Florida Petitioner Form – Fill Out and Use This PDF

Special notes...

If you do not have the money to pay the filing fee, you may obtain an Application for Determination of Civil Indigent Status, fill it out, and the clerk will determine whether you are eligible to have filing fees deferred.

More than one child of the same alleged father may be listed on a single petition. However, if you are filing a paternity action involving more than one possible father, a separate petition must be filed for each alleged father.

If the respo de t files a a swer de yi g that the perso a ed i the petitio is the hild re ’s

father, one of you should file a Motion for Scientific Paternity Testing, Florida Supreme Court Approved

Family Law Form 12.983(e). This is used to ask the court to order a scientific test to determine who is the hild re ’s father.

If the father signed papers at the hospital acknowledging that he was the father, paternity was established as a matter of law. This should be indicated on page 2, section 9a on this form.

If the paternity of a child who was conceived or born during a marriage is at issue, the court may appoint a guardian ad litem to assist the court in this matter and to protect the rights of child.

With this petition, you must file the following and provide a copy to the other party:

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

∙Notice of Social Security Number, Florida Supreme Court Approved Family Law Form 12.902(j).

∙Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c).

∙Certificate of Compliance with Mandatory Disclosure, Florida Family Law Rules of Procedure Form 12.932. (This must be filed within 45 days, if not filed with the petition, unless you and the other party have agreed not to exchange these documents.)

∙Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e). (If

you do ot k ow the other party’s i o e, you ay file this worksheet after his or her fi a ial affidavit has been filed.)

∙Parenting Plan, Florida Supreme Court Approved Family Law Form, 12.995(a), 12.995(b), or 12.995(c). If the parents have reached an agreement, a signed and notarized Parenting Plan should be attached. If the parents have not reached an agreement, a proposed Parenting Plan may be filed.

Parenting Plan and Time-Sharing. If the parties are unable to agree on parenting arrangements and a

time-sharing schedule, a judge will decide as part of establishing a Parenting Plan. The judge will decide the parenting arrangements and time-sharing based on the child re ’s est i terests. Regardless of

whether there is an agreement between the parties, the court reserves jurisdiction to modify issues relating to minor or dependent child(ren).

The judge may request a parenting plan recommendation or appoint a guardian ad litem in your case. This means that a neutral person will review your situation and report to the judge concerning parenting

Instructions for Florida Supreme Court Approved Family Law Form 12.983(a), Petition to Determine Paternity and for Related Relief (03/15)

IN THE CIRCUIT COURT OF THE ________ JUDICIAL CIRCUIT,

IN AND FOR ______________________________ COUNTY, FLORIDA

Case No: ________________________

Division: ________________________

_________________________________,

Petitioner,

And

_________________________________,

Respondent.

PETITION TO DETERMINE PATERNITY AND FOR RELATED RELIEF

Petitioner, {full legal name}____________________________, being sworn, certifies that the following

information is true:

This is an action for paternity and to determine parental responsibility, time-sharing, and child support under chapter 742, Florida Statutes.

SECTION I.

1. Petitioner is the _____ Mother _____ Father of the following minor child(ren):

NameBirth Date

1.________________________________________________________________________

2.________________________________________________________________________

3.________________________________________________________________________

4.________________________________________________________________________

5.________________________________________________________________________

6.________________________________________________________________________

2.Petitio er’ s urre t address is: {street address, city, state} __________________________________

_________________________________________________________________________________.

3.Respo de t’s urre t address is: {street address, city, state} ______________________________

________________________________________________________________________________

4.Both parties are over the age of 18.

Florida Supreme Court Approved Family Law Form 12.983(a), Petition to Determine Paternity and for Related Relief (03/15)

5.Petitioner {Choose only ONE} _____ is _____ is not a member of the military service. Respondent {Choose only ONE} _____ is _____ is not a member of the military service.

6.Neither Petitioner nor Respondent is mentally incapacitated.

7.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.

8.A completed Notice of Social Security Number, Florida Supreme Court Approved Family Law Form 12.902(j), is filed with this petition.

9.A completed Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c), is, or will be, filed.

10.Paternity Facts. {Choose only ONE}

a._____Paternity has previously been established as a matter of law.

b._____The parties engaged in sexual intercourse with each other in the month(s) of {list month(s) and year(s)} ____________________________________________________________________

in {city and state} ________________________________________________________________

As a result of the sexual intercourse, _____ Petitioner _____ Respondent conceived and gave birth to the minor child(ren) named in paragraph 1. _____ Petitioner _____Respondent is the natural father of the minor child(ren). The mother _____ was _____ was not married at the time of the conception and/or birth of the minor child(ren) named in paragraph 1. If the mother was married, the name and address of her husband at the time of conception and/or birth is:

______________________________________________________________________________

______________________________________________________________________________.

SECTION II. 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 i the hild re ’s est i terests that pare tal respo si ility e:

{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: ______________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________.

Florida Supreme Court Approved Family Law Form 12.983(a), Petition to Determine Paternity and for Related Relief (03/15)

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 _____ have _____ have not agreed to the Parenting Plan.

b._____ The court should establish a Parenting Plan with the following provisions:

1.____	No time-sharing for the	_____ Father	_____ Mother
2.____	Limited time-sharing with the	_____ Father	_____ Mother
3.____	Supervised time-sharing for the	_____ Father	_____ Mother.
4.____	Supervised or third-party exchange of the child(ren).
5.____	Time-sharing schedule as follows:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Explain why this schedule is in the best interests of the child(ren): _______________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

4. The minor child(ren) should

{Choose only ONE}

a. _____retain his/her (their) present name(s).

b. _____receive a change of name as follows:
present name(s)	be changed to
(1). ____________________________________	(1). ___________________________________
(2). ____________________________________	(2). ___________________________________
(3). ____________________________________	(3). ___________________________________
(4). ____________________________________	(4). ___________________________________
(5). ____________________________________	(5). ___________________________________
(6). ____________________________________	(6). ___________________________________

c.The name change would be in the best interest of the child(ren) because:___________________

______________________________________________________________________________.

SECTION III. CHILD SUPPORT

{Indicate all that apply}

1._____Petitioner requests that the Court award child support as determined by Florida’s hild 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:

{Choose only ONE}

a._____the date when the parents did not reside together in the same household with the child, not to exceed a period of 24 months before the date of filing of this petition.

Florida Supreme Court Approved Family Law Form 12.983(a), Petition to Determine Paternity and for Related Relief (03/15)

b._____the date of the filing of this petition.

c._____other: {date}________________ {Explain} ________________________________

______________________________________________________________________________

2._____Petitioner requests that the Court award a child support amount that is more than or less than Florida’s hild support guideli es. Petitioner understands that a Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, must be completed before the Court will consider this request.

3._____Petitioner requests that medical/dental insurance for the minor child(ren) be provided by: {Choose only ONE}

a._____Father.

b._____Mother.

4._____Petitioner requests that uninsured medical/dental expenses for the child(ren) be paid by: {Choose only ONE}

a._____Father.

b._____Mother.

c._____Father and Mother each pay one-half.

d._____Father and Mother each pay according to the percentages in the Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e).

e._____Other {explain}: ___________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

5._____Petitioner requests that life insurance to secure child support be provided by: [Choose only ONE]

a._____Father.

b._____Mother.

c._____Both

6._____ Petitioner _____ Respondent _____ Both has (have) incurred medical expenses in the amount of $__________ on behalf of the minor child(ren), including hospital and other expenses incidental to the birth of the minor child(ren). There should be an appropriate allocation or apportionment of these expenses.

7._____ Petitioner _____ Respondent _____ Both has (have) received past public assistance for this (these) minor child(ren).

PETITIONER’“ REQUE“T

1.Petitioner requests a hearing on this petition and understands that he or she must attend the hearing.

2.Petitioner requests that the Court enter an order that:

[Indicate ALL that apply]

Florida Supreme Court Approved Family Law Form 12.983(a), Petition to Determine Paternity and for Related Relief (03/15)

a.____establishes paternity of the minor child(ren), ordering proper scientific testing, if necessary;

b._____adopts or establishes a Parenting Plan containing provisions for parental responsibility and time-sharing for the minor or dependent child(ren);

c._____awards child support, including medical/dental insurance coverage for the minor child(ren);

d._____determines the appropriate allocation or apportionment of all expenses incidental to the birth of the child(ren), including hospital and medical expenses;

e._____determines the appropriate allocation or apportionment of all other past, present, and future medical and dental expenses incurred or to be incurred on behalf of the minor

child(ren);

f. _____ ha ges the hild re ’s a e s ;

g._____other relief as follows: ______________________________________________________

______________________________________________________________________________

______________________________________________________________________________

___________________________________________________________________________ and grants such other relief as may be appropriate and in the best interests of the minor child(ren).

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 PETITIONER
	Printed Name: _________________________________
	Address: _____________________________________
	City, State, Zip: ________________________________
	Telephone Number: _____________________________
	Fax Number: __________________________________
	Designated E-mail Address(es):____________________
	____________________________________________
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 deputy clerk.}

_____ Personally known

_____ Produced identification

_____ Type of identification produced ________________________________

Florida Supreme Court Approved Family Law Form 12.983(a), Petition to Determine Paternity and for Related Relief (03/15)

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 Petitioner.

This form was completed with the assistance of:

{name of individual} ________________________________,

{name of business}________________________________________________________________,

{address} ___________________________________________,

{city} _______________,{state} _______,{zip code}_________, {telephone number} _______________,

.

Florida Supreme Court Approved Family Law Form 12.983(a), Petition to Determine Paternity and for Related Relief (03/15)