# Supreme Court of Florida

____________

No. SC20 24

- 0072

____________

IN R E : AMENDMENTS TO F LORIDA F AMILY L AW R ULES OF
P ROCEDURE

– F ORMS 12.90 0 ( h ) AND 12.9 28.

February 22, 2024

PER CURIAM.

This matter is before the Court for consideration of proposed

amendments to the Florida Family Law Rules of Procedure Forms

.

We have jurisdiction. See art. V, § 2(a), Fla. Const. ; see also Fla. R.

Gen. Prac. & Jud. Admin. 2.140(e).

The Florida Bar’s Family Law Rules Committee has filed a f ast

track report proposing amendments to forms 12.900(h) (Notice of

Related Cases) and 12.928 (Cover Sheet for Family Court Cases) in

response to recent legislation creating section 61.1255, Florida

Statutes

. See ch. 2023

- 213, § 1, Laws of Fla. The Board of

Governors of The Florida Bar unanimously recommends adopting

the proposed amendments. The Committee did not publish the

proposals for comment before filing them with the Court.

## - 2

- Chapter 2023

- 213, s ection 1, Laws of Florida, created section

61.1255 , Florida Statutes, which established procedures and

guidelines for obtaining support for dependent adult children

. The

Committee propose s amending forms 12.900(h) and 12.928 to add

“Support for Dependent Adult Children” to the type s of proceeding s

in eac h of these forms. Having considered the Committee’s report

and the relevant legislation, we hereby amend the forms as

proposed by the Committee.

Accordingly, the Florida Family Law Rules of Procedure Forms

are amended as reflected in the appendix to this opinion , with the

forms fully engrossed and ready for use

. The forms may be

accessed and downloaded from the Florida State Courts’ website at

http://www.flcourts.org/resources

- and

- services/court

improvement/family

- courts/family

- law

- forms.stml. The

amend ments shall take effect immediately upon the release of this

opinion. Because the amendments were not published for comment

prior to their adoption, interested persons shall have 75 days from

the date of this opinion in which to file comments with the Cou rt. 1



## 1. All comments must be filed with the Court on or before May 7, 2024 , as well as a separate request for oral argument if the

## - 3

- It is so ordered.

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

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

Original Proceeding

– Florida Family Law Rules of Procedure

Hon. Howard Ogle McGillin, Jr., Chair, Family Law Rules Committee, St. Augustine , Florida, Joshua E. Doyle, Executive Director, The Florida Bar, Tallahassee, Florida, and Kelly N. Smith, Staff Liaison, The Florida Bar, Tallahassee, Flori da,

for Petitioner

person filing the comment wishes to participate in oral argument, which may be scheduled in this case. If filed by an attorney i n good standing with The Florida Bar, the comment must be electronically filed via the Florida Courts E

- Filing Portal (Portal). If filed by a nonlawyer or a lawyer not licensed to practice in Florida, the comment may be, but is not required to be, filed v ia the Portal. Any person unable to submit a comment electronically must mail or hand

- deliver the originally signed comment to the Florida Supreme Court, Office of the Clerk, 500 South Duval Street, Tallahassee, Florida 32399

- 1927.Instructions for F lorida Family Law Rules of Procedure Form 12.900( h ), Notice of Related Cases ( 02 / 24 )



## - 4

- APPENDIX

**INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.900(h), NOTICE OF RELATED CASES (**  **02 /**  **24 )** 

**When should this form be used?**

Florida Rule of General Practice and Judicial Administration 2.545(d) requires the petitioner in a family law case to file with the court a notice of related cases, if any. Your circuit may also require this form to
be filed even if there are no related cases. A case is c onsidered related if:

• it involves the same parties, children, or issues and is pending when the family law case is filed; or

• it affects the court’s jurisdiction to proceed; or

• an order in the related case may conflict with an order on the same issues in t he new case; or

• an order in the new case may conflict with an order in the earlier case.

This form is used to provide the required notice to the court.

This form should be typed or printed in black ink. It must be filed with the clerk of the circuit court with the initial pleading in the family law case.



## What should I do next?

A copy of the form must be served on the presiding judge, either the chief j udge or the family law administrative judge, and all parties in the related cases. You should also keep a copy for your records.
Service must be in accordance with Florida Rule of General Practice and Judicial Administration 2.516.



## Where can I look for mo **re information?**

Before proceeding, you should read “General Information for Self

- Represented Litigants” found at the beginning of these forms. The words that are in ” bold and underline” in these instructions are defined there. For further information, see Florida Rule of General Practice and Judicial Administration 2.545(d).



## Special notes . . .

Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fil l 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 must also put his or her name, address, and t elephone number on the bottom of the last page of every form he or she helps you complete.F lorida Family Law Rules of Procedure Form 12.900( h ), Noti ce of Related Cases ( 02 / 24 )



## - 5

- IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,

IN AND FOR COUNTY, FLORIDA

Case No.:
Division:

____________________ _________, Petitioner,
and

_____________________________, Respondent.



## NOTICE OF RELATED CASES

1. Petitioner submits this Notice of Related Cases as required by Florida Rule of General Practice and Judicial Administration 2.545(d). A related case may be an open or closed civil, criminal, guardianship, domestic violence, juvenile delinquency, juvenile dependency, or domestic relations case. A case is “related” to this family law case if it involves any of the same parties, children, or issues and it is

pen ding at the time the party files a family case; if it affects the court’s jurisdiction to proceed; if an order in the related case may conflict with an order on the same issues in the new case; or if an order in the new case may conflict with an order in t he earlier litigation.

[check one only]

_

___ There are no related cases.

____ The following are the related cases (add additional pages if necessary):

Related Case No. 1 Case Name(s): _____________________________________________________________________ Petitioner ________________________________________________________________________ Respondent

_______________________________________________________________________ Case No.: _________________________ ________ Division:

________________________________

Type of Proceeding: [check all that apply] ____ Dissolution of Marriage

____ Paternity ____ Custody

____ Adoption

____ Child Support

____ Support for Dependent Adult Children

____ Modification/Enforcement/Contempt Proceedings

____ Juvenile Dependency

____ Juvenile Delinquency

____ Termination of Parental Rights

____ Criminal

____ Domestic/Sexual/Dating/Repeat

____ Mental Health ____ Violence or Stalking Injunctions ____ Other {specify} ___________________________

State where case was decided or is pending: ____ Florida ____ Other: {specify} _________________

Name of Court where case was decided or is pending ( for example, Fifth Circuit Court, Marion County, Florida ): _______________________F lorida Family Law Rules of Procedure Form 12.900( h ), Notice of Related Cases ( 02 / 24 )



## - 6

- ___________________________________________ Title of last Court Order/Judgment (if any): ______________________________________________ Date of Court Order/Judgment (if any): _________________________________________________

Relationship of cases check all that apply]:

____ pending case involves same parties, children, or issues;

____ may affect court’s jurisdiction;

____ order in related case may conflict with an order in this case;

____ order in this case may conflict with previous order in related case.

Statement as to the relationship of the cases: ____________________________________________

_______________________ ___________________________________________________________

__________________________________________________________________________________

Related Case No. 2 Case Name(s): _____________________________________________________________________

Petitione r ________________________________________________________________________ Respondent

_______________________________________________________________________ Case No.: _________________________________ D ivision:

________________________________

Type of Proceeding: [check all that apply] ____ Dissolution of Marriage

____ Paternity ____ Custody

____ Adoption

____ Child Support

____ Support for Dependent Adult Children

____ Modificatio n/Enforcement/Contempt Proceedings

____ Juvenile Dependency

____ Juvenile Delinquency

____ Termination of Parental Rights

____ Criminal

____ Domestic/Sexual/Dating/Repeat

____ Mental Health ____ Violence or Stalking Injunctions ____ Other {specify}

__________________________

State where case was decided or is pending:

____ Florida

____ Other: {specify} _________________

Name of Court where case was decided or is pending ( for example, Fifth Circuit Court, Marion County, Florida ): __________________________________________________________________

_ Title of last Court Order/Judgment (if any): ______________________________________________ Date of Court Order/Judgment (if any): _______________________________________

__________

Relationship of cases check all that apply]:

____ pending case involves same parties, children, or issues.

____ may affect court’s jurisdiction;

____ order in related case may conflict with an order in this case;

____ order in this case may conflict with previous order in related case.

Statement as to the relationship of the cases: ____________________________________________

__________________________________________________________________________________

__________________________________________________________________________________F lorida Family Law Rules of Procedure Form 12.900( h ), Notice of Related Cases ( 02 / 24 )



## - 7

- Related Case No. 3 Case Name(s): _______________________________________________________

_____________ _

_ Petitioner ______________________________________________________________________

_

__ Respondent

_______________________________________________________________________ Case No.: _________ ________________________ Division:

________________________________

Type of Proceeding: [check all that apply] ____ Dissolution of Marriage

____ Paternity ____ Custody

____ Adoption

____ Child Support

____ Support for Dependent Adult Children

____ Modification/Enforcement/Contempt Proceedings

____ Juvenile Dependency

____ Juvenile Delinquency

____ Termination of Parental Rights

____ Criminal

____ Domestic/Sexual/Dating/Repeat

____ Mental Health

____ Viol ence or Stalking Injunctions ____ Other {specify}

__________________________

State where case was decided or is pending: ____ Florida ____ Other: {specify} _________________

Name of Court where case was decided or is pending ( 

### for example, Fifth Circuit Court, Marion County, Florida ): __________________________________________________________________ Title of last Court Order/Judgment (if any): ______________________________________________ Date of Court Order/Judgment (if any): __________________

_______________________________

Relationship of cases check all that apply]:

____ pending case involves same parties, children, or issues;

____ may affect court’s jurisdiction;

____ order in related case may conflict with an order in this case;

____ o rder in this case may conflict with previous order in related case.

Statement as to the relationship of the cases: ____________________________________________

__________________________________________________________________________________

___________ _______________________________________________________________________

2. [check one only] ____ I do not request coordination of litigation in any of the cases listed above.

____ I do request coordination of the following cases: ____________________________

_________

______________________________________________________________________________

______________________________________________________________________________

3. [check all that apply] ____ Assignment to one judge ____ Coordination of existing cases will conserve judicial resources and promote an efficient
determination of these case because :_

______________________________________________

______________________________________________________________________________F lorida Family Law Rules of Procedure Form 12.900( h ), Notice of Related Cases ( 02 / 24 )



## - 8

- 4. The Petitioner ackn owledges a continuing duty to inform the court of any cases in this or any other state that could affect the current proceeding.

Dated: _________________

_______________________________________ Petitioner’s Signature
Printed Name:
Address:

C ity, State, Zip: Telephone Number:
Fax Number:

E

- mail Address(es):



## CERTIFICATE OF SERVICE

I CERTIFY that I delivered a copy of this Notice of Related Cases to the _____________________ County Sheriff’s Department or a certified process server for service on the Respondent, and [ check all used ] ( ) e

- mailed ( ) mailed ( ) hand delivered, a copy to {name} ________________________, who is the [ check all that apply ] ( ) judge assigned to new case, ( ) chief judge or family law administrative judge, ( ) {name} __________________________________ a party to the related case, ( ) {name}

____________________________ , a party to the related case on {date}

_________________________.

_______________________________________ Signature of Petitioner/Attorney for Petitioner
Printed Name:
Address: City, State, Zip: Telephone Number:

E

- mail Address(es):
Florida Bar Number:

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] This form was prepared for the {choose only one} : ( ) Petitioner ( ) Respondent. This form was completed with the assistance of: {name of individual}

, {name of business}

_______________________________________________________________, {address}

, {city}

_______________________ {state}

__________, {telephone number}

.Instructions for Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases ( 02 / 24 )



## - 9

-

**INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE**
**FORM 12.928 COVER SHEET FOR FAMILY COURT CASES (**  **02 /**  **24 )** 

**When should this form be used?**

The Cover Sheet for Family Court Cases and the information contained in it does not replace nor supplement the filing and service of pleadings or other documents as required by la w. This form shall be filed by the petitioner/party opening or reopening a case for the use of the clerk of the

circuit court for the purpose of reporting judicial workload data pursuant to Florida Statutes

section 25.075.

This form should be typed or printed in black ink. The petitioner must file this cover sheet with the first pleading or motion filed to open or reopen a case in all domestic and juvenile cases.



### What should I do next?

Follow these instructions for comple ting the form:

I. Case Style. Enter the name of the court, the appropriate case number assigned at the time of filing of the original petition, the name of the judge assigned (if applicable), and the name (last, first, middle initial) of the petitioner(s) an d respondent(s).

II. Type of Action /Proceeding. Place a check beside the proceeding you are initiating. If you are filing more than one type of proceeding, (such as a modification and an enforcement proceeding) against the same party at the same time, then you must complete a separate cover sheet for each action being filed.

(A) Initial Action/Petition (B) Reopening Case. If you check “Reopening Case,” indicate whether you are filing a modification or supplemental petition or an action for enforcement by placing a check beside the appropriate action/petition.

1. Modification/Supplemental Petition

2. Motion for Civil Contempt/ Enforcement

3. Other

– All reopening actions not involving modification/supplemental petitions or petition enforcement.

III. Type of Case. Place a ch eck beside the appropriate case. If the case fits more than one category, select the most definitive. Definitions of the categories are provided below. (A) Simplified Dissolution of Marriage

- petitions for the termination of marriage pursuant to Florida Family Law Rule of Procedure 12.105. (B) Dissolution of Marriage

- petitions for the termination of marriage pursuant to ChapterInstructions for Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases ( 02/24 )



## - 10

- (C) 61, Florida Statutes, other than simplified dissolution. (D) Domestic Violence

- all matters relating to injunctions for protection against domestic violence pursuant to section 741.30, Florida Statutes. (E) Dating Violence

- all matters relating to injunctions for protection against dating violence pursuant to section 784.046, Florida Statu tes. (F) Repeat Violence

- all matters relating to injunctions for protection against repeat violence pursuant to section 784.046, Florida Statutes. (G) Sexual Violence

- all matters relating to injunctions for protection against sexual violence pursuant to secti on 784.046, Florida Statutes. (H) Stalking

- all matters relating to injunctions for protection against stalking pursuant to section 784.0485, Florida Statutes (I) Support

- IV

- D

- all matters relating to child or spousal support in which an application
for assistan ce has been filed with the Department of Revenue, Child Support
Enforcement under Title IV

- D, Social Security Act, except for such matters relating to dissolution of marriage petitions (sections 409.2564, 409.2571, and 409.2597, Florida Statutes), paternit y, or UIFSA. (J) Support

- Non IV

- D

- all matters relating to child or spousal support in which an application for assistance has not been filed under Title IV

- D, Social Security Act. (K) UIFSA

- IV

- D

- all matters relating to Chapter 88, Florida Statutes, in which an application
for assistance has been filed under Title IV

- D, Social Security Act. (L) UIFSA

- Non IV

- D

- all matters relating to Chapter 88, Florida Statutes, in which an application for assistance has not been filed under Title IV

- D, Social Security Act. (M) Support for Dependent Adult Children

– all matters related to support of a dependent
adult child. (N) Other Family Court

- all matters involving time

- sharing and/or parenting plans relating to minor child(ren), support unconnected with dissolution of marriag e, annulment, delayed birth certificates pursuant to Florida Statutes section 382.0195, expedited affirmation of parental status pursuant to Florida Statutes section 742.16, termination of parental rights proceedings pursuant to Florida Statutes section 63 .087, declaratory judgment actions related to premarital, marital, post

- marital agreements, or other matters not included in the categories above. (O) Adoption Arising Out Of Chapter 63

- all matters relating to adoption pursuant to Chapter 63, Florida Statute s, excluding any matters arising out of Chapter 39, Florida

Statutes. (P) Name Change

- all matters relating to name change, pursuant to section 68.07, Florida

Statutes. (Q) Paternity/Disestablishment of Paternity

– all matters relating to paternity pursuant to Chapter 742, Florida Statutes. (R) Juvenile Delinquency

- all matters relating to juvenile delinquency pursuant to Chapter 985, Florida Statutes. (S) Petition for Dependency

- all matters relating to petitions for dependency. (T) Shelter Petition

– all matters relat ing to shelter petitions pursuant to Chapter 39, Florida

Statutes. (U) Termination of Parental Rights Arising Out Of Chapter 39

– all matters relating toInstructions for Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases ( 02/24 )



## - 11

- (V) termination of parental rights pursuant to Chapter 39, Florida Statutes. (W) Adoption Arising Out Of Chapter 39

– all matters relating to adoption pursuant to Chapter 39, Flori da Statutes. (X) CINS/FINS

– all matters relating to children in need of services (and families in need of services) pursuant to Chapter 984, Florida Statutes. (Y) Petition for Temporary or Concurrent Custody by Extended Family

- all matters relating to petitions fo r temporary or concurrent custody pursuant to Chapter 751. (Z) Emancipation of a Minor

- all matters relating to emancipation of a minor pursuant to Chapter 743.

ATTORNEY OR PARTY SIGNATURE. Sign the Cover Sheet for Family Court Cases. Print legibly the

name o f the person signing the Cover Sheet for Family Court Cases. Attorneys must include a Florida Bar number. Insert the date the Cover Sheet for Family Court Cases is signed. Signature is a certification that filer has provided accurate information on the Cov er Sheet for Family Court

Cases.

Nonlawyer 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 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 c omplete.

A copy of this form must be filed with the court and served on the other party or his or her attorney. The copy you are serving to the other party must be either mailed, e

- mailed, or hand

delivered to the opposing party or his or her attorney on the same day indicated on the certificate of service. If it is mailed, it must be postmarked on the date indicated in the
certificate of service.



### IMPORTANT INFORMATION REGARDING E

**- FILING** 

The Florida Rules of General Practice and Judicial Administration now require that all petitions, pleadings, and documents be filed electronically except in certain circumstances. Self

represented litigants may file petitions or other pleadings or documents electronically; however, they are not required to do so. If you choose to file your pleadings or other documents electronically, you must do so in accordance with Florida Rule of General Practice and Judicial Administration 2.525, and you must follow the procedures of the judicial circuit in which you file. The rules and procedures should be carefully read and followed.



### IMPORTANT INFORMATION REGARDING E

**- SERVICE ELECTION** 

After the initial service of process of the petition or supplemental petition by the Sheriff or certified process server, the Florida Rules of General Practice and Judicial Administration now require that all documents required or permitted to be served on the other party must be served by electronic mail (e

- mail) except in certain circumstances. You must strictly comply with the format requirements set forth in the Florida Rules of General Practice and Judicial
Administration . If you elect to participate i n electronic service, which means serving or receiving pleadings by electronic mail (e

- mail), or through the Florida Courts E

- Filing Portal, you mustInstructions for Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases ( 02/24 )



## - 12

- review Florida Rule of General Practice and Judicial Administration 2.516. You may find this rule
at www.f lcourts.org through the link to the Rules of General Practice and Judicial Administration provided under either Family Law Forms: Getting Started, or Rules of Court in the A

- Z Topical
Index.

SELF

- REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E

- MAIL; HOWEV ER, THEY ARE NOT REQUIRED TO DO SO. If a self

- represented litigant elects to serve and receive documents by email, the procedures must always be followed once the initial election is made.

To serve and receive documents by e

- mail, you must designate your e

- mail addresses by using the Designation of Current Mailing and E

- mail Address, Florida Supreme Court Approved Family Law Form 12.915, and you must provide your e

- mail address on each form on which your signature appears. Please CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme Court Approved Family Law Form 12.914; Designation of Current Mailing and E

- mail Address , Florida Supreme Court Approved Family Law Form 12.915; and
Florida Rule of General Practice an d Judicial Administration 2.516.



### 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 Rule 12.100, Florida Family
Law Rules of Procedure.Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases ( 02/24 )



## - 13

- **COVER SHEET FOR FAMILY COURT CASES**

I. Case Style

IN THE CIRCUIT COURT OF THE

__ ____ JUDICIAL CIRCUIT,

IN AND FOR

_____________ _____ COUNTY, FLORIDA

Case No.:

__________ ______ Judge:

________________ __

__________________________ ___ , Petitioner,

and

_________________________ ____ , Respondent.

II. Type of Action/Proceeding. Place a check beside the proceeding you are initiating. If you ar e filing more than one type of proceeding (such as a modification and an enforcement proceeding) against the same party at the same time, then you must complete a separate cover sheet for each action being filed. If you are reopening a case, choose one of the three options below it.

(A) ____ Initial Action/Petition (B) ____ Reopening Case

1.

____ Modification/Supplemental Petition

2. ____ Motion for Civil Contempt/Enforcement

3.

____ Other

III. Type of Case. If the case fits more than one type of case, select the most definitive.

(A) ____ Simplified Dissolution of Marriage (B) ____ Dissolution of Marriage (C) ____ Domestic Violence (D) ____ Dating Violence (E) ____ Repeat Violence (F) ____ Sexual Violence (G) ____ Stalking (H) ____ Support IV

- D (Department of Revenue, Child Support Enforcement) (I) ____ Support Non

- IV

- D ( not Department of Revenue, Child Support Enforcement) (J) ____ UIFSA IV

- D (Department of Revenue, Child Support Enforcement) (K) ____ UIFSA Non

- IV

- D ( not Department of Revenue, Child Support Enforcement) (L) ____ Support for Dependent Adult Children

– all matters related to support of a dependent adult
child. (M) ____ Other Family Court (N) ____ Adoption Arising Out Of Chapter 63Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases ( 02/24 )



## - 14

- (O)

____ Name Change (P)

____ Paternity/Disestablishment of Paternity (Q) ____ Juvenile Delinquency (R) ____ Petition for Dependency (S) ____ Shelter Petition (T) ____ Term ination of Parental Rights Arising Out Of Chapter 39 (U) ____ Adoption Arising Out Of Chapter 39 (V) ____ CINS/FINS (W) ____ Petition for Temporary or Concurrent Custody by Extended Family (X) ____ Emancipation of a Minor

IV. Rule of General Practice and Judicial Administra tion 2.545(d) requires that a Notice of Related Cases Form, Family Law Form 12.900(h), be filed with the initial pleading/petition by the filing attorney or
self

- represented litigant in order to notify the court of related cases. Is Form 12.900(h) being f iled with this Cover Sheet for Family Court Cases and initial pleading/petition?

____ No, to the best of my knowledge, no related cases exist. ____ Yes, all related cases are listed on Family Law Form 12.900(h).

ATTORNEY OR PARTY SIGNATURE

I CERTIFY that the information I have provided in this cover sheet is accurate to the best of my knowledge and belief.

Signature

______________________________________ _ FL Bar No.:

_____________________ Attorney or party (Bar number, if attorney)

_______________________________________ _ __________________________ (Type or print name) (E

- mail Address(es))

_______________ _____________ Date

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in
all blanks] This form was prepared for the: {choose only one } _____Petitioner _____ Respondent This form was completed with the assistance of: {name of individual}

, {name of business}

, {address}

, {city}

, {state} ____

, {zip code}

______, {telephone number}

.