Case Title: In Re: Amendments To The Florida Supreme Court Approved Family Law Forms – Forms 12.982(A), 12.982(C), And 12.982(F)

Citation: 

Docket Number: SC10-828

State: florida

Court: Florida Supreme Court

Date: 2010-06-24T00:00:00Z

Document:
Supreme Court of Florida 
 
 
____________ 
 
SC10-828 
____________ 
 
 
IN RE AMENDMENTS TO THE FLORIDA SUPREME COURT 
APPROVED FAMILY LAW FORMS—FORMS 12.982(a), 12.982(c), and 
12.982(f). 
 
[June 24, 2010] 
 
PER CURIAM. 
 
This matter is before the Court for consideration of amendments to the 
Florida Supreme Court Approved Family Law Forms.  We have jurisdiction.  See 
art. V, § 2(a), Fla. Const. 
Under Amendments to the Florida Family Law Rules of Procedure and 
Family Law Forms, 810 So. 2d 1, 13-14 (Fla. 2000), the Court internally reviews 
and maintains the Florida Supreme Court Approved Family Law Forms.  Revisions 
to Florida Supreme Court Approved Family Law Forms 12.982(a), Petition for 
Change of Name (Adult), 12.982(c), Petition for Change of Name (Minor 
Child(ren)), and 12.982(f), Petition for Change of Name (Family), have become 
necessary as a result of 2009 amendments to section 68.07, Florida Statutes.  See 
Ch. 2009-173, Laws of Fla.  The amendments are meant to reflect the new 
- 2 - 
fingerprinting and criminal history records check requirements and the clarified 
hearing and costs provisions under the amended statute.  Other minor and editorial 
amendments are also made.    
Accordingly, the Florida Supreme Court Approved Family Law Forms are 
hereby amended as set forth in the appendix to this petition, fully engrossed and 
ready for use.  The amendments shall become effective immediately upon release 
of this opinion.  Because the amendments were not published for comment prior to 
adoption, interested persons shall have sixty days from the date of this opinion in 
which to file comments with the Court.1  By adoption of these forms, we express 
no opinion as to their correctness or applicability, or on the substance of the 
relevant legislation.  The forms discussed herein may also be accessed and 
downloaded from the Florida State Courts website at 
www.flcourts.org/gen_public/family/forms_rules/index.shtml.      
It is so ordered.    
QUINCE, C.J., and PARIENTE, LEWIS, CANADY, POLSTON, LABARGA, 
and PERRY, JJ., concur. 
 
                                          
 
 
1.  An original and nine paper copies of all comments must be filed with the 
Court on or before August 23, 2010.  A separate request for oral argument must be 
filed if the person filing the comment wishes to participate in oral argument, which 
may be scheduled in this case.  Electronic copies of all comments also must be 
filed in accordance with the Court's administrative order in In re Mandatory 
Submission of Electronic Copies of Documents, Fla. Admin. Order No. AOSC04-
84 (Sept. 13, 2004). 
- 3 - 
THE FILING OF A MOTION FOR REHEARING SHALL NOT ALTER THE 
EFFECTIVE DATE OF THESE AMENDMENTS. 
 
 
 
Original Proceeding – The Family Law Rules Committee 
 
Jack A. Moring, Chair, The Family Law Rules Committee, Moring and Moring, 
P.A., Crystal River, Florida, John F. Harkness, Executive Director, and Ellen H. 
Sloyer, Bar Liaison, The Florida Bar, Tallahassee, Florida, 
 
 
for Petitioner 
 
 
 
 
Instructions for Florida Supreme Court Approved Family Law Form 12.982(a), Petition for Change of Name (Adult) 
(06/10) 
- 4 -  
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW 
FORM 12.982(a), PETITION FOR CHANGE OF NAME (ADULT) (06/10) 
 
When should this form be used? 
 
This form should be used when an adult wants the court to change his or her name.  This form is not to 
be used in connection with a dissolution of marriage or for adoption of child(ren).  If you want a change 
of name because of a dissolution of marriage or adoption of child(ren) that is not yet final, the change 
of name should be requested as part of that case. 
 
This form should be typed or printed in black ink and must be signed before a notary public or deputy 
clerk.  You should file the original with the clerk of the circuit court in the county where you live and 
keep a copy for your records  
 
What should I do next? 
 
 Unless you are seeking to restore a former name, you must have fingerprints submitted for a state 
and national criminal records check.  The fingerprints must be taken in a manner approved by the 
Department of Law Enforcement and must be submitted to the Department for a state and national 
criminal records check.  You may not request a hearing on the petition until the clerk of court has 
received the results of your criminal history records check.  The clerk of court can instruct you on the 
process for having the fingerprints taken and submitted, including information on law enforcement 
agencies or service providers authorized to submit fingerprints electronically to the Department of Law 
Enforcement.  The process may take several weeks and you will have to pay for the cost of processing 
the fingerprints and conducting the state and national criminal history records check.  
 
Next, you must obtain a hearing date for the court to consider your request. If you are seeking to 
restore a former name, a hearing on the petition MAY be held immediately after the petition is filed.  
The final hearing on any other petition for a name change may be held immediately after the clerk of 
court receives the results of your criminal history records check. You should ask the clerk of court, family 
law intake staff, or judicial assistant about the local procedure for setting a hearing.  You may be 
required to attend the final hearing.  Included in these forms is a Final Judgment of Change of Name 
(Adult), Florida Supreme Court Approved Family Law Form 12.982(b), which the judge may use. You 
should check with the clerk, family law intake staff, or judicial assistant, to see if you need to bring a 
final judgment form with you. If so, you should type or print the heading, including the circuit, county, 
case number, division, and the parties’ names, and leave the rest blank for the judge to complete at 
your hearing or trial. 
 
If the judge grants your petition, he or she will sign this order.  This officially changes your name.  The 
clerk can provide you with certified copies of the signed order.  There will be charges for the certified 
copies, and the clerk can tell you the amount of the charges. 
 
 
Instructions for Florida Supreme Court Approved Family Law Form 12.982(a), Petition for Change of Name (Adult) 
(06/10) 
- 5 -  
 
Where can I look for more information? 
 
Before proceeding, you should read General Information for Self-Represented Litigants found at the 
beginning of these forms.  For further information, see Section 68.07, Florida Statutes. 
 
Special notes... 
 
The heading of the form calls for the name of the petitioner.  Your current name should go there, as you 
are the one who is asking the court for something.  The judicial circuit, case number, and division may be 
obtained from the clerk of court’s office when you file the petition. 
 
It may be helpful to compile a list of all of the people and/or places that will need a copy of your final 
judgment.  This list may include the driver’s license office, social security office, banks, schools, etc.  A 
list will help you know how many copies of your order you should get from the clerk of court after your 
hearing. 
 
Remember, a person who is NOT an attorney 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 bottom of the last page of every 
form he or she helps you complete. 
 
Florida Supreme Court Approved Family Law Form 12.982(a), Petition for Change of Name (Adult) (06/10) 
- 6 - 
IN THE CIRCUIT COURT OF THE _______________________JUDICIAL CIRCUIT, 
IN AND FOR______________________COUNTY, FLORIDA 
 
Case No.: ________________________ 
Division: _________________________ 
 
_________________________________, 
Petitioner. 
 
PETITION FOR CHANGE OF NAME (ADULT) 
 
I, {full legal name} _________________________________, being sworn, certify that the 
following information is true: 
1. My complete present name is: ________________________________________________________. 
I request that my name be changed to: _________________________________________________. 
 
2. I live in _________________ County, Florida, at {street address} _____________________________ 
_______________________________________________________________________________. 
 
3. I was born on {date}______________, in {city} _________________________, {county} __________, 
{state} ______________________, {country} _________________. 
 
4. My father’s full legal name : __________________________________________________________. 
My mother’s full legal name: __________________________________________________________. 
My mother’s maiden name: ___________________________________________________________. 
 
5. I have lived in the following places since birth: 
Dates (to/from) 
 
Address 
 
_______/_________ 
____________________________________________________ 
_______/_________ 
____________________________________________________ 
_______/_________ 
____________________________________________________ 
_______/_________ 
____________________________________________________ 
(___ Please indicate here if you are continuing these facts on an attached page.) 
 
6. Family 
[Choose all that apply] 
a. ____ I am not married. 
b. ____ I am married.  My spouse’s full legal name is: _____________________________________ 
c. ____ I do not have child(ren). 
d. ____ The name(s), age(s), and address(es) of my child(ren) are as follows (all children, including 
those over 18, must be listed): 
 
Florida Supreme Court Approved Family Law Form 12.982(a), Petition for Change of Name (Adult) (06/10) 
- 7 - 
Name {last, first, middle initial} 
 
Age       Address, City, State 
__________________________________________________________________________________ 
__________________________________________________________________________________ 
__________________________________________________________________________________ 
__________________________________________________________________________________ 
__________________________________________________________________________________ 
(______Please indicate here if you are continuing these facts on an attached page.) 
 
7. Former names 
[Choose all that apply] 
        
My name has never been changed by a court. 
        
My name previously was changed by court order from  
 
to   
 
 
 
 
 
 on {date} 
, 
by {court, city, and state}  
. 
A copy of the court order is attached. 
 
        
My name previously was changed by marriage from  
 
to   
 
 
 
 
 
 on {date} 
, 
in {city, county, and state}  
. 
A copy of the marriage certificate is attached. 
 
        
I have never been known or called by any other name. 
        
I have been known or called by the following other name(s): {list name(s) and explain where you 
were known or called by such name(s)}  
 
 
8. Occupation 
My occupation is:  
. 
I am employed at: {company and address}  
 
 
. 
During the past 5 years, I have had the following jobs: 
 
Dates (to/from) 
 
Employer and employer’s address 
_______/_______               __________________________________________________________ 
_______/_______               __________________________________________________________ 
_______/_______               __________________________________________________________ 
_______/_______               __________________________________________________________ 
_______/_______               __________________________________________________________ 
(_______Please indicate here if you are continuing these facts on an attached page.) 
9. Business 
[Choose one only] 
        
 I do not own and operate a business. 
        
 I own and operate a business.  The name of the business is:  
. 
The street address is:  
. 
My position with the business is:  
. 
I have been involved with the business since: {date}  
. 
 
Florida Supreme Court Approved Family Law Form 12.982(a), Petition for Change of Name (Adult) (06/10) 
- 8 - 
 
10. Profession 
[Choose one only] 
        
I am not in a profession. 
        
I am in a profession.  My profession is:  
. 
I have practiced this profession: 
Dates (to/from) 
 
Place and address 
_______/_______               __________________________________________________________ 
_______/_______               __________________________________________________________ 
_______/_______               __________________________________________________________ 
_______/_______               __________________________________________________________ 
_______/_______               __________________________________________________________ 
( _____ Please indicate here if you are continuing these facts on an attached page.) 
 
11. Education 
I have graduated from the following school(s): 
Degree 
      Date of 
Received 
   Graduation 
 
School 
_________   _____________ 
__________________________________________________ 
_________  _____________              __________________________________________________ 
_________ _____________               __________________________________________________ 
(________ Please indicate here if you are continuing these facts on an attached page.) 
 
12. Criminal History 
[Choose one only] 
         I have never been arrested for or charged with, pled guilty or nolo contendere to, or been 
found to have committed a criminal offense, regardless of adjudication. 
         I have a criminal history.  In the past I have been arrested for or charged with, pled guilty or 
nolo contendere to, or been found to have committed a criminal offense, regardless of adjudication.  
The details of my criminal history are: 
 
Date 
 
City/State 
 
Event (arrest, charge, plea, or adjudication) 
                                                                        
 
                                                                        
 
                                                                        
 
( _______ Please indicate here if you are continuing these facts on an attached page.) 
 
13. Bankruptcy 
[Choose one only] 
        
I have never been adjudicated bankrupt. 
        
I was adjudicated bankrupt on {date}  
 
 
, in {city}  
, 
{county}  
 
 
, {state}  
. 
(_______ Please indicate here if you have filed additional bankruptcies, and explain on an attached 
page.)
 
Florida Supreme Court Approved Family Law Form 12.982(a), Petition for Change of Name (Adult) (06/10) 
- 9 - 
14. Creditor(s)’ Judgments 
[Choose one only] 
        
I have never had a money judgment entered against me by a creditor. 
        
The following creditor(s)’ money judgment(s) have been entered against me:   
Date 
    Amount 
Creditor      Court entering judgment and case number        if Paid{date} 
______ 
    _________ 
_________      _______________________________________________         
______ 
    _________ 
_________      _______________________________________________         
______ 
    _________ 
_________      _______________________________________________         
______ 
    _________ 
_________      _______________________________________________         
(_______ Please indicate here if these facts are continued on an attached page.) 
 
15. Fingerprints and Criminal History Records Check 
Unless I am seeking to restore a former name, a copy of my fingerprints has been taken in a manner 
approved by the Department of Law Enforcement and submitted for a state and national criminal 
history records check.  I understand that I cannot request a hearing on my Petition until the Clerk 
of Court receives the results of the criminal history records check.  
 
16. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner 
invade the property rights of others, whether partnership, patent, good will, privacy, trademark, or 
otherwise. 
 
17. My civil rights have never been suspended, or, if my civil rights have been suspended, they have 
been fully restored. 
 
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this 
motion 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:  __________________________________ 
 
Florida Supreme Court Approved Family Law Form 12.982(a), Petition for Change of Name (Adult) (06/10) 
- 10 - 
 
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  ________________________________ 
 
 
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, whose address is {street} _________________________, {city} ______________________, 
{state} ______________,{phone} ______, helped {name} _______________________________, who is 
the petitioner, fill out this form. 
Instructions for Florida Supreme Court Approved Family Law Form 12.982(c), Petition for Change of Name 
(Minor Child(ren)) (06/10) 
- 11 - 
 
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY 
LAW FORM 12.982(c), PETITION FOR CHANGE OF NAME (MINOR 
CHILD(REN)) (06/10) 
 
When should this form be used? 
 
This form should be used when parents want the court to change the name of their minor 
child(ren).  For the purposes of this proceeding, a person under the age of 18 is a minor.  This 
form is not to be used in connection with an adoption, dissolution of marriage, or paternity 
action.  If you want a change of name for your child(ren) because of an adoption or paternity 
action that is not yet final, the change of name should be requested as part of that case. 
 
This form should be typed or printed in black ink and must be signed before a notary public or 
deputy clerk. You should file the original with the clerk of the circuit court, in the county where 
you live and keep a copy for your records. The Petition should only be completed by one 
Petitioner for one child.  If you wish to change the name of more than one child or if there is 
more than one Petitioner, you should complete and file a Supplemental Form for Petition for 
Change of Name (Minor Child) for each child and/or a Supplemental Form for Petition for 
Change of Name.  The supplemental form(s) is an attachment to the petition.  Be sure that the 
bottom of each page of each supplemental form is initialed by the petitioner(s).   
What should I do next? 
 Unless  you are seeking to restore a former name, each adult petitioner(s)’s fingerprints must 
be submitted for a state and national criminal history records check.  The fingerprints must be 
taken in a manner approved by the Department of Law Enforcement. The fingerprints must be 
submitted to the Department of Law Enforcement for a state and national criminal history 
records check. The Petitioner(s) may not request a hearing on the Petition until the copy of the 
fingerprints are filed and the clerk of court has received the results of the criminal history 
records check.  The clerk of court can instruct you on the process for having the fingerprints 
taken and submitted, including information on law enforcement agencies or service providers 
authorized to submit fingerprints electronically to the Department of Law Enforcement. The 
process may take several weeks and the parent or guardian of the minor must pay the cost of 
processing the fingerprints and conducting the state and national history records check. 
 
If both parents agree to the change of name and live in the county where the change of name is 
sought, you may both file as petitioners.  In this situation, service is not necessary, and you 
need only to set a hearing. You should ask the clerk of court, family law intake staff, or judicial 
assistant about the local procedure for setting a hearing. 
 
Instructions for Florida Supreme Court Approved Family Law Form 12.982(c), Petition for Change of Name 
(Minor Child(ren)) (06/10) 
- 12 - 
 
If only one parent is a resident of the county where the change of name(s) is sought or only one 
parent asks for the child(ren)’s name(s) to be changed, the other parent must be notified and his 
or her consent obtained, if possible.  If the other parent consents to the change of name, a 
Consent for Change of Name (Minor Child(ren)), Florida Supreme Court Approved Family Law 
Form 12.982(d), should be filed. 
 
If the other parent does not consent to the change of name, you may still have a hearing on the 
petition if you have properly notified the other parent about your petition and the hearing.  If 
you know where he or she lives, you must use personal service.  If you absolutely do not know 
where he or she lives, you may use constructive service.  For more information about personal 
and constructive service, you should refer [to] the “General Instructions for Self-Represented 
Litigants” found at the beginning of these forms and the instructions to Florida Family Law Rules 
of Procedure Forms 12.910(a) and 12.913(b) and Florida Supreme Court Approved Family Law 
Form 12.913(a).  However, the law regarding constructive service is very complex and you may 
wish to consult an attorney regarding that issue. 
 
Next, you must obtain a final hearing date for the court to consider your request.  If you are 
seeking to restore a former name, a hearing on the petition MAY be held immediately after the 
petition is filed.  The final hearing on any other petition for a name change may be held 
immediately after the clerk of court receives the results of your criminal history records check. 
You should ask the clerk of court, family law intake staff, or judicial assistant about the local 
procedure for setting a hearing.  You may be required to attend the hearing.  Included in these 
forms is a Final Judgment of Change of Name (Minor Child(ren)), Florida Supreme Court 
Approved Family Law Form 12.982(e), which may be used when a judge grants a change of 
name for a minor child(ren).  If you attend the hearing, you should take the final judgment with 
you.  You should complete the top part of the form, including the circuit, county, case number, 
division, and the name(s) of the petitioner(s) and leave the rest blank for the judge to complete.  
It should be typed or printed in black ink. 
 
If the judge grants your petition, he or she will sign this order. This officially changes your 
child(ren)’s name(s).  The clerk can provide you with certified copies of the signed order.  There 
will be charges for the certified copies, and the clerk can tell you the amount of the charges. 
 
Where can I look for more information? 
 
Before proceeding, you should read “General Information for Self-Represented Litigants” 
found at the beginning of these forms.  For further information, see section 68.07, Florida 
Statutes. 
Special notes... 
 
Instructions for Florida Supreme Court Approved Family Law Form 12.982(c), Petition for Change of Name 
(Minor Child(ren)) (06/10) 
- 13 - 
 
The heading of the form calls for the name(s) of the petitioner(s).  This means the parent(s) who 
is (are) requesting the change of their child(ren)’s name(s).  The judicial circuit, case number, 
and division may be obtained from the clerk of court’s office when you file the petition. 
 
It may be helpful to compile a list of all of the people and places that will need a copy of the final 
judgment.  This list may include the driver’s license office, social security office, banks, schools, 
etc.  A list will help you know how many copies of your order you should get from the clerk of 
court after your hearing. 
 
Remember, a person who is NOT an attorney 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 
bottom of the last page of every form he or she helps you complete. 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(c), Petition for Change of Name (Minor Child(ren)) 
(06/10) 
- 14 - 
IN THE CIRCUIT COURT OF THE                                                       JUDICIAL CIRCUIT, 
IN AND FOR                                                       COUNTY, FLORIDA 
 
Case No.:  
 
Division:  
 
IN RE: THE NAME CHANGE OF 
 
 
                                                                            , 
Petitioner/Father, 
 
 
                                                                              , 
Petitioner/Mother. 
 
PETITION FOR CHANGE OF NAME (MINOR CHILD(REN)) 
 
I/We, {full legal name(s)}  
 
 
 
 
 
 
, being sworn, 
certify that the following information is true: 
 
I am/We are the birth or legal parent(s) or guardian of the minor child(ren) named in this 
petition. 
[Choose only one] 
a. ___   There is only one minor child named in this petition. 
b. ___   There are {enter number of children}  
 
 children named in this petition.  The 
information on the first child is entered below.  I/We have attached the completed 
supplemental forms for each other child. 
 
The adult petitioner(s)’s fingerprints have been taken in a manner approved by the Department of Law 
Enforcement and submitted for a state and national criminal history records check.  I /We understand 
that I/we cannot request a hearing on my/our Petition until the clerk of court receives the results of 
the criminal history records check. 
 
A. 
THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # 
      1      : 
 
1. Minor child’s complete present name is: 
 
 
 
 
 
 
 
I/We request that this minor child’s name be changed to: 
 
 
 
 
 
 
 
 
2. The minor child lives in   
 
 County, Florida, at {street address}  
 
 
 
 
 
 
 
. 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(c), Petition for Change of Name (Minor Child(ren)) 
(06/10) 
- 15 - 
 
3. The minor child was born on {date}  
 
 
, in {city, county, state, country}  
 
 
 
 
 
 
 
. 
 
4. The minor child’s father’s full legal name:  
. 
The minor child’s mother’s full legal name:  
. 
The minor child’s mother’s maiden name:  
. 
 
5. The minor child has lived in the following places since birth: 
Dates (to/from)  
Address  
_______/________ 
______________________________________________________ 
 
_______/________ 
______________________________________________________ 
 
_______/________ 
_______________________________________________________  
_______/________ 
______________________________________________________ 
 
_______/________ 
______________________________________________________ 
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
6. [Choose one only] 
___   The minor child is not married. 
___   The minor child is married to: {full legal name} __________________________________. 
 
 
7. [Choose one only] 
___ The minor child has no children. 
___ The minor child is the parent of the following child(ren): {enter full name(s) and date(s) of 
birth}  ___________________________________________________________________. 
 
8. Former names. 
[Choose all that apply] 
___ The minor child’s name has never been changed by a court. 
___ The minor child’s name previously was changed by court order from _______________ 
to   
 
   
  
 on {date} 
 
 
, 
by {court, city, and state}  
. 
A copy of the court order is attached. 
___ The minor child’s name previously was changed by marriage from _________________ 
to  
   
  
 
 
 on {date} 
, 
in {city, county, and state}  
. 
A copy of the marriage certificate is attached. 
___ The minor child has never been known or called by any other name. 
___ The minor child has been known or called by the following other name(s): {list name(s) 
and explain where child was known or called by such name(s)} ____________________ 
_____________________________________________________________________ 
_____________________________________________________________________ 
 
 
9. The minor child is not employed in an occupation or profession, does not own and operate a 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(c), Petition for Change of Name (Minor Child(ren)) 
(06/10) 
- 16 - 
business, and has received no educational degrees.  If the minor child has a job, explain:  
 
 
 
 
 
 
 
 
 
10. Criminal History. 
[Choose one only] 
___ 
The minor child has never been arrested for or charged with, pled guilty or nolo 
contendere to, or been found to have committed a criminal offense, regardless of 
adjudication. 
___ 
The minor child has a criminal history.  In the past, the minor child was arrested for or 
charged with, pled guilty or nolo contendere to, or been found to have committed a 
criminal offense, regardless of adjudication.  The details of the criminal history are: 
 
Date  
City/State 
 
Event (arrest, charge, plea, or adjudication) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
11. Money Judgments. 
         
[Choose one only] 
___ 
The minor child has never been adjudicated bankrupt, and no money judgment has ever 
been entered against him or her. 
___ 
The following money judgment(s) has been entered against him or her: 
Date     Amount   Creditor  
Court entering judgment and case number   Indicate if Paid 
 
 
                          
     
 
                  
 
                  
 
 
                          
     
 
                  
 
                  
 
B. 
THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER(S): 
(    ) FATHER  (    ) MOTHER  (   ) GUARDIAN  
(    ) A Supplemental Form has been attached for the other parent or petitioner. 
 
1. My complete present name is: __________________________________________________ 
______________________________________________________________________________  
 
 
2. I live in  ________________ County, Florida, at {street address} ___________________________ 
 
______________________________________________________________________________. 
 
3. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner 
invade the property rights of others, whether partnership, patent, good will, privacy, trademark, 
or otherwise. 
 
4. My civil rights have never been suspended, or, if ever suspended, they have been fully restored. 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(c), Petition for Change of Name (Minor Child(ren)) 
(06/10) 
- 17 - 
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:  
 
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, whose address is {street}   
 
 
 
, {city}  
, 
{state}   
 
, {phone}   
 , helped {name(s)}  
 
, 
who is (are) the petitioner(s), fill out this form. 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(c), Supplemental Petition for Change of Name (Minor 
Child(ren)) (06/10) 
- 18 - 
ADULT SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (MINOR CHILDREN) 
 
Case No.:  ______________________________  
 
THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER(S): 
(    ) FATHER  (    ) MOTHER   (   ) GUARDIAN 
 
1. My complete present name is: __________________________________________________ 
______________________________________________________________________________  
 
 
2. I live in  ________________ County, Florida, at {street address} ___________________________ 
 
______________________________________________________________________________. 
 
3. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner 
invade the property rights of others, whether partnership, patent, good will, privacy, trademark, 
or otherwise. 
 
4. My civil rights have never been suspended, or, if ever suspended, they have been fully restored. 
 
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:  
 
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   
 
 
 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(c), Supplemental Petition for Change of Name (Minor 
Child(ren)) (06/10) 
- 19 - 
 
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, whose address is {street}   
 
 
 
, {city}  
, 
{state}   
 
, {phone}   
 , helped {name(s)}  
 
, 
who is (are) the petitioner(s), fill out this form. 
 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(c), Supplemental Form for Petition for Change of Name 
(Minor Child(ren)) (06/10) 
- 20 - 
SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (MINOR CHILD(REN)) 
 
Case No.:  
 
 
THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD # 
 
: 
 
1. Minor child’s complete present name is: 
 
 
 
 
 
 
. 
I/We request that minor child’s name be changed to: 
 
 
 
 
 
 
. 
 
2. The minor child lives in   
 
 County, Florida, at {street address}  
 
 
 
 
 
 
 
. 
 
3. The minor child was born on {date}  
 
 
 
, in {city, county, state, country}  
 
________________________________________________________________________. 
 
4. The minor child’s father’s full legal name:  
. 
The minor child’s mother’s full legal name:  
. 
The minor child’s mother’s maiden name:  
. 
 
5. The minor child has lived in the following places since birth: 
Dates (to/from)  
Address 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
 
6. [Choose  one only] 
        
The minor child is not married. 
        
The minor child is married to: {full legal name}  
. 
 
 
7. [Choose one only] 
        
The minor child has no children. 
        
The minor child is the parent of the following child(ren): {enter name(s) and date(s) of  birth} 
 
 
 
   
  
.
Florida Supreme Court Approved Family Law Form 12.982(c), Supplemental Form for Petition for Change of Name 
(Minor Child(ren)) (06/10) 
- 21 - 
 
8. Former names 
[Choose all that apply] 
___ The minor child’s name has never been changed by a court. 
___ The minor child’s name previously was changed by court order from  
 
to   
 
   
  on {date}  
 
 
 
, 
by {court, city, and state}  
. 
A copy of the court order is attached. 
___ The minor child’s name previously was changed by marriage from  
 
to   
 
   
  on {date}  
 
 
 
, 
in {city, county, and state}  
. 
A copy of the marriage certificate is attached. 
___ The minor child has never been known or called by any other name. 
___ The minor child has been known or called by the following other name(s): {list name(s) and 
explain where child was known or called by such name(s)}  
 
______________________________________________________________________________ 
______________________________________________________________________________  
 
 
9. The minor child is not employed in an occupation or profession, does not own and operate a 
business, and has received no educational degrees.  If the minor child has a job, explain:  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
. 
 
10. Criminal History 
[Choose one only] 
___  The minor child has never been arrested for or charged with, pled guilty or nolo contendere 
to or been found to have committed a criminal offense, regardless of adjudication. 
___  The minor child has a criminal history.  In the past, the minor child was arrested for or 
charged with, pled guilty or nolo contendere to, or been found to have committed a 
criminal offense, regardless of adjudication.  The details of the criminal history are: 
 
Date  
City/State 
 
Event (arrest, charge, plea, or adjudication) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
11. Money Judgments 
[Choose one only] 
___  The minor child has never been adjudicated bankrupt, and no money judgment has ever 
been entered against him or her. 
___   The following money judgment(s) has (have) been entered against him or her: 
Date 
    Amount 
Creditor     Court entering judgment and case number     Indicate if Paid 
 
 
                        
     
 
                            
                      
 
 
                         
     
 
                  
                                     
 
 
Instructions for Florida Supreme Court Approved Family Law Form 12.982(f), Petition for Change of Name (Family) 
(06/10) 
- 22 - 
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW 
FORM 12.982(f), PETITION FOR CHANGE OF NAME (FAMILY) (06/10) 
 
When should this form be used? 
 
This form should be used when a family wants the court to change its name.  This form is not to be used 
in connection with a dissolution of marriage, paternity, or adoption action.  If you want a change of 
name because of a dissolution of marriage, paternity, or adoption action that is not yet final, the change 
of name should be requested as part of that case. 
 
This form should be typed or printed in black ink and must be signed before a notary public or deputy 
clerk. You should file the original with the clerk of the circuit court in the county where you live and 
keep a copy for your records. The petition should only be completed for one adult.  If you wish to 
change the name(s) of another adult and/or any child(ren), you should complete and file with the clerk 
of court the attached Supplemental Form(s) for Petition for Change of Name (Family) for each additional 
family member.  Be sure that the bottom of each page of each supplemental form is initialed.   
What should I do next? 
Unless you are seeking to restore a former name, each adult petitioner must have fingerprints 
submitted for a state and national criminal history records check. The fingerprints must be taken in a 
manner approved by the Department of Law Enforcement and must be submitted to the Department 
for a state and national criminal history records check.  You may not request a hearing on the petition 
until the clerk of court has received the results of your criminal history records check.  The clerk of 
court can instruct you on the process for having the fingerprints taken and submitted, including 
information on law enforcement agencies or service providers authorized to submit finger prints 
electronically to the Department of Law Enforcement.  The process may take several weeks and you will 
have to pay for the cost of processing the fingerprints and conducting the state and national criminal 
history records check. 
 
If any of the children for whom you are requesting this change of name are not the legal children of both 
adults filing this petition, you must obtain the consent of the legal parent(s).  A parent not named as a 
petitioner in this action may consent by submitting a Consent for Change of Name (Minor Child(ren)), 
Florida Supreme Court Approved Family Law Form 12.982(d). 
 
If the other parent does not consent to the change of name, you may still have a hearing on the petition 
if you have properly notified the other parent about your petition and the hearing.  If you know where 
he or she lives, you must use personal service.  If you absolutely do not know where he or she lives, you 
may use constructive service. For more information about personal and constructive service, you should 
refer to the “General Instructions for Self-Represented Litigants” found at the beginning of these forms 
and the instructions to  Florida Family Law Rules of Procedure Forms 12.910(a) and 12.913(b) and  
 
 
Instructions for Florida Supreme Court Approved Family Law Form 12.982(f), Petition for Change of Name (Family) 
(06/10) 
- 23 - 
Florida Supreme Court Approved Family Law Form 12.913(a).  The law on constructive service is very 
complex and you may wish to consult an attorney regarding constructive service. 
 
Next, you must obtain a final hearing date for the court to consider your request. If you are seeking to 
restore a former name, hearing on the petition MAY be held immediately after the petition is filed.  The 
final hearing on any other petition for a name change may be held immediately after the clerk of court 
receives the results of your criminal history records check.  You should ask the clerk of court, family law 
intake staff, or judicial assistant about the local procedure for setting a hearing.  You may be required 
to attend the hearing.   Included in these forms is a Final Judgment of Change of Name (Family), Florida 
Supreme Court Approved Family Law Form 12.982(g), which may be used when a judge grants a change 
of name for a family.  If you attend the hearing, you should take the final judgment form with you.  You 
should complete the top part of this form, including the circuit, county, case number, division, the 
name(s) of the petitioner(s) and leave the rest blank for the judge to complete.  It should be typed or 
printed in black ink. 
 
If the judge grants your petition, he or she will sign this order.  This officially changes your family’s 
name. The clerk can provide you with certified copies of the signed order.  There will be charges for the 
certified copies, and the clerk can tell you the amount of the charges. 
Where can I look for more information? 
 
Before proceeding, you should read “General Information for Self-Represented Litigants” found at the 
beginning of these forms.  For further information, see section 68.07, Florida Statutes. 
 
Special notes... 
 
The heading of the form calls for the name(s) of the petitioner(s).  This is (are) the parent(s) who is/are 
requesting the change of their family’s name(s).  The judicial circuit, case number, and division may be 
obtained from the clerk of court’s office when you file the petition. 
 
It may be helpful to compile a list of all of the people and places that will need a copy of the final 
judgment. This list may include the driver’s license office, social security office, banks, schools, etc.  A list 
will help you know how many copies of your order you should get from the clerk of court after your 
hearing. 
 
Remember, a person who is NOT an attorney 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 bottom of the last page of every 
form he or she helps you complete. 
 
 
Florida Supreme Court Approved Family Law Form 12.982(f), Petition for Change of Name (Family) (06/10) 
- 24 - 
IN THE CIRCUIT COURT OF THE                                                       JUDICIAL CIRCUIT, 
IN AND FOR                                                       COUNTY, FLORIDA 
 
Case No.:  
 
Division:  
 
IN RE: THE NAME CHANGE OF 
 
                                                                      , 
 
 
 
  Petitioner/Father, 
 
                                                                      , 
 
 
 
 Petitioner/Mother. 
 
PETITION FOR CHANGE OF NAME (FAMILY) 
 
I/We, {full legal name(s)}  
, being sworn, 
certify that the following information is true: 
There are {enter number}  
 
 adults named in this petition.  A supplemental form is attached for each 
adult not set out below. 
There are {enter number}  
 
 children named in this petition.  I am/We are the birth or legal parents 
or guardian of the minor child(ren) named in this petition.  I/We have attached a completed 
supplemental form for each minor child. 
Unless I am seeking to restore a former name, a copy of the fingerprints of each adult person seeking a 
name change in this petition has/have been taken in a manner approved by the Department of Law 
Enforcement, and submitted for a state and national criminal history records check. I/We understand 
that I/we cannot request a hearing on my/our Petition until the clerk of court receives the results of 
the criminal history records check. 
 
THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER: 
(    ) HUSBAND (    ) WIFE (   ) GUARDIAN 
(    ) A Supplemental Form has been attached for the other parent or petitioner. 
 
5. My complete present name is: 
 
 
 
 
 
 
. 
I request that my name be changed to: 
 
 
 
 
 
 
. 
 
6. I live in   
  County, Florida, at {street address}  
 
 
 
 
 
 
 
. 
 
 
 
Florida Supreme Court Approved Family Law Form 12.982(f), Petition for Change of Name (Family) (06/10) 
- 25 - 
7. I was born on {date}    
, in {city} 
 
 
, {county} 
, 
{state}   
  , {country}  
 
. 
 
8. My father’s full legal name:  
. 
My mother’s full legal name:  
. 
My mother’s maiden name:  
. 
 
9. I have lived in the following places since birth: 
Dates (to/from)  
Address 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
10. Family 
[Choose all that apply] 
a. ___  I am not married. 
b. ___  I am married.  My spouse’s full legal name is:  
. 
c. ___  I do not have child(ren). 
d. ___  The name(s), age(s), and address(es) of my child(ren) are as follows (all children, 
including those over 18, must be listed): 
Name {last, first, middle initial} 
 
Age       Address, City, State 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
11. Former names 
[Choose all that apply] 
__ My name has never been changed by a court. 
__ My name previously was changed by court order from  
 
to   
   
  
 
 on {date} 
 
, 
by {court, city, and state}  
. 
A copy of the court order is attached. 
__ My name previously was changed by marriage from  
 
 
 
Florida Supreme Court Approved Family Law Form 12.982(f), Petition for Change of Name (Family) (06/10) 
- 26 - 
to  
   
  
 
 on {date} 
 
, 
in {city, county, and state}  
. 
A copy of the marriage certificate is attached. 
__ I have never been known or called by any other name. 
__ I have been known or called by the following other name(s): {list name(s) and explain where 
you were known or called by such name(s)}  
 
 
 
 
 
 
 
 
 
 
. 
 
12. Occupation 
My occupation is:  
 
. 
I am employed at: {company and address}  
 
 
 
 
 
 
 
. 
During the past 5 years, I have had the following jobs: 
 
Dates (to/from)  
Employer and employer’s address 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
13. Business 
[Choose one only] 
__ I do not own and operate a business. 
__ I own and operate a business.  The name of the business is:  
. 
The street address is:  
. 
My position with the business is:  
. 
I have been involved with the business since: {date}  
. 
 
14. Profession 
[Choose one only] 
__ I am not in a profession. 
__ I am in a profession.  My profession is:  
. 
I have practiced this profession: 
Dates (to/from)  Place and address 
 
 /  
                 
 
 
 /  
                 
 
 
 /  
                 
 
 
 /  
                 
 
 
 /  
                 
 
 
 
Florida Supreme Court Approved Family Law Form 12.982(f), Petition for Change of Name (Family) (06/10) 
- 27 - 
(____ Please indicate here if you are continuing these facts on an attached page.) 
15. Education 
I have graduated from the following school(s): 
 Degree        
Date of 
Received 
   Graduation 
 
School 
 
        
   
  
 
 
 
 
 
 
   
  
 
 
 
 
 
 
   
  
 
 
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
16. Criminal History 
[Choose one only] 
__ 
I have never been arrested for or charged with, pled guilty or nolo contendere to, or 
have been found to have committed a criminal offense, regardless of adjudication. 
__ 
I have a criminal history.  In the past I have been arrested for or charged with, pled 
guilty or nolo contendere to, or been found to have committed a criminal offense, 
regardless of adjudication.  The details of my criminal history are: 
Date  
City/State 
 
Event (arrest, charge, plea, or adjudication) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
17. Bankruptcy 
[Choose one only] 
__ I have never been adjudicated bankrupt. 
__ I was adjudicated bankrupt on {date}  
 
 
, in {city}  
 
, 
{county}  
 
 
, {state}  
 
 . 
(____ Please indicate here if you have had additional bankruptcies, and explain on an attached 
page.) 
 
18. Creditor(s)’ Judgments 
[Choose one only] 
__ I have never had a money judgment entered against me by a creditor. 
__ The following creditor(s)’ money judgment(s) have been entered against me: 
Date 
    Amount 
    Creditor 
Court entering judgment and case number indicate if 
Paid 
 
 
     
   
     
 
     
 
 
 
                  
 
 
 
     
   
     
 
     
 
 
       
                  
 
 
 
     
   
     
 
     
 
 
 
                  
 
 
 
     
   
     
 
     
 
 
 
                  
 
(____ Please indicate here if these facts are continued on an attached page.) 
 
 
 
Florida Supreme Court Approved Family Law Form 12.982(f), Petition for Change of Name (Family) (06/10) 
- 28 - 
19. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner 
invade the property rights of others, whether partnership, patent, good will, privacy, trademark, 
or otherwise. 
 
20. My civil rights have never been suspended, or, if my civil rights have been suspended, they have 
been fully restored. 
 
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:  
 
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, whose address is{street}   
 
 
 
, {city}  
, 
{state}   
 
, {phone}   
 , helped {name}  
 
, 
who is the petitioner, fill out this form. 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name 
(Family) (06/10) 
 -29 - 
ADULT SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (FAMILY) 
 
Case No.:  
 
 
THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER: 
(    ) HUSBAND (    ) WIFE  (   ) GUARDIAN 
 
1. My complete present name is: 
 
 
 
 
 
 
. 
I request that my name be changed to: 
 
 
 
 
 
 
. 
 
2. I live in   
  County, Florida, at {street address}  
 
 
 
 
 
 
 
. 
 
3. I was born on {date}    
, in {city} 
 
 
, {county}  
, 
{state}   
  , {country}  
 
. 
 
4. My father’s full legal name:  
. 
My mother’s full legal name:  
. 
My mother’s maiden name:  
. 
 
5. I have lived in the following places since birth: 
Dates (to/from)  Address 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
6. Family 
[Choose all that apply] 
a. ___   I am not married. 
b. ___   I am married.  My spouse’s full legal name is:  
. 
c. ___   I do not have child(ren). 
d. ___   The name(s), age(s), and address(es) of my child(ren) are as follows (all children, 
including those over 18, must be listed): 
 
Name {last, first, middle initial} 
 
Age       Address, City, State 
 
 
 
 
 
 
 
 
 
 
 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name 
(Family) (06/10) 
 -30 - 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
7. Former names 
[Choose all that apply] 
__ My name has never been changed by a court. 
__ My name previously was changed by court order from_______________________________ 
to   
   
  
 on {date} 
 
 
 
by {court, city, and state}  
. 
A copy of the court order is attached. 
__ My name previously was changed by marriage from ________________________________ 
to   
   
  
 on {date} 
 
 
 
in {city, county, and state}  
. 
A copy of the marriage certificate is attached. 
__ I have never been known or called by any other name. 
__ I have been known or called by the following other name(s): {list name(s) and explain where 
you were known or called by such name(s)} ___________________________________________ 
 
 
 
 
 
 
 
 
 
 
 
 
 
8. Occupation 
My occupation is:  
 
. 
I am employed at: {company and address}  
 
 
 
 
 
 
 
. 
During the past 5 years, I have had the following jobs: 
Dates (to/from)  
Employer and employer’s address 
             / 
              
 
            /  
   
  
 
            /  
   
  
 
            /  
   
  
 
            /  
   
  
 
            /  
   
  
 
            /  
   
  
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
9. Business 
[Choose all that apply] 
__ I do not own and operate a business. 
__ I own and operate a business.  The name of the business is:  
. 
The street address is:  
                                                                                                           . 
My position with the business is:  
. 
I have been involved with the business since: {date}  
. 
 
10. Profession 
[Choose all that apply] 
__ I am not in a profession. 
PETITIONER #              , continued 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name 
(Family) (06/10) 
 -31 - 
__ I am in a profession.  My profession is:  
. 
I have practiced this profession: 
Dates (to/from)  
Place and address 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
(___ Please indicate here if you are continuing these facts on an attached page.) 
 
11. Education 
I have graduated from the following school(s): 
Degree  
Date of 
Received 
Graduation 
 
School 
             
   
  
 
 
 
             
   
  
 
 
 
             
   
  
 
 
 
(___ Please indicate here if you are continuing these facts on an attached page.) 
 
12. Criminal History 
[Choose all that apply] 
__ I have never been arrested for or charged with, pled guilty or nolo contendere to, or been 
found to have committed a criminal offense, regardless of adjudication. 
__ I have a criminal history.  In the past I have been arrested for or charged with, pled guilty or 
nolo contendere to, or been found to have committed a criminal offense, regardless of 
adjudication.  The details of my criminal history are: 
 
Date  
City/State 
 
Event (arrest, charge, plea, or adjudication) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(___ Please indicate here if you are continuing these facts on an attached page.) 
 
13. Bankruptcy 
[Choose one only] 
__ I have never been adjudicated bankrupt. 
__ I was adjudicated bankrupt on {date}  
 
 
, in {city}  
                           , 
{county}   
 
  
, {state}  
 
. 
(___ Please indicate here if you have had additional bankruptcies, and explain on an attached 
page.) 
 
14. Creditors’ Judgments 
[Choose one only] 
__ 
I have never had a money judgment entered against me by a creditor. 
__ 
The following creditor(s)’ money judgment(s) have been entered against me:   
PETITIONER #              , continued 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name 
(Family) (06/10) 
 -32 - 
Date 
Amount  
Creditor     
 Court entering judgment and case number       check if Paid 
                                       
 
 
 
                  
 
                  
                                   
  
 
 
 
                  
 
                  
                                    
     
 
 
                  
 
 
                  
                                   
  
 
 
 
                      
 
                  
(____ Please indicate here if these facts are continued on an attached page.) 
 
15. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner 
invade the property rights of others, whether partnership, patent, good will, privacy, trademark, 
or otherwise. 
 
16. My civil rights have never been suspended, or, if my civil rights have been suspended, they have 
been fully restored. 
 
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:  
 
 
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, whose address is {street}   
 
 
 
, {city} ____________________ , 
 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name 
(Family) (06/10) 
 -33 - 
{state}   
 
, {phone}   
 , helped {name}  
 
, 
who is the petitioner, fill out this form. 
Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name 
(Family) (06/10) 
- 34 - 
 
CHILD SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (FAMILY) 
 
Case No.:  
 
 
THE FOLLOWING INFORMATION IS TRUE ABOUT MINOR CHILD #  
      : 
 
1. Minor child’s complete present name is: 
 
 
 
 
 
 
 
I/We request that minor child’s name be changed to: 
 
 
 
 
 
 
 
 
2. The minor child lives in   
 
 County, Florida, at {street address}  
 
 
 
 
 
 
 
. 
 
3. The minor child was born on  
 
 
 
, in {city, county, state, country} 
 
 
 
 
 
 
. 
 
4. The minor child’s father’s full legal name:  
. 
The minor child’s mother’s full legal name:  
. 
The minor child’s mother’s maiden name:  
. 
 
5. The minor child has lived in the following places since birth: 
Dates (to/from)  
Address 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
 
 
/ 
   
  
 
(____ Please indicate here if continuing these facts on an attached page.) 
 
6. [Choose one only] 
__ The minor child is not married 
__ The minor child is married to: {full legal name}  
. 
 
7. [Choose one only] 
__ The minor child has no children. 
__ The minor child is the parent of the following child(ren): {enter name(s) and date(s) of birth} 
  
 
 
 
_______________________________________________________________. 
 
8. Former names 
[Choose all that apply] 
__ The minor child’s name has never been changed by court order. 
__ The minor child’s name previously was changed by court order from __________ 
to   
   
  
 
 on {date} __________________    {court, city, and 
state}  
                                                                                               . 
 
 
PETITIONER(S) MUST INITIAL HERE                      
Florida Supreme Court Approved Family Law Form 12.982(f), Supplemental Form for Petition for Change of Name 
(Family) (06/10) 
  - 35 -  
A copy of the court order is attached. 
__   The minor child’s name previously was changed by marriage from ______________ 
                       to   
 
 
 
 
 
 
 on {date} __________, in {city, 
                      county, and state}                                                                                            . 
__ The minor child has never been known or called by any other name. 
__ The minor child has been known or called by the following other name(s): {list name(s) and 
explain where child was known or called by such name(s)} _________ 
____________________________________________________________________ 
____________________________________________________________________. 
 
9. The minor child is not employed in an occupation or profession, does not own and operate a 
business, and has received no educational degrees.  If the minor child has a job, explain: 
_____________________________________________________________ 
________________________________________________________________________ 
________________________________________________________________________ 
 
10. Criminal History 
[Choose one only] 
__ The minor child has never been arrested for or charged with, pled guilty or nolo contendere 
to, or been found to have committed a criminal offense, regardless of adjudication. 
__ The minor child has a criminal history.  In the past, the minor child was arrested for or 
charged with, pled guilty or nolo contendere to, or been found to have committed a criminal 
offense, regardless of adjudication.  The details of the criminal history are: 
 
Date  
City/State 
 
Event (arrest, charge, plea, or adjudication) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(____ Please indicate here if you are continuing these facts on an attached page.) 
 
11. Money Judgments 
[Choose one only] 
__ The minor child has never been  adjudicated bankrupt, and no money judgment has ever 
been entered against him or her. 
__ The following money judgment(s) has been entered against him or her: 
Date 
    Amount 
Creditor     Court entering judgment and case number Indicate if Paid 
                                    
  
     
 
                  
 
 
          
                                    
  
     
 
                  
 
 
         