Petition For Dissolution of Marriage with Dependent or Minor Children. - Broward County
IN THE CIRCUIT COURT OF THE 17th JUDICIAL CIRCUIT,
IN AND FOR BROWARD COUNTY, FLORIDA
Case No.:
Division:
In re: The Marriage of:
______________________________,
Husband,
and
_______________________________,
Wife.
PETITION FOR DISSOLUTION OF MARRIAGE WITH DEPENDENT OR MINOR CHILD(REN)
I, {full legal name} , the
[Choose only one]
( ) Husband ( ) Wife, being sworn, certify that the following statements are true:
1. JURISDICTION/RESIDENCE
( ) Husband ( ) Wife ( ) Both has (have) lived in Florida for at least 6 months before the filing of this Petition for Dissolution of Marriage.
2. The husband [Choose only one] ( ) is ( ) is not a member of the military service.
The wife [Choose only one] ( ) is ( ) is not a member of the military service.
3. MARRIAGE HISTORY
Date of marriage: {month, day, year} ___________________
Date of separation: {month, day, year}__________________ (__Please indicate if approximate)
4. DEPENDENT OR MINOR CHILD(REN)
[Choose all that apply]
a. ___ The wife is pregnant. Baby is due on: {date}
b. ___ The minor (under 18) child(ren) common to both parties are:
Name Birth date
_______________________________________________________________________________
c.___The minor child(ren) born or conceived during the marriage who are not common to both paties are:
Name Birth date
_______________________________________________________________________________
The birth father(s) of the above minor child(ren) is (are) {name and address} ________________
______________________________________________________________________________
d.___The child(ren) common to both parties who are 18 or older but who are dependent upon the parties due to a mental or physical
disability are:
Name Birth date
_______________________________________________________________________________
5. A completed Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c) [choose only one]( ) is filed with this petition or ( ) will be timely filed.
6. A completed Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit, Florida Supreme Court Approved Family Law Form 12.902(d), is filed with this petition. (You must complete and attach this form in a dissolution of marriage with minor child(ren)).
7. A completed Notice of Social Security Number, Florida Supreme Court Approved Family Law Form 12.902(j), is filed with this petition.
8. This petition for dissolution of marriage should be granted because:
[Choose only one]
a. ___ The marriage is irretrievably broken.
b. ___ One of the parties has been adjudged mentally incapacitated for a period of 3 years prior to the filing of this petition. A copy of the Judgment of Incapacity is attached.
SECTION I. MARITAL ASSETS AND LIABILITIES
[Choose only one]
1. ___ There are no marital assets or liabilities.
2. ___ There are marital assets or liabilities. All marital and nonmarital assets and liabilities are (or
will be) listed in the financial affidavits, Florida Family Law Rules of Procedure Form 12.902(b) or (c), filed in this case.
[Choose all that apply]
a. ___ All marital assets and liabilities have been divided by a written agreement between the parties, which is attached, to be incorporated into the final judgment of dissolution of marriage. (The parties may use Marital Settlement Agreement for Dissolution of Marriage with Dependent or Minor Child(ren), Florida Supreme Court Approved Family Law Form 12.902(f)(1).
b. ___ The Court should determine how the assets and liabilities of this marriage are to be distributed, under section 61.075, Florida Statutes.
c. ___ Husband ____Wife should be awarded an interest in the other spouse’s property because:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SECTION II. SPOUSAL SUPPORT (ALIMONY)
1. ___ Husband ____Wife forever gives up his/her right to spousal support (alimony) from the other spouse .
OR
2. ___ Husband _____Wife requests that the Court order the other spouse to pay the following spousal support (alimony) and claims that he or she has an actual need for the support that he or she is requesting and that the other spouse has the ability to pay that support. Spousal support (alimony) is requested in the amount of $________ every ( ) week ( ) other week ( ) month, beginning {date} ___________ and continuing until {date or event} _________________
Explain why the Court should order ____Husband ____Wife to pay, and any specific request(s) for type of alimony (temporary, permanent, bridge-the-gap, durational, rehabilitative, and/or lump sum):
3. ____Other provisions relating to alimony, including any tax treatment and consequences:
____________________________________________________________________________________________________
4. ( ) Husband ( ) Wife requests life insurance on the other spouse’s life, provided by that spouse , to secure such support.
SECTION III. PARENTING PLAN ESTABLISHING PARENTAL RESPONSIBILITY AND TIME-SHARING
1. The minor child(ren) currently reside(s) with ( ) Mother ( ) Father ( ) Other: {explain}
2. Parental Responsibility. It is in the child(ren)’s best interests that parental responsibility be:
[Choose only one]
a. ___ shared by both Father and Mother.
b. ___ awarded solely to ( ) Father ( ) Mother. Shared parental responsibility would be detrimental to the child(ren) because:____________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. Parenting Plan and Time-Sharing. It is in the best interests of the child(ren) that the family be ordered to comply with a Parenting Plan that ( ) includes ( ) does not include parental time-sharing with the child(ren). The Petitioner states that it is in the best interests of the child (ren) that:
[Choose only one]
a. ___ The attached proposed Parenting Plan should be adopted by the court. The parties
[choose only one] ( ) have ( ) have not agreed to the Parenting Plan.
b. ___ The court should establish a Parenting Plan with the following provisions:
___ No time-sharing for the ___ Father___ Mother.
___ Limited time-sharing with the ___Father___Mother.
___ Supervised Time-Sharing for the ___ Father___ Mother.
___ Supervised or third-party exchange of the child(ren).
___ Time-Sharing Schedule as follows:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. Explain why this request is in the best interests of the child(ren): __________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SECTION IV. CHILD SUPPORT
[Choose all that apply]
1. ___ Husband ___Wife requests that the Court award child support as determined by Florida’s child support guidelines, section 61.30, Florida Statutes. A completed Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e), ( ) is, or ( ) will be filed. Such support should be ordered retroactive to:
a. ___ the date of separation {date} ___________.
b. ___ the date of the filing of this petition.
c. ___ other {date} _______ {explain} ___________________________________.
2. ___ Husband ___Wife requests that the Court award child support to be paid beyond the age of 18 years because:
a. ___ the following child(ren) {name(s)}
is (are) dependent because of a mental or physical incapacity which began before the age of 18. {explain}
b. ___ the following child(ren) {name(s)}________________________is (are) dependent in fact, is (are) in high school, and are between the ages of 18 and 19; said child(ren) is (are) performing in good faith with reasonable expectation of graduation before the age of 19.
3. ___Husband ___ Wife requests that the Court award a child support amount that is more than or less than Florida’s child support guidelines and understands that a Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, must be filed before the Court will consider this request.
4. ___Husband ____Wife requests that medical/dental insurance for the minor child(ren) be provided by:
[Choose only one]
a. ___ Husband.
b. ___ Wife.
5. ___Husband ___ Wife requests that uninsured medical/dental expenses for the child(ren) be paid:
[ Choose only one]
a. ___by Husband.
b. ___by Wife .
c. ___by Husband and Wife equally [each pay one-half].
d. ___according to the percentages in the Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e).
e. ___Other {explain}: __________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6. _____Husband ____Wife requests that life insurance to secure child support be provided by the other spouse.
SECTION V. OTHER
1. ____ Wife requests to be known by her former name, which was {full legal name}:
_____________________________________________________________________.
2. Other relief {specify}:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SECTION VI. REQUEST (This section summarizes what you are asking the Court to include in the final judgment of dissolution of marriage.)
[Choose only one] ____Husband ___Wife requests that the Court enter an order dissolving the marriage and:
[Choose all that apply]
1. ___distributing marital assets and liabilities as requested in Section I of this petition;
2. ___awarding spousal support (alimony) as requested in Section II of this petition;
3. ___ adopting or establishing a Parenting Plan containing provisions for parental responsibility
and time-sharing for the dependent or minor child(ren) common to both parties, as requested in Section III of this petition;
4. ___establishing child support for the dependent or minor child(ren) common to both parties, as requested in Section IV of this petition;
5. ___restoring Wife’s former name as requested in Section V of this petition;
6. ___awarding other relief as requested in Section V of this petition; and any other terms the Court deems necessary.
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this petition and that the punishment for knowingly making a false statement includes fines and/or imprisonment.
Dated_________________________ _____________________________________________
Signature of ( ) HUSBAND ( ) WIFE
Printed Name:
Address: ______________________________________
City, State, Zip:
Telephone Number: _____________________________
Fax Number: __________________________________________
Email Address: _________________________________
STATE OF FLORIDA
COUNTY OF BROWARD
Sworn to or affirmed and signed before me on __________ by _________________________________.
_____________________________________________
NOTARY PUBLIC or DEPUTY CLERK
_____________________________________________
[Print, type, or stamp commissioned name of notary or deputy clerk.]
____ Personally known
____ Produced identification
Type of identification produced ________________________________
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} ( ) Husband ( ) Wife
This form was completed with the assistance of:
{name of individual}_______________________________________________________________,
{name of business} ________________________________________________________________,
{address} ________________________________________________________________________,
{city}______________________________{state}______, {telephone number} ________________.
For more detailed information including instructions on how to prepare this form click here.
Also See:
Broward County Family Law and Divorce
Answer to Petition for Dissolution of Marriage With Minor Children - Free Form
Petition For Dissolution Of Marriage With Property But No Minor Children - Free Form
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