• Skip to primary navigation
  • Skip to content
  • Skip to primary sidebar
  • Skip to footer

e-database.org

Free Document Samples & Templates to Download!

  • Google Sheets
  • PDFs
  • Excel Spreadsheets
  • Letters
  • Lists
  • Calendars
  • Sheets
  • Charts
  • Planners
  • Receipts
You are here: Home / Legal / Family Law Form / Child Custody Form / Free Florida Child Custody Form Download

Free Florida Child Custody Form Download

Available for Download in PDF Format


Download PDF

Florida Child Custody Form Preview

Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit (02/09

Submit


image

IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT, IN AND FOR ST LUCIE COUNTY, FLORIDA



,

Petitioner,


and

Case No.: Division:


,

Respondent.


UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) AFFIDAVIT

I, {full legal name} .div1 , being sworn, certify that the following statements are true:


  1. The number of minor child(ren) subject to this proceeding is . The name, place of birth, birth date, and sex of each child; the present address, periods of residence, and places where each child has lived within the past five (5) years; and the name, present address, and relationship to the child of each person with whom the child has lived during that time are:


    THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # 1 :


    Child’s Full Legal Name: Place of Birth: Date of Birth: Sex:


    Child’s Residence for the past 5 years:


    Dates (From/To)

    Address (including city and state) where child lived

    Name and present address of person child lived with

    Relationship to child


    /present*





    /





    /





    /





    /





    Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit (12/10)



    /




    * If you are the petitioner in an injunction for protection against domestic violence case and you have filedaRequest for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h), you should write confidential in any space on this form that would require you to enter the address where you are currently living.


    THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # :


    Child’s Full Legal Name: Place of Birth: Date of Birth: Sex:

    Child’s Residence for the past 5 years:


    Dates (From/To)

    Address (including city and state) where child lived

    Name and present address of person child lived with

    Relationship to child


    /present





    /





    /





    /





    /




    /





    THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # :


    Child’s Full Legal Name: Place of Birth: Date of Birth: Sex:

    Child’s Residence for the past 5 years:


    Dates (From/To)

    Address (including city and state) where child lived

    Name and present address of person child lived with

    Relationship to child


    /present





    /





    Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit (12/10)


    /





    /





    /





    /





  2. Participation in custody or time-sharing proceeding(s):

    [ Choose only one]

    image

    I HAVE NOT participated as a party, witness, or in any capacity in any other litigation or custody proceeding in this or any other state, concerning custody of or time-sharing with a child subject to this proceeding.

    I HAVE participated as a party, witness, or in any capacity in any other litigation or custody proceeding in this or another state, concerning custody of or time-sharing with a child subject to this proceeding. Explain:

    1. Name of each child:

    2. Type of proceeding:

    3. Court and state:

    4. Date of court order or judgment (if any):


  3. Information about custody or time-sharing proceeding(s):

    [Choose only one]

    I HAVE NO INFORMATION of any custody or time-sharing proceeding pending in a court of this or any other state concerning a child subject to this proceeding.

    I HAVE THE FOLLOWING INFORMATION concerning a custody or time-sharing proceeding pending in a court of this or another state concerning a child subject to this proceeding, other than set out in item 2. Explain:

    1. Name of each child:

    2. Type of proceeding:

    3. Court and state:

    4. Date of court order or judgment (if any):


  4. Persons not a party to this proceeding:

    [Choose only one]

    I DO NOT KNOW OF ANY PERSON not a party to this proceeding who has physical custody or claims to have custody, visitation or time-sharing with respect to any child subject to this proceeding.

    I KNOW THAT THE FOLLOWING NAMED PERSON(S) not a party to this proceeding has (have) physical custody or claim(s) to have custody, visitation, or time-sharing with respect to any child subject to this proceeding:

    1. Name and address of person:


      image

      ( ) has physical custody ( ) claims custody rights ( ) claims visitation or time-sharing

      Name of each child:


      Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit (12/10)


    2. Name and address of person:


      image

      ( ) has physical custody ( ) claims custody rights ( ) claims visitation. or time-sharing

      Name of each child:

    3. Name and address of person:


      image

      ( ) has physical custody ( ) claims custody rights ( ) claims visitation or time-sharing

      Name of each child:


  5. Knowledge of prior child support proceedings:

    [Choose only one]

    The child(ren) described in this affidavit are NOT subject to existing child support order(s) in this or any state or territory.

    The child(ren) described in this affidavit are subject to the following existing child support order(s):

    1. Name of each child:

    2. Type of proceeding:

    3. Court and address:

    4. Date of court order/judgment (if any):

    5. Amount of child support paid and by whom:


  6. I acknowledge that I have a continuing duty to advise this Court of any custody, visitation or time-sharing, child support, or guardianship proceeding (including dissolution of marriage, separate maintenance, child neglect, or dependency) concerning the child(ren) in this state or any other state about which information is obtained during this proceeding.


I certify that a copy of this document was [Choose only one] ( ) mailed ( ) faxed and mailed ( ) hand delivered to the person(s) listed below on {date} .div1 .


Other party or his/her attorney:

Name: Address: City, State, Zip: Fax Number:


Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit (12/10)


I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this affidavit and that the punishment for knowingly making a false statement includes fines and/or imprisonment.


Dated:


image


STATE OF FLORIDA

Signature of Party

Printed Name: Address: City, State, Zip: Telephone Number: Fax Number:

COUNTY OF

ST LUCIE


Sworn to or affirmed and signed before me on by .


image

NOTARY PUBLIC or DEPUTY CLERK


image

[Print, type, or stamp commissioned name of notary or 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]

I, {full legal name and trade name of nonlawyer} .div1 , a nonlawyer, located at {street} .div1 , {city} .div1 ,

{state} .div1 , {phone} .div1 , helped {name} .div1 , who is the [Choose only one] petitioner or respondent, fill out this form.


Florida Supreme Court Approved Family Law Form 12.902(d), Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit (12/10)



Florida Child Custody Form Thumbnail Preview

Florida Child Custody Form

Click to Expand



Download PDF
Edit this File
Convert this PDF
Sign this Document
Fill this Form



Text Preview:

IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, IN AND FOR COUNTY, FLORIDA Case No.: Division: , Petitioner, and , Respondent. UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) AFFIDAVIT I, {full legal name} , being sworn, certify that the following statements are true: 1. The number of minor child(ren) subject to this proceeding is . The name, place of birth, birth date, and sex of each child; the present address, periods of residence, and places where each child has lived within the past five (5) years; and the name, present address, and relationship to the child of each person with whom the child has lived during that time are: THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # 1 : Child’s Full Legal Name: Place of Birth: Date of Birth: Sex: Child’s Residence for the past 5 years: Dates (From/To) Address (including city and state) where child lived Name and present address of person child lived with Relationship to child /present* ____/____ ____/____ ____/____ ____/____ ____/____ * If you are the petitioner in an injunction for protection against domestic violence case and you have filedaRequest for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h), you should write confidential in any space on this form that would require you to enter the address where you are currently living. THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # : Child’s Full Legal Name: Place of Birth: Date of Birth: Sex: Child’s Residence for the past 5 years: Dates (From/To) Address (including city and state) where child lived Name and present address of person child lived with Relationship to child /present ____/____ ____/____ ____/____ ____/____ ____/____ THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # : Child’s Full Legal Name: Place of Birth: Date of Birth: Sex: Child’s Residence for the past 5 years: Dates (From/To) Address (including city and state) where child lived Name and present address of person child lived with Relationship to child /present ____/____ ____/____ ____/____ ____/____ ____/____ 2. Participation in custody or time-sharing proceeding(s): [ Choose only one] ___ I HAVE NOT participated as a party, witness, or in any capacity in any other litigation or custody proceeding in this or any other state, concerning custody of or time-sharing with a child subject to this proceeding. ___ I HAVE participated as a party, witness, or in any capacity in any other litigation or custody proceeding in this or another state, concerning custody of or time-sharing with a child subject to this proceeding. Explain: a. Name of each child: b. Type of proceeding: c. Court and state: d. Date of court order or judgment (if any): 3. Information about custody or time-sharing proceeding(s): [Choose only one] ___ I HAVE NO INFORMATION of any custody or time-sharing proceeding pending in a court of this or any other state concerning a child subject to this proceeding. ___ I HAVE THE FOLLOWING INFORMATION concerning a custody or time-sharing proceeding pending in a court of this or another state concerning a child subject to this proceeding, other than set out in item 2. Explain: a. Name of each child: b. Type of proceeding: c. Court and state: d. Date of court order or judgment (if any): 4. Persons not a party to this proceeding: [Choose only one] ___ I DO NOT KNOW OF ANY PERSON not a party to this proceeding who has physical custody or claims to have custody, visitation or time-sharing with respect to any child subject to this proceeding. ___ I KNOW THAT THE FOLLOWING NAMED PERSON(S) not a party to this proceeding has (have) physical custody or claim(s) to have custody, visitation, or time-sharing with respect to any child subject to this proceeding: a. Name and address of person: ( ) has physical custody ( ) claims custody rights ( ) claims visitation or time-sharing Name of each child: b. Name and address of person: ( ) has physical custody ( ) claims custody rights ( ) claims visitation. or time-sharing Name of each child: c. Name and address of person: ( ) has physical custody ( ) claims custody rights ( ) claims visitation or time-sharing Name of each child: 5. Knowledge of prior child support proceedings: [Choose only one] ___ The child(ren) described in this affidavit are NOT subject to existing child support order(s) in this or any state or territory. ___ The child(ren) described in this affidavit are subject to the following existing child support order(s): a. Name of each child: b. Type of proceeding: c. Court and address: d. Date of court order/judgment (if any): e. Amount of child support paid and by whom: 6. I acknowledge that I have a continuing duty to advise this Court of any custody, visitation or time-sharing, child support, or guardianship proceeding (including dissolution of marriage, separate maintenance, child neglect, or dependency) concerning the child(ren) in this state or any other state about which information is obtained during this proceeding. I certify that a copy of this document was [Choose only one] ( ) mailed ( ) faxed and mailed ( ) hand delivered to the person(s) listed below on {date} . Other party or his/her attorney: Name: Address: City, State, Zip: _______ Fax Number: I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this affidavit and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Dated: ______________________ Signature of Party Printed Name: Address: City, State, Zip: Telephone Number: Fax Number: STATE OF FLORIDA COUNTY OF ________________________ Sworn to or affirmed and signed before me on by . NOTARY PUBLIC or DEPUTY CLERK [Print, type, or stamp commissioned name of notary or 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] I, {full legal name and trade name of nonlawyer} , a nonlawyer, located at {street} , {city} , {state} , {phone} , helped {name} , who is the [Choose only one] petitioner or respondent, fill out this form.
Edit this File
Convert this PDF
Sign this Document
Fill this Form



Related Posts

Free Basic Metric Conversion Data Chart Template Download
Free Blood Type Chart 2 Download
Free Confidentiality Settlement Agreement For Legal Proceeding Download

Related PDF Downloads

AscDesc
TitlePublish Date
Free Free Diamond Color Scale And Clarity Chart PDF Download
Free Free Diamond Color Scale And Clarity Chart PDF Download

Download
810 downloads
Free Free Diamond Color Scale And Clarity Chart PDF Download
Free February 2019 Calendar 1 PDF Download
Free February 2019 Calendar 1 PDF Download

Download
771 downloads
Free February 2019 Calendar 1 PDF Download
Free February 2018 Calendar 3 PDF Download
Free February 2018 Calendar 3 PDF Download

Download
438 downloads
Free February 2018 Calendar 3 PDF Download
Free February 2015 Calendar 3 PDF Download
Free February 2015 Calendar 3 PDF Download

Download
820 downloads
Free February 2015 Calendar 3 PDF Download
Free Example Business Continuity Gap Analysis PDF Download
Free Example Business Continuity Gap Analysis PDF Download

Download
911 downloads
Free Example Business Continuity Gap Analysis PDF Download
Free Electric Guitar Chords Chart For Beginner PDF Download
Free Electric Guitar Chords Chart For Beginner PDF Download

Download
722 downloads
Free Electric Guitar Chords Chart For Beginner PDF Download
Free Electric Guitar Bar Chords Chart PDF Download
Free Electric Guitar Bar Chords Chart PDF Download

Download
904 downloads
Free Electric Guitar Bar Chords Chart PDF Download
Free Diamond Grading Color Chart PDF Download
Free Diamond Grading Color Chart PDF Download

Download
389 downloads
Free Diamond Grading Color Chart PDF Download
Free Diamond Cut And Clarity Chart Template PDF Download
Free Diamond Cut And Clarity Chart Template PDF Download

Download
509 downloads
Free Diamond Cut And Clarity Chart Template PDF Download
Free December 2018 Calendar 3 PDF Download
Free December 2018 Calendar 3 PDF Download

Download
204 downloads
Free December 2018 Calendar 3 PDF Download
Free December 2018 Calendar 1 PDF Download
Free December 2018 Calendar 1 PDF Download

Download
180 downloads
Free December 2018 Calendar 1 PDF Download
Free December 2017 Calendar 1 PDF Download
Free December 2017 Calendar 1 PDF Download

Download
119 downloads
Free December 2017 Calendar 1 PDF Download
  • ◄
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • ...
  • 432
  • 433
  • ►


Related posts:

Free Employee Work Schedule Template Download
Free Crisis Communication Plan Templates Download
Free General Affidavit 2 PDF Download

Primary Sidebar

Recent Posts

  • Free Illinois Certified Transcript Of Payroll PDF Download
  • Free Illinois Certified Payroll Form 2 PDF Download
  • Free Illinois Boat Bill Of Sale PDF Download
  • Free Illinois Authorization To Release Medical Records PDF Download
  • Free Illinois Authorization For The Release Of Medical Information PDF Download
  • Free Illinois Authorization For Release Of Confidential Health Information PDF Download
  • Free Illinois Affidavit Of Repossession PDF Download
  • Free Illinois Affidavit And Certificate Of Correction Request PDF Download
  • Free Illinois Advance Health Care Directive Form PDF Download
  • Free Ikea Assembly Instruction Sample PDF Download
  • Free Ihop Restaurant Employer Application For Employment PDF Download
  • Free Ihop Employment Application New Hire Information PDF Download
  • Free Ihop Application For Employment PDF Download
  • Free Ihop Application For Employment Fillable PDF Download
  • Free Identity Theft Victims Complaint And Affidavit PDF Download
  • Free Identity Theft Affidavit 2 PDF Download
  • Free Identity Theft Affidavit 1 PDF Download
  • Free Identify Coins Money Worksheets For Kids Template PDF Download
  • Free Ideal Male Body Fat Chart PDF Download
  • Free Ideal Body Weight Chart For Women PDF Download
ad1

Footer

  • Home
  • Contact Us
  • Privacy Policy

sponsored

[ Placeholder content for popup link ] WordPress Download Manager - Best Download Management Plugin