical condi�on.

c. If you are reques�ng a change in shared or sole parental responsibility, ul�mate decision- making, the �me-sharing schedule, the paren�ng plan, or any combina�on thereof, for the minor child(ren), describe in detail the change in circumstances since the entry of the Final Judgment sought to be modiﬁed that you feel jus�fy the requested change. State when the change of circumstances occurred, how the change or circumstances aﬀects the child(ren), and why it is in the best interests of the child(ren) that the Court make the requested change.

Atach your proposed paren�ng plan.

d. If you do not feel the requested change in shared or sole parental responsibility, ul�mate decision-making, the �me-sharing schedule, the paren�ng plan, or any combina�on thereof, for the minor child(ren) is in their best interests, or if you feel there has not been a change in circumstances since the entry of the Final Judgment sought to be modiﬁed, describe in detail any facts since the entry of the Final Judgment sought to be modiﬁed that you feel jus�fy the Court denying the requested change. State what requested change, if any, in shared or sole paren�ng responsibility, ul�mate decision-making, the �me-sharing schedule, or of the paren�ng plan is jus�ﬁed or agreeable to you and why it is in the best interests of the child(ren).

LONG FORM AFFIDAVIT: If you ﬁled the short form aﬃdavit, Florida Family Law Rules of Procedure Form 12.902(b), and you were speciﬁcally requested in the No�ce of Service of Standard Family Law Interrogatories to ﬁle the Long Form Aﬃdavit, Form 12.902(c), you must do so within the �me to serve the answers to these interrogatories.

Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 8 - 86 - I cer�fy that a copy of this document was [check all used]: ( ) emailed ( ) mailed ( ) hand delivered to the person(s) listed below on {date} ____________________________.

Other party or his/her atorney: Name: Address: City, State, Zip: Telephone Number: ______________________ Email Address(es): ________________________ Under penal�es of perjury, I declare that I have read this document and the facts stated in it are true.

Dated: Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: Email Address(es): ____________________________

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [ﬁll in all blanks] This form was prepared for the: {choose only one} _____ Pe��oner _____ Respondent This form was completed with the assistance of: {name of individual} ____________________________________________________________________, {name of business} _____________________________________________________________________, {address} ____________________________________________________________________________, {city} __________________, {state} ______, {zip code} ________, {telephone number} ______________.

Florida Family Law Rules of Procedure Form 12.930(c), Standard Family Law Interrogatories for Modification Proceedings (06/25) of 8 - 87 - INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.932 CERTIFICATE OF COMPLIANCE WITH MANDATORY DISCLOSURE (06/25) When should this form be used?

Mandatory disclosure requires each party in a family mater to provide the other party with certain ﬁnancial informa�on and documents. Within 45 days of service of the ini�al pe��on or supplemental pe��on for modiﬁca�on on the respondent, these documents must be served on the other party. The mandatory disclosure rule applies to all original and supplemental cases, except simpliﬁed dissolu�on of marriage cases and cases where the respondent is served by construc�ve service and does not answer.

You should use this form to no�fy the court and the other party that you have complied with the mandatory disclosure rule.

Each party must provide the other party with the documents listed in sec�on 2 of this form if the relief being sought is permanent regardless of whether it is an ini�al or supplemental proceeding. ONLY THE COMPLETED FORM IS FILED WITH THE COURT. NO OTHER DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER, EXCEPT FOR THE FINANCIAL AFFIDAVIT, UNLESS THE PARTIES HAVE EXECUTED AND FILED FLORIDA FAMILY LAW FORM 12.902(k). THE DOCUMENTS LISTED ON THIS FORM ARE TO BE GIVEN TO THE OTHER PARTY. If your individual gross annual income is under $50,000, you should complete the Family Law Financial Aﬃdavit (Short Form), Florida Family Law Rules of Procedure Form 12.902(b). If your individual gross annual income is $50,000 or more, you should complete the Family Law Financial Aﬃdavit (Long Form), Florida Family Law Rules of Procedure Form 12.902(c).

In addi�on, there are separate mandatory disclosure requirements that apply to temporary ﬁnancial relief hearings, which are listed in sec�on 1 of this form. The party seeking temporary ﬁnancial relief must serve these documents on the other party with the no�ce of temporary ﬁnancial relief hearing. The responding party must serve the required documents on the party seeking temporary relief. Any documents that have already been served under the requirements for temporary or ini�al proceedings do not need to be reserved again in the same proceeding. If a supplemental pe��on is ﬁled, seeking modiﬁca�on, then the mandatory disclosure requirements begin again.

You must state with speciﬁcity the documents that you are producing to the other party. References to account numbers and personal iden�fying informa�on are governed by Florida Rule of General Prac�ce and Judicial Administra�on 2.425, which you should review prior to comple�ng this form.

This form should be typed or printed in black ink. A�er comple�ng this form, you should ﬁle this document with the clerk of the circuit court in the county where your case is ﬁled and keep a copy for your records. A copy of this form must be served on any other party in your case. Service must be in accordance with Florida Rule of General Prac�ce and Judicial Administra�on 2.516.

Instructions for Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (06/25) of 3 - 88 - What should I do next?

A�er you have provided the other party all of the ﬁnancial informa�on and documents and have ﬁled this form cer�fying that you have complied with this rule, you are under a con�nuing duty to promptly give the other party any informa�on or documents that change your ﬁnancial status or that make the informa�on already provided inaccurate. Refer to the instruc�ons regarding the pe��on in your case to determine how you should proceed a�er ﬁling this form.

Where can I look for more information?

Before proceeding, you should read “General Informa�on for Self-Represented Li�gants” found at the beginning of these forms. The words that are in bold and underlined in these instruc�ons are deﬁned there. For further informa�on, see Florida Family Law Rule of Procedure 12.285.

IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION A�er the ini�al service of process of the pe��on or supplemental pe��on by the Sheriﬀ or cer�ﬁed process server, the Florida Rules of General Prac�ce and Judicial Administra�on require that all documents required or permited 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 Florida Rules of General Prac�ce and Judicial Administra�on. If you elect to par�cipate 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 General Prac�ce and Judicial Administra�on 2.516. You may ﬁnd this rule at www.ﬂcourts.org through the link to the Rules of General Prac�ce and Judicial Administra�on provided under either Family Law Forms: Ge�ng Started, or Rules of Court in the A-Z Topical Index.

Instructions for Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (06/25) of 3 - 89 - To serve and receive documents by e-mail, you must designate your e-mail addresses by using the Designa�on 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.

Special notes . . .

You may provide copies of required documents; however, the originals must be produced for inspec�on if the other party requests to see them.

Although the ﬁnancial aﬃdavits are based on individual gross income, either party may ask the other party to complete the Family Law Financial Aﬃdavit (Long Form), Florida Family Law Rules of Procedure Form 12.902(c), by serving the appropriate interrogatory form. (See Standard Family Law Interrogatories, Florida Family Law Rules of Procedure Form 12.930(b) (original proceedings) or (c) (modiﬁca�on proceedings)).

Any por�on of the mandatory disclosure rule may be modiﬁed by order of the court or agreement of the par�es. Therefore, you and the other party may agree that you will not require each other to produce the documents required under the mandatory disclosure rule. This excep�on does not apply to the Financial Aﬃdavit, Family Law Rules of Procedure Form 12.902(b) or (c), which is required in all cases and cannot be waived.

Remember, a person who is NOT an atorney is called a nonlawyer. If a nonlawyer helps you ﬁll 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 ﬁll out these forms also must put his or her name, address, and telephone number on the botom of the last page of every form he or she helps you complete.

Instructions for Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (06/25) of 3 - 90 - IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Pe��oner, and , Respondent.

CERTIFICATE OF COMPLIANCE WITH MANDATORY DISCLOSURE ONLY THE COMPLETED FORM IS FILED WITH THE COURT.

THE DOCUMENTS LISTED BELOW ARE TO BE GIVEN TO THE OTHER PARTY. NO DOCUMENTS SHALL BE FILED IN THE COURT FILE WITHOUT A PRIOR COURT ORDER, EXCEPT THE FINANCIAL AFFIDAVIT, UNLESS THE PARTIES HAVE EXECUTED AND FILED FLORIDA FAMILY LAW FORM 12.902(k).

I, {full legal name} , cer�fy that I have complied with the mandatory disclosure required by Florida Family Law Rule 12.285 as follows: 1. FOR TEMPORARY FINANCIAL RELIEF, ONLY: The date the following documents were served: . [Check all that apply. State with speciﬁcity the documents being produced; if suﬃcient space is not provided, you may atach addi�onal papers with this form and refer to them in the space provided.]

a. ____ Financial Aﬃdavit _____ Florida Family Law Rules of Procedure Form 12.902(b) (short form) _____ Florida Family Law Rules of Procedure Form 12.902(c) (long form) b. ____ All complete federal and state personal income tax, gi� tax, and foreign tax returns for the past 3 years; including all atachments, including IRS forms W-2, 1099, and K-1, and all accompanying schedules and worksheets comprising the en�re tax return; or _____ Transcript of tax return as provided by IRS form 4506-T; or _____ IRS forms W-2, 1099, and K-1 for the past year because the income tax return for the past year has not been prepared; and for any of the prior 2 years beyond the past year if tax returns for any of those years have not been ﬁled.

c.____ Pay stubs or other evidence of earned income for the 6 months before the compliance Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (06/25) of 5 - 91 - with the disclosure requirements for temporary relief. The following are produced: ________________________________________________________________________

2. FOR INITIAL, SUPPLEMENTAL, AND PERMANENT FINANCIAL RELIEF: The date the following documents were served: . [Check all that apply. State with speciﬁcity the documents being produced; if suﬃcient space is not provided, you may atach addi�onal papers with this form and refer to them in the space provided.]

a. ____ Financial Aﬃdavit _____ Florida Family Law Rules of Procedure Form 12.902(b) (short form) _____ Florida Family Law Rules of Procedure Form 12.902(c) (long form) b. ____ All complete federal and state personal income tax, gi� tax, and foreign tax returns, for the past 3 years; including all atachments, including IRS forms W-2, 1099, and K-1, and all accompanying schedules and worksheets comprising the en�re tax return; _____ Transcript of the tax return as provided by IRS form 4506-T; or _____ IRS forms W-2, 1099, and K-1 for the past year because the income tax return for the past year has not been prepared; and for any of the prior 2 years beyond the past year if tax returns for any of those years have not been ﬁled.

c. ____ Pay stubs or other evidence of earned income for the 6 months before the compliance with these disclosure requirements for ini�al or supplemental proceedings. The following are produced: ____________________________________________________ .

d. ____ A statement iden�fying the source and amount of all income for the 6 months before the compliance with these disclosure requirements for ini�al or supplemental proceedings, if not reﬂected on the pay stubs produced. The following are produced: _______________ .

e. ____ All loan applica�ons, ﬁnancial statements, credit reports, or any other form of ﬁnancial disclosure, including ﬁnancial aid forms, prepared for any purpose or used for any purpose within the 24 months preceding the compliance with these disclosure requirements for ini�al or supplemental proceedings. The following are produced:

f. ____ All deeds to real estate in which I presently own or owned an interest within the past 3 years. All promissory notes or other documents evidencing money owed to me or my spouse at any �me within the last 24 months. All leases, whether in my name individually, in my name jointly with any other person or en�ty, in my name as trustee or guardian for a party or a minor or adult dependent child of both par�es, or in someone else’s name on my behalf wherein either party (A) is receiving or has received payments at any �me within the last 3 years, or (B) owns or owned an interest. The Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (06/25) of 5 - 92 - following are produced:

g. ____ All periodic statements for the last 12 months for all checking accounts and for the last year for all savings accounts, money market funds, cer�ﬁcates of deposit, etc., whether in my name individually, in my name jointly with any other person or en�ty, in my name as trustee or guardian for a party or a minor or adult dependent child of both par�es, or in someone else’s name on my behalf; and for all accounts that have check-wri�ng privileges, copies of canceled checks and registers, whether writen or electronically maintained. The following are produced:

h. ____ All brokerage account statements for the last 12 months, in either party’s name individually or jointly with any person or en�ty, or as a trustee or guardian for a party or a minor or adult dependent child of both par�es, or in someone else’s name on my behalf; and for all accounts that have check-wri�ng privileges, copies of canceled checks and registers, whether writen or electronically maintained. The following are produced:

i. ____ Most recent statement and statements for the past 12 months for any pension, proﬁt sharing, deferred compensa�on, or re�rement plan (for example, IRA, 401(k), 403(b), SEP, KEOGH, etc.) and summary plan descrip�on for any such plan in which I am a par�cipant or an alternate payee receiving payments. The following are produced:

j. ____ Most recent statement and statements for the past 12 months for any virtual currency transac�ons in which either party par�cipated within the last 12 months or holds an interest in, either individually, jointly with any other person or en�ty, as trustee or guardian for a party or minor or adult dependent child of both par�es, or in someone else’s name on my behalf, and a lis�ng of all current holdings of virtual currency. The following are produced:

k. ____ The declara�on page, the last periodic statement, statements for the past 12 months and the cer�ﬁcate for any group insurance for all life insurance policies insuring my life or the life of my spouse. The following are produced:

Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (06/25) of 5 - 93 - l. ____ All health and dental insurance cards covering either me or my spouse and/or our dependent child(ren). The following are produced: .

m. ____ Corporate, partnership, and trust tax returns for the last 3 tax years, in which I have an ownership or interest. The following are produced: .

n. ____ All credit card and charge account statements and other records showing my (our) indebtedness as of the date of the ﬁling of this ac�on and for the prior 24 months preceding compliance with these disclosure requirements for ini�al or supplemental proceedings. All promissory notes on which I presently owe or owned within the past 24 months, whether paid or not. All lease agreements I presently owe, either in my name individually, jointly with any other person or en�ty, in my name as trustee or guardian for a party or a minor or adult dependent child of both par�es, or in someone else’s name on my behalf. The following are produced: .

o. ____ All premarital and marital agreements between the par�es to this case, and all aﬃdavits and declara�on of non-paternity or judgments of disestablishment of paternity for any minor or dependent children born or conceived during the marriage. The following are produced: .

p. ____ If a modiﬁca�on proceeding, all writen agreements entered into between the par�es at any �me since the order to be modiﬁed was entered. The following are produced:

q. ____ All documents rela�ng to claims for an unequal distribu�on of marital property, enhancement or apprecia�on in nonmarital property, or nonmarital status of an asset or debt. The following are produced: .

r. ____ Any court order direc�ng that I pay or receive spousal support (alimony) or child support. The following are produced: .

I certify that a copy of this document was [check all used]: ( ) e-mailed ( ) mailed ( ) hand delivered to the person(s) listed below on {date}_____________________________.

Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (06/25) of 5 - 94 - Other party or his/her atorney: Name: Address: City, State, Zip: Telephone Number: E-mail Address(es):

Under penal�es of perjury, I swear or aﬃrm that the above disclosure and statements made in it are complete, accurate, and in compliance with the requirements of Rule 12.285, Fla. Fam. L.R.P. Dated: Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: E-mail Address(es):

Florida Family Law Rules of Procedure Form 12.932, Certificate of Compliance with Mandatory Disclosure (06/25) of 5 - 95 -

Case-law data current through December 31, 2025. Source: CourtListener bulk data.