Court Opinion

ID: 9685818
Source: CourtListenerOpinion
Date Created: 2023-08-24 15:05:26.004973+00
Date Added: 2024-06-11T09:35:21.877404
License: Public Domain

Supreme Court of Florida
                             ____________

                          No. SC2023-0919
                            ____________

     IN RE: AMENDMENTS TO FLORIDA SUPREME COURT
     APPROVED FAMILY LAW FORMS 12.980(a), 12.980(f),
             12.980(n), 12.980(q), AND 12.980(t).

                          August 24, 2023

PER CURIAM.

     Pursuant to the procedures approved in Amendments to the

Florida Family Law Rules of Procedure & Family Law Forms, 810 So.

2d 1, 13-14 (Fla. 2000), this Court has internally reviewed the

Florida Supreme Court Approved Family Law Forms and has

determined that amendments to forms 12.980(a) (Petition for

Injunction for Protection Against Domestic Violence), 12.980(f)

(Petition for Injunction for Protection Against Repeat Violence),

12.980(n) (Petition for Injunction for Protection Against Dating

Violence), 12.980(q) (Petition for Injunction for Protection Against

Sexual Violence), and 12.980(t) (Petition for Injunction for

Protection Against Stalking) are needed. 1

     1. We have jurisdiction. See art. V, § 2(a), Fla. Const.
     First, we add language to form 12.980(a) providing an

additional factor that the court must consider in determining

whether a petitioner of a domestic violence injunction is in

imminent danger in accordance with recent amendments to section

741.30(3)(b), Florida Statutes (2023). See ch. 2023-112, § 3, Laws

of Fla.

     Additionally, in a recent amendment to the forms, references

to the deputy clerk were omitted from the notary block. It has been

determined that the reference to the deputy clerk in the notary

block is necessary and should be restored to forms 12.980(a),

12.980(f), 12.980(n), 12.980(q), and 12.980(t).

     Finally, the instructions to these forms are amended to reflect

changes to Florida Rule of General Practice and Judicial

Administration 2.516 requiring self-represented litigants to serve

documents by e-mail unless in custody or excused by the clerk after

declaring a lack of e-mail account or regular internet access.

     The forms are hereby amended as set forth in the appendix to

this opinion, fully engrossed. The amendments shall become

effective immediately and may be accessed and downloaded from

the Florida State Courts’ website at

                                 -2-
https://www.flcourts.gov/Resources-Services/Office-of-Family-

Courts/Family-Court-in-Florida/Family-Law-Forms. We direct that

the forms be published for comment. Interested persons shall have

seventy-five days from the date of this opinion to file comments with

the Court. 2

     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

       2. All comments must be filed with the Court on or before
November 7, 2023, as well as a separate request for oral argument
if the person filing the comment wishes to participate in oral
argument, which may be scheduled in this case. If filed by an
attorney in 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 via 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; no additional copies are required
or will be accepted.

                                  -3-
                                                   APPENDIX

           INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED
                        FAMILY LAW FORM 12.980(a)
             PETITION FOR INJUNCTION FOR PROTECTION AGAINST
                        DOMESTIC VIOLENCE (08/23)

                                     When should this form be used?

If you are a victim of any act of domestic violence or have reasonable cause to believe that you are in imminent
danger of becoming a victim of domestic violence, you can use this form to ask the court for a protective order
prohibiting domestic violence. Because you are making a request to the court, you are called the petitioner. The
person whom you are asking the court to protect you from is called the respondent. Domestic violence includes:
assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking,
kidnapping, false imprisonment, or any other criminal offense resulting in physical injury or death to petitioner by
any of petitioner’s family or household members. In determining whether you have reasonable cause to believe you
are in imminent danger of becoming a victim of domestic violence, the court must consider all relevant factors
alleged in the petition, including, but not limited to the following:
     1. The history between the petitioner and the respondent, including threats, harassment, stalking, and
          physical abuse.
     2. Whether the respondent has attempted to harm the petitioner or family members or individuals closely
          associated with the petitioner.
     3. Whether the respondent has threatened to conceal, kidnap, or harm the petitioner’s child or children.
     4. Whether the respondent has intentionally injured or killed a family pet.
     5. Whether the respondent has used, or has threatened to use, against the petitioner any weapons such as
          guns or knives.
     6. Whether the respondent has physically restrained the petitioner from leaving the home or calling law
          enforcement.
     7. Whether the respondent has a criminal history involving violence or the threat of violence.
     8. The existence of a verifiable order of protection issued previously or from another jurisdiction.
     9. Whether the respondent has destroyed personal property, including, but not limited to, telephones or
          other communications equipment, clothing, or other items belonging to the petitioner.
     10. Whether the respondent has or had engaged in a pattern of abusive, threatening, intimidating, or
          controlling behavior composed of a series of acts over a period of time, however short, which evidences a
          continuity of purpose and which reasonably causes the petitioner to believe that the petitioner or his or
          her minor child or children are in imminent danger of becoming victims of any act of domestic violence.
     11. Whether the respondent engaged in any other behavior or conduct that leads the petitioner to have
          reasonable cause to believe that he or she is in imminent danger of becoming a victim of domestic violence.

The domestic violence laws only apply to your situation if the respondent is your spouse, former spouse, related to
you by blood or marriage, living with you now or has lived with you in the past (if you are or were living as a family),
or the other parent of your children whether or not you have ever been married or ever lived together. With the

Instructions for Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection
Against Domestic Violence (08/23)
                                                         -4-
exception of persons who have a child in common, the family or household members must be currently residing
together or have in the past resided together in the same single dwelling unit. If the respondent is not one of the
above, you should look at Petition for Injunction for Protection Against Repeat Violence, Florida Supreme Court
Approved Family Law Form 12.980(f), to determine if your situation will qualify for an injunction for protection
against repeat violence, or Petition for Injunction for Protection Against Dating Violence, Florida Supreme Court
Approved Family Law Form 12.980(n), to determine if your situation will qualify for an injunction for protection
against dating violence, or Petition for Injunction for Protection Against Sexual Violence, Florida Supreme Court
Approved Family Law Form 12.980(q), to determine if your situation will qualify for an injunction for protection
against sexual violence.

If you are under the age of eighteen and you have never been married or had the disabilities of nonage removed by
a court, then one of your parents, custodians, or your legal guardian must sign this petition with you.

This form should be typed or printed in black ink. You should complete this form (giving as much detail as possible)
and sign it in front of a notary public or the clerk of the circuit court in the county where you live. The clerk will
take your completed petition to a judge. You should keep a copy for your records. If you have any questions or
need assistance completing this form, the clerk or family law intake staff will help you.

                         What should I do if the judge grants my petition?

If the facts contained in your petition convince the judge that you are a victim of domestic violence or that an
imminent danger of domestic violence exists, the judge will sign either an immediate Temporary Injunction for
Protection Against Domestic Violence with Minor Child(ren), Florida Supreme Court Approved Family Law Form
12.980(c)(1) or an immediate Temporary Injunction for Protection Against Domestic Violence without Minor
Child(ren), Florida Supreme Court Approved Family Law Form 12.980(c)(2). A temporary injunction is issued without
notice to the respondent. The clerk will give your petition, the temporary injunction, and any other papers filed with
your petition to the sheriff or other law enforcement officer for personal service on the respondent. The temporary
injunction will take effect immediately after the respondent is served with a copy of it. It lasts until a full hearing
can be held or for a period of 15 days, whichever comes first. The court may extend the temporary injunction beyond
15 days for a good reason, which may include failure to obtain service on the respondent.

The temporary injunction is issued ex parte. This means that the judge has considered only the information
presented by one side—YOU. The temporary injunction gives a date that you must appear in court for a hearing. At
that hearing, you will be expected to testify about the facts in your petition. The respondent will be given the
opportunity to testify at this hearing, also. At the hearing, the judge will decide whether to issue either a Final
Judgment of Injunction for Protection Against Domestic Violence with Minor Child(ren) (After Notice), Florida
Supreme Court Approved Family Law Form 12.980(d)(1), or a Final Judgment of Injunction for Protection Against
Domestic Violence without Minor Child(ren) (After Notice), Florida Supreme Court Approved Family Law Form
12.980(d)(2). Either of these final judgments will remain in effect for a specific time period or until modified or
dissolved by the court. If either you or the respondent do not appear at the final hearing, the temporary injunction
may be continued in force, extended, or dismissed, and/or additional orders may be granted, including entry of a
permanent injunction and the imposition of court costs. You and respondent will be bound by the terms of any
injunction issued at the final hearing.

Instructions for Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection
Against Domestic Violence (08/23)
                                                        -5-
IF EITHER YOU OR RESPONDENT DO NOT APPEAR AT THE FINAL HEARING, YOU WILL BOTH BE BOUND BY THE
TERMS OF ANY INJUNCTION ISSUED IN THIS MATTER.

If the judge signs a temporary or final injunction, the clerk will provide you with the necessary copies. Make sure
that you keep one certified copy of the injunction with you at all times!

                            What can I do if the judge denies my petition?

If your petition is denied solely on the grounds that it appears to the court that no imminent danger of domestic
violence exists, the court will set a full hearing, at the earliest possible time, on your petition, unless you request
that no hearing be set. The respondent will be notified by personal service of your petition and the hearing. If your
petition is denied, you may: amend your petition by filing a Supplemental Affidavit in Support of Petition for
Injunction for Protection Against Domestic Violence, Repeat or Dating Violence, Florida Family Law Form 12.980
(g); attend the hearing and present facts that support your petition; and/or dismiss your petition.

                                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. The words that are in bold underline are defined in that section. The clerk of the circuit court or family
law intake staff will help you complete any necessary domestic violence forms and can give you information about
local domestic violence victim assistance programs, shelters, and other related services. You may also call the
Domestic Violence Hotline at 1-800-500-1119. For further information, see Chapter 741, Florida Statutes, and Rule
12.610, Florida Family Law Rules of Procedure.

                         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 Rules of General Practice and Judicial
Administration and you must review Florida Rule of General Practice and Judicial Administration 2.516. You may
find this rule at www.flcourts.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 MUST SERVE DOCUMENTS BY E-MAIL UNLESS EXCUSED PURSUANT TO FLORIDA
RULE OF GENERAL PRACTICE AND JUDICIAL ADMINISTRATION 2.516(b)(1)(D). If a self-represented litigant has been
excused from serving documents by e-mail and then elects to serve and receive documents by e-mail, the procedures

Instructions for Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection
Against Domestic Violence (08/23)
                                                         -6-
must always be followed once that 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 and Judicial Administration 2.516.

                                                Special notes . . .

With this form you may also need to file the following:
    • Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit, Florida Supreme Court
         Approved Family Law Form 12.902(d), must be completed and filed if you are asking the court to determine
         issues with regard to your parenting plan or time-parenting plan means a document created to govern the
         relationship between the parents relating to the decisions that must be made regarding the minor child(ren)
         and must contain a time-sharing schedule for the parents and child(ren). The issues concerning the minor
         child(ren) may include, but are not limited to, the child(ren)’s education, health care, and physical, social,
         and emotional well-being. In creating the plan, all circumstances between the parents, including their
         historic relationship, domestic violence, and other factors must be taken into consideration. The parenting
         plan shall be developed and agreed to by the parents and approved by a court, or established by the court,
         with or without the use of a court-ordered parenting plan recommendation. If the parents cannot agree,
         or if the parents agreed to a plan that is not approved by the court, a parenting plan shall be established by
         the court. “Time-sharing schedule” means a timetable that must be included in the parenting plan that
         specifies the time, including overnights and holidays, that a minor child will spend with each parent. If
         developed and agreed to by the parents of a minor child, it must be approved by the court. If the parents
         cannot agree, of if their agreed-upon schedule is not approved by the court, the schedule shall be
         established by the court.

    •    Notice of Related Cases, Florida Family Law Rules of Procedure Form 12.900(h), must be completed and
         filed.

    •    Notice of Social Security Number, Florida Supreme Court Approved Family Law Form 12.902(j), must be
         completed and filed if you are asking the court to determine issues of temporary child support.

    •    Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c), must be
         completed and filed if you are seeking temporary alimony or temporary child support.

    •    Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e), MUST be filed
         with the court at or prior to a hearing to establish or modify child support.

Additionally, if you fear that disclosing your address to the respondent would put you in danger, you should complete
a Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h), and file
it with the clerk of the circuit court and write confidential in the space provided on the petition.

Instructions for Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection
Against Domestic Violence (08/23)
                                                        -7-
                  IN THE CIRCUIT COURT OF THE                                   JUDICIAL CIRCUIT,
                           IN AND FOR                                   COUNTY, FLORIDA

                                                                Case No.:
                                                                Division:
                                        ,
                                  Petitioner,

                  and

                                        ,
                                 Respondent.

                        PETITION FOR INJUNCTION FOR PROTECTION
                              AGAINST DOMESTIC VIOLENCE

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

SECTION I. PETITIONER
(This section is about you. It must be completed. However, if you fear that disclosing your address to the respondent
would put you in danger, you should complete and file a Request for Confidential Filing of Address, Florida Supreme
Court Approved Family Law Form 12.980(h), and write confidential in the space provided on this form for your address
and telephone number.)

    1.   Petitioner’s current address is: {street address}
         {city, state, and zip code}
         Telephone Number: {area code and number}
         Physical description of Petitioner:
         Race: _____            Sex: Male _____ Female _____          Date of Birth:

    2.   Petitioner’s attorney’s name, address, and telephone number is:
                                                                                                                    .
         (If you do not have an attorney, write none.)

SECTION II. RESPONDENT
(This section is about the person you want to be protected from. It must be completed.)

    1.   Respondent’s current address is: {street address, city, state, and zip code}
                                                                                                                    .
         Respondent’s Driver’s License number is: {if known}                                                        .

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                         -8-
    2.   Respondent is: {Indicate all that apply}
         a.     the spouse of Petitioner.
                Date of Marriage:
         b.     the former spouse of Petitioner.
                Date of Marriage:
                Date of Dissolution of Marriage:
         c.     related by blood or marriage to Petitioner.
                Specify relationship:
         d.     a person who is or was living in one home with Petitioner, as if a family.
         e.     a person with whom Petitioner has a child in common, even if Petitioner and Respondent never
                were married or living together.

    3.   Petitioner has known Respondent since {date}

    4.   Respondent’s last known place of employment:
         Employment address:
         Working hours:

    5.   Physical description of Respondent:
         Race: _____ Sex: Male _____ Female _____ Date of Birth:
         Height:           Weight:         Eye Color:      Hair Color:
         Distinguishing marks or scars:
         Vehicle: (make/model)                      Color:        Tag Number:

    6.   Other names Respondent goes by (aliases or nicknames):

    7.   Respondent’s attorney’s name, address, and telephone number is:

         (If you do not know whether Respondent has an attorney, write unknown. If Respondent does not have an
         attorney, write none.)

SECTION III. CASE HISTORY AND REASON FOR SEEKING PETITION (This section must be completed.)

    1.   Has Petitioner ever received or tried to get an injunction for protection against domestic violence against
         Respondent in this or any other court?
               Yes         No      If yes, what happened in that case? {Include case number, if known}

                                                                                                                   .

    2.   Has Respondent ever received or tried to get an injunction for protection against domestic violence against
         Petitioner in this or any other court?

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                        -9-
               Yes         No        If yes, what happened in that case? {Include case number, if known}

                                                                                                                      .

    3.   Describe any other court case that is either going on now or that happened in the past, including a
         dissolution of marriage, paternity action, or child support enforcement action, between Petitioner and
         Respondent {Include city, state, and case number, if known}:
                                                                                                               .

    4.   Petitioner is either a victim of domestic violence or has reasonable cause to believe he or she is in imminent
         danger of becoming a victim of domestic violence because respondent has: {Mark all sections that apply
         and describe in the spaces below the incidents of violence or threats of violence, specifying when and where
         they occurred, including, but not limited to, locations such as a home, school, place of employment, or time-
         sharing exchange}

         a.       committed or threatened to commit domestic violence defined in s. 741.28, Florida Statutes, as
                  any assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery,
                  stalking, aggravated stalking, kidnapping, false imprisonment, or any criminal offense resulting in
                  physical injury or death of one family or household member by another. With the exception of
                  persons who are parents of a child in common, the family or household members must be currently
                  residing or have in the past resided together in the same single dwelling unit.

         b.       previously threatened, harassed, stalked, or physically abused the petitioner.

         c.       attempted to harm the petitioner or family members or individuals closely associated with the
                  petitioner.

         d.       threatened to conceal, kidnap, or harm the petitioner’s child or children.

         e.       intentionally injured or killed a family pet.

         f.       used, or has threatened to use, against the petitioner any weapons such as guns or knives.

         g.       physically restrained the petitioner from leaving the home or calling law enforcement.

         h.       a criminal history involving violence or the threat of violence (if known).

         i.       another order of protection issued against him or her previously or from another jurisdiction (if
                  known).

         j.       destroyed personal property, including, but not limited to, telephones or other communication
                  equipment, clothing, or other items belonging to the petitioner.

         k. _____engaged in a pattern of abusive, threatening, intimidating, or controlling behavior composed of a
                 series of acts over a period of time, however short.

         l.       engaged in any other behavior or conduct that leads the petitioner to have reasonable cause to
                  believe he or she is in imminent danger of becoming a victim of domestic violence.

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                         -10-
          Below is a brief description of the latest act of violence or threat of violence that causes Petitioner to
          honestly fear imminent domestic violence by Respondent.
          {Please begin your narrative below. Use additional pages if necessary but please do not write in the margins
          or on the back of any of the pages Please indicate below if you are using additional pages.}

          On {date}                 ________, at {location} ___________________________________,
          Respondent:

                                                                                                                     .

          _______ Please indicate here if you are attaching additional pages to continue these facts.

    5.    Additional Information
         {Indicate all that apply}
          a.       Other acts or threats of domestic violence as described on attached sheet.
          b.       This or other acts of domestic violence have been previously reported to {person or
                   agency}: _____________________________________________________________
          c.       Respondent owns, has, and/or is known to have guns or other weapons.
                   Describe weapon(s):
          d.       Respondent has a drug problem.
          e.       Respondent has an alcohol problem.
          f.       Respondent has a history of mental health problems. If checked, answer the following, if known:
                   Has Respondent ever been the subject of a Baker Act proceeding? _____ Yes _____ No
                   Is Respondent supposed to take medication for mental health problems?          Yes        No
                   If yes, is Respondent currently taking his/her medication? _____ Yes _____ No

SECTION IV. TEMPORARY EXCLUSIVE USE AND POSSESSION OF HOME (Complete this section only if you want the
Court to grant you temporary exclusive use and possession of the home that you share with the Respondent.)
    1. Petitioner claims the following about the home that Petitioner and Respondent share or that Petitioner left
         because of domestic violence:

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                       -11-
         {Indicate all that apply}
          a.       Petitioner needs the exclusive use and possession of the home that the parties share at {street
                   address}                                                                                      ,
                   {city, state, zip code}                                                                        .
          b.       Petitioner cannot get another safe place to live because:

                                                                                                           .
          c.      If kept out of the home, Respondent has the money to get other housing or may live without
                  money at {street address}                                                                ,
                  {city, state, zip code}                                                                  .
    2.    The home is:
          {Choose one only}
          a.      owned or rented by Petitioner and Respondent jointly.
          b.      solely owned or rented by Petitioner.
          c.      solely owned or rented by Respondent.

SECTION V. TEMPORARY PARENTING PLAN WITH TEMPORARY TIME-SHARING SCHEDULE FOR MINOR CHILDREN
(Complete this section only if you are asking the court to provide a temporary parenting plan, including a temporary
time-sharing schedule with regard to, the minor child or children of the parties which might involve prohibiting or
limiting time-sharing or requiring that it be supervised by a third party. You must be the natural parent, adoptive
parent, or guardian by court order of the minor child or children. If you are asking the court to provide a temporary
parenting plan, including a temporary time-sharing schedule with regard to, the minor child or children of the parties
which might involve prohibiting or limiting time-sharing or requiring that it be supervised by a third party, you must
also complete and file a Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit, Florida
Supreme Court Approved Family Law Form 12.902(d)).

Note: If the paternity of the minor children listed below has not been established through either marriage or
court order, the Court may deny a request to provide a temporary parenting plan, including a temporary time-
sharing schedule with regard to, the minor child or children, and/or a request for child support.

    1.    Petitioner is the natural parent, adoptive parent, or guardian by court order of the minor children whose
          name(s) and age(s) are listed below.
          Name                                                  Birth date

    2.    The minor children for whom Petitioner is asking the court to provide a temporary parenting plan, including
          a temporary time-sharing schedule with regard to:
          {Choose one only}
          a.      saw the domestic violence described in this petition happen.
          b.      were at the place where the domestic violence happened but did not see it.
          c.      were not there when the domestic violence happened this time but have seen previous acts of
                  domestic violence by Respondent.

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                       -12-
         d.       have not witnessed domestic violence by Respondent.

    3.   Name any other minor children who were there when the domestic violence happened. Include children’s
         name, age, and parents’ names.

                                                                                                                            .

    4.   Temporary Parenting Plan and Temporary Time-Sharing Schedule
         {Indicate all that apply}
         a.       Petitioner requests that the Court provide a temporary parenting plan, including a temporary time-
                  sharing schedule, with regard to the minor child or children of the parties, as follows:

                                                                                                                .
         b.       Petitioner requests that the Court order supervised exchange of the minor children or exchange
                  through a responsible person designated by the Court. The following person is suggested as a
                  responsible person for purposes of such exchange. {Explain}:

                                                                                                             .
         c.       Petitioner requests that the Court limit time-sharing by Respondent with the minor children.
                  {Explain}:

                                                                                                                .
         d.       Petitioner requests that the Court prohibit time-sharing by Respondent with the minor children
                  because Petitioner genuinely fears that Respondent imminently will abuse, remove, or hide the
                  minor children from Petitioner. {Explain}:

                                                                                                                        .
         e.       Petitioner requests that the Court allow only supervised time-sharing by Respondent with the
                  minor children. {Explain}:
                                                                                                                        .
                  Supervision should be provided by a Family Visitation Center, or other (specify):
                                                                                                                        .

SECTION VI. EXCLUSIVE CARE, POSSESSION, OR CONTROL OF FAMILY PET(S) (Complete this section only if you are
seeking exclusive care, possession, or control of an animal owned, possessed, harbored, kept, or held by you (the
Petitioner), the Respondent, or a minor child residing in either your residence or household or Respondent’s residence
or household. The court may order the Respondent to have no contact with the animal and may prohibit the
Respondent from taking, transferring, encumbering, concealing, harming, or otherwise disposing of the animal. You
may not request to have exclusive care, possession, or control of an animal owned primarily for a bona fide
agricultural purpose, as defined in section 193.461, Florida Statutes, or a service animal, as defined in section 413.08,
Florida Statutes, if Respondent is the service animal’s handler.) {Indicate all that apply}.

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                        -13-
    1.       Petitioner requests to have exclusive care, possession, and control of the following animal(s) which are
             owned, possessed, harbored, kept, or held by Petitioner, Respondent, or a minor child residing in
             Petitioner’s or Respondent’s residence or household:

                                                                                                                     .

    2.       Petitioner requests that Respondent have no contact with the following animal(s) and be prohibited
             from taking, transferring, encumbering, concealing, harming, or otherwise disposing of them

                                                                                                                     .

SECTION VII. TEMPORARY SUPPORT (Complete this section only if you are seeking financial support from the
Respondent. You must also complete and file a Family Law Financial Affidavit, Florida Family Law Rules of Procedure
Form 12.902(b) or (c), and Notice of Social Security Number, Florida Supreme Court Approved Family Law Form
12.902(j), if you are seeking child support. A Child Support Guidelines Worksheet, Florida Family Law Rules of
Procedure Form 12.902(e), must be filed with the court at or prior to a hearing to establish or modify child support.)
{Indicate all that apply}
     1.        Petitioner claims a need for the money he or she is asking the Court to make Respondent pay, and that
               Respondent has the ability to pay that money.

    2.       Petitioner requests that the Court order Respondent to pay the following temporary alimony to
             Petitioner. (Petitioner must be married to Respondent to ask for temporary alimony.) Temporary
             Alimony Requested $           every:     week      other week       month.

    3.       Petitioner requests that the Court order Respondent to pay the following temporary child support to
             Petitioner. (The Respondent must be the natural parent, adoptive parent, or guardian by court order
             of the minor children for the court to order the Respondent to pay child support.) Temporary child
             support is requested in the amount of $           every:     week        other week        month.

SECTION VIII. INJUNCTION (This section summarizes what you are asking the Court to include in the injunction.
This section must be completed.)

    1.   Petitioner asks the Court to enter a TEMPORARY INJUNCTION for protection against domestic violence that
         will be in place from now until the scheduled hearing in this matter.

    2.   Petitioner asks the Court to enter, after a hearing has been held on this petition, a final judgment on
         injunction prohibiting Respondent from committing any acts of domestic violence against Petitioner and:
         a. prohibiting Respondent from going to or within 500 feet of any place the Petitioner lives;
         b. prohibiting Respondent from going to or within 500 feet of the Petitioner’s place(s) of employment or
            school; the address of Petitioner’s place(s) of employment or school is:

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                       -14-
                                                                                                                 ;
        c. prohibiting Respondent from contacting Petitioner by mail, by telephone, through another person, or in
           any other manner;
        d. prohibiting Respondent from knowingly and intentionally going to or within 100 feet of Petitioner’s
           motor vehicle;
        e. prohibiting Respondent from defacing or destroying Petitioner’s personal property;

        {Indicate all that apply}
         f.       prohibiting Respondent from going to or within 500 feet of the following place(s) Petitioner or
                  Petitioner’s minor children must go often {include address}:

                                                                                                                     ;
        g.       granting Petitioner temporary exclusive use and possession of the home Petitioner and
                 Respondent share;
        h.       granting Petitioner on a temporary basis 100% of the time sharing with the parties’ minor children;
        i.       establishing a temporary parenting plan including a temporary time-sharing schedule for the
                 parties’ minor children;
        j.       granting Petitioner exclusive care, possession, or control of the animal(s) identified in paragraph 1
                 of Section VI which are owned, possessed, harbored, kept or held by Petitioner, Respondent, or a
                 minor child residing in Petitioner or Respondent’s residence or household;
        k.       prohibiting Respondent from having any contact with the animal(s) identified in paragraph 2 of
                 Section VI or from taking, transferring, encumbering, concealing, harming, or otherwise disposing
                 of them;
        l.       granting temporary alimony for Petitioner;
        m.       granting temporary child support for the minor children;
        n.       ordering Respondent to participate in treatment, intervention, and/or counseling services;
        o.       referring Petitioner to a certified domestic violence center; and any other terms the Court deems
                 necessary for the protection of Petitioner and/or Petitioner’s children, including injunctions or
                 directives to law enforcement agencies, as provided in Section 741.30, Florida Statutes.

I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT TO HOLD A HEARING ON THIS PETITION,
THAT BOTH THE RESPONDENT AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST APPEAR AT THE
HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR I FAIL TO APPEAR AT THE FINAL HEARING, WE WILL
BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED AT THAT HEARING.

I HAVE READ EVERY STATEMENT MADE IN THIS PETITION, AND EACH STATEMENT IS TRUE AND CORRECT. I
UNDERSTAND THAT THE STATEMENTS MADE IN THIS PETITION ARE BEING MADE UNDER PENALTY OF PERJURY,
PUNISHABLE AS PROVIDED IN SECTION 837.02, FLORIDA STATUTES.

THIS PETITION MUST BE SIGNED BY THE PETITIONER BUT IT IS NOT REQUIRED TO BE NOTARIZED IF IT IS FILED
DURING THE SCOPE AND DURATION OF A STATE OF EMERGENCY DECLARED BY A GOVERNMENTAL ENTITY.

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                      -15-
Dated:                                              _______________________________
                                                    Signature of Petitioner
                                                    Printed Name:
                                                    Address:
                                                    City, State, Zip:
                                                    Telephone Number:
                                                    Fax Number:
                                                    Designated E-Mail Address(es):

STATE OF FLORIDA
COUNTY OF

Sworn to (or affirmed) and subscribed before me by means of  physical presence or  online notarization, this
      day of                  20 , by                               .

                                                    NOTARY PUBLIC or DEPUTY CLERK

                                                    {Print, type, or stamp commissioned name of notary or clerk.}

 Personally Known OR  Produced Identification
Type of Identification Produced:

Florida Supreme Court Approved Family Law Form 12.980(a), Petition for Injunction for Protection Against
Domestic Violence (08/23)
                                                     -16-
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
                        FORM 12.980(f),
                 PETITION FOR INJUNCTION FOR
            PROTECTION AGAINST REPEAT VIOLENCE
                           (08/23)

                                      When should this form be used?

If you or a member of your immediate family are a victim of repeat violence, you can use this form to ask the court
for a protective order prohibiting repeat violence. Repeat violence means that two incidents of violence have been
committed against you or a member of your immediate family by another person, one of which must have been
within 6 months of filing this petition. Repeat violence includes assault, aggravated assault, battery, aggravated
battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, or false imprisonment, or any
criminal offense resulting in physical injury or death. Because you are making a request to the court, you are called
the petitioner. The person whom you are asking the court to protect you from is called the respondent. If you are
under the age of eighteen and have never been married or had the disabilities of nonage removed by a court, one
of your parents or your legal guardian must sign this petition on your behalf.

The parent or legal guardian of any minor child who is living at home may seek an injunction for protection against
repeat violence on behalf of the minor child. With respect to a minor child who is living at home, the parent or legal
guardian must have been an eye-witness to, or have direct physical evidence or affidavits from eye-witnesses of,
the specific facts and circumstances that form the basis of the petition.

If the respondent is your spouse, former spouse, related to you by blood or marriage, living with you now or has
lived with you in the past (if you are or were living as a family), or the other parent of your child(ren), whether or
not you have ever been married or ever lived together, you should use Petition for Injunction for Protection Against
Domestic Violence, Florida Supreme Court Approved Family Law Form 12.980(a), rather than this form.

This form should be typed or printed in black ink. You should complete this form (giving as much detail as possible)
and sign it the presence of a notary or in front of the clerk of the circuit court in the county where you live. The clerk
will take your completed petition to a judge. You should keep a copy for your records. If have any questions or need
assistance completing this form, the clerk or family law intake staff will help you.

                          What should I do if the judge grants my petition?

If the facts contained in your petition convince the judge that you or a member of your immediate family are a victim
of repeat violence and that an immediate and present danger of repeat violence to you or that family exists, the
judge will sign a Temporary Injunction for Protection Against Repeat Violence, Florida Supreme Court Approved
Family Law Form 12.980(k). A temporary injunction is issued without notice to the respondent. The clerk will give
your petition, the temporary injunction, and any other papers filed with your petition to the sheriff or other law
enforcement officer for personal service on the respondent. The temporary injunction will take effect immediately
after the respondent is served with a copy of it. It lasts until a full hearing can be held or for a period of 15 days,
whichever comes first. The court may extend the temporary injunction beyond 15 days for a good reason, which
may include failure to obtain service on the respondent.

The temporary injunction is issued ex parte. This means that the judge has considered only the information
presented by one side—YOU. Section I of the temporary injunction gives a date that you should appear in court for
a hearing. You will be expected to testify about the facts in your petition. The respondent will be given the
opportunity to testify at this hearing, also. At the hearing, the judge will decide whether to issue a Final Judgment

Instructions for Florida Supreme Court Approved Family Law Form 12.980(f), Petition for Injunction for Protection
Against Repeat Violence (08/23)
                                                         -17-
of Injunction for Protection Against Repeat Violence (After Notice), Florida Supreme Court Approved Family Law
Form 12.980(l), which will remain in effect for a specific time period or until modified or dissolved by the court. If
you and/or the respondent do not appear, the temporary injunction may be continued in force, extended, or
dismissed, and/or additional orders may be granted, including entry of a permanent injunction and the imposition
of court costs. You and respondent will be bound by the terms of any injunction or order issued at the final
hearing.

IF EITHER YOU OR RESPONDENT DO NOT APPEAR AT THE FINAL HEARING, YOU WILL BOTH BE BOUND BY THE
TERMS OF ANY INJUNCTION OR ORDER ISSUED IN THIS MATTER.

If the judge signs a temporary or final injunction, the clerk will provide you with the necessary copies. Make sure
that you keep one certified copy of the injunction with you at all times!

                            What can I do if the judge denies my petition?

If your petition is denied on the grounds that it appears to the court that no immediate and present danger of repeat
violence exists, the court will set a full hearing on your petition. The respondent will be notified by personal service
of your petition and the hearing. If your petition is denied, you may: amend your petition by filing a Supplemental
Affidavit in Support of Petition for Injunction for Protection, Florida Supreme Court Approved Family Law Form
12.980(g); attend the hearing and present facts that support your petition; and/or dismiss your petition.

                                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. The words that are in bold underline are defined in that section. The clerk of the circuit court or family
law intake staff will help you complete any necessary forms. For further information, see Section 784.046, Florida
Statutes, and Rule 12.610, Florida Family Law Rules of Procedure.

                         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 Rules of General Practice and Judicial
Administration and you must review Florida Rule of General Practice and Judicial Administration 2.516. You may
find this rule at www.flcourts.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 MUST SERVE DOCUMENTS BY E-MAIL UNLESS EXCUSED PURSUANT TO FLORIDA
RULES OF GENERAL PRACTICE AND JUDICIAL ADMINISTRATION 2.516(b)(1)(D). If a self-represented litigant has
been excused from serving documents by e-mail and then elects to serve and receive documents by e-mail, the
Instructions for Florida Supreme Court Approved Family Law Form 12.980(f), Petition for Injunction for Protection
Against Repeat Violence (08/23)
                                                        -18-
procedures must always be followed once that 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 and Judicial Administration 2.516.

Instructions for Florida Supreme Court Approved Family Law Form 12.980(f), Petition for Injunction for Protection
Against Repeat Violence (08/23)
                                                     -19-
                        IN THE CIRCUIT COURT OF THE                          JUDICIAL CIRCUIT,
                                IN AND FOR                            COUNTY, FLORIDA

                                                                 Case No.:
                                                                 Division:
                                              ,
                                     Petitioner,

                  and

                                            ,
                                     Respondent.

                      PETITION FOR INJUNCTION FOR PROTECTION
                             AGAINST REPEAT VIOLENCE

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

SECTION I. PETITIONER
(This section is about you. It must be completed.)

    1.   Petitioner currently lives at the following address: {address, city, state, zip code}
                                                                                                                 .
         {Indicate if applicable}
         ____Petitioner seeks an injunction for protection on behalf of a minor child. Petitioner is the parent or
                  legal guardian of {full legal name}                                           , a minor child
                  who is living at home.

    2.   Petitioner’s attorney’s name, address, and telephone number is:
                                                                                                                  .
         (If you do not have an attorney, write “none.”)

SECTION II. RESPONDENT
(This section is about the person you want to be protected from. It must be completed.)

    1.   Respondent currently lives at the following address: {address, city, state, and zip code}
                                                                                                                  .
         Respondent’s Driver’s License number is: {if known}                                                      .

    2.   Petitioner has known Respondent since: {date}                                                            .

    3.   Respondent’s last known place of employment:
         Employment address:
         Working hours:

Florida Supreme Court Approved Family Law Form 12.980(f), Petition for Injunction for Protection Against Repeat
Violence (08/23)
                                                         -20-
    4.   Physical description of Respondent:
         Race:                Sex: Male      Female        Date of Birth:
         Height:           Weight:          Eye Color:                   Hair Color:
         Distinguishing marks and/or scars:
         Vehicle: (make/model)                         Color:                     Tag Number:

    5.   Other names Respondent goes by (aliases or nicknames):

    6.   Respondent’s attorney’s name, address, and telephone number is:
                                                                                                            .
         (If you do not know whether Respondent has an attorney, write “unknown.” If Respondent does not have
         an attorney, write “none.”)

SECTION III. CASE HISTORY AND REASON FOR SEEKING PETITION (This section must be completed.)

    1.   Has Petitioner ever received or tried to get an injunction for protection against domestic violence, repeat
         violence, dating violence, or sexual violence against Respondent in this or any other court?
                Yes           No If yes, what happened in that case? {include case number, if known}

                                                                                                                       .

    2.   Has Respondent ever received or tried to get an injunction for protection against domestic violence, repeat
         violence, dating violence, or sexual violence against Petitioner in this or any other court?
                Yes           No If yes, what happened in that case? {include case number, if known}

                                                                                                                       .

    3.   Describe any other court case that is either going on now or that happened in the past between Petitioner
         and Respondent {include case number, if known}:

                                                                                                                       .

    4.   Respondent has directed at least two incidents of violence, meaning assault, aggravated assault, battery,
         aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, or false
         imprisonment, or any criminal offense resulting in physical injury or death against Petitioner or a member
         of Petitioner’s immediate family. One of these two incidents of violence has occurred within 6 months of
         the date of filing of this petition. The most recent incident (including date and location) is described below.

         On {date}                                     , at {location}                                                 ,
         Respondent

                                                                                                                       .
                Please indicate here if you are attaching additional pages to continue these facts.

Florida Supreme Court Approved Family Law Form 12.980(f), Petition for Injunction for Protection Against Repeat
Violence (08/23)
                                                        -21-
    5.   Other prior incidents (including dates and location) are described below:

         On {date}                                    , at {location}                                                ,
         Respondent

                                                                                                                     .
                Please indicate here if you are attaching additional pages to continue these facts.

    6.   Petitioner genuinely fears repeat violence by Respondent. Explain:

                                                                                                                     .

    7.   Additional Information
         {Choose all that apply}
         a.     Respondent owns, has, and/or is known to have guns or other weapons.
         Describe weapon(s):
                                                                                                                     .
         b.     This or prior acts of repeat violence have been previously reported to: {person or agency}
                                                                                                                     .

SECTION IV. INJUNCTION (This section must be completed.)

    1.        Petitioner asks the Court to enter a TEMPORARY INJUNCTION for protection against repeat violence
         that will be in place from now until the scheduled hearing in this matter.

    2.         Petitioner asks the Court to enter, after a hearing has been held on this petition, a final judgment of
         injunction prohibiting Respondent from committing any acts of violence against Petitioner and:
         a. prohibiting Respondent from going to or within 500 feet of any place Petitioner lives;
         b. prohibiting Respondent from going to or within 500 feet of Petitioner’s place(s) of employment or the
         school that Petitioner attends; the address of Petitioner’s place(s) of employment and/or school is:
                                                                                                                     ;
         c. prohibiting Respondent from contacting Petitioner by telephone, mail, by e-mail, in writing, through
         another person, or in any other manner;
         d. ordering Respondent not to use or possess any guns or firearms;
         {Indicate all that apply}
         e.      prohibiting Respondent from going to or within 500 feet of the following place(s) Petitioner or
         Petitioner’s immediate family must go to often:
                                                                                                                     .

Florida Supreme Court Approved Family Law Form 12.980(f), Petition for Injunction for Protection Against Repeat
Violence (08/23)
                                                       -22-
         f.     prohibiting Respondent from knowingly and intentionally going to or within 100 feet of Petitioner’s
         motor vehicle; and any other terms the Court deems necessary for the safety of Petitioner and Petitioner’s
         immediate family.

I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT TO HOLD A HEARING ON THIS PETITION,
THAT BOTH THE RESPONDENT AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST APPEAR AT THE
HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR I FAIL TO APPEAR AT THE FINAL HEARING, WE WILL
BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED AT THAT HEARING.

I HAVE READ EVERY STATEMENT MADE IN THIS PETITION, AND EACH STATEMENT IS TRUE AND CORRECT. I
UNDERSTAND THAT THE STATEMENTS MADE IN THIS PETITION ARE BEING MADE UNDER PENALTY OF PERJURY,
PUNISHABLE AS PROVIDED IN SECTION 837.02, FLORIDA STATUTES.

THIS PETITION MUST BE SIGNED BY THE PETITIONER BUT IT IS NOT REQUIRED TO BE NOTARIZED IF IT IS FILED
DURING THE SCOPE AND DURATION OF A STATE OF EMERGENCY DECLARED BY A GOVERNMENTAL ENTITY.

Dated:
                                                     Signature of Petitioner
                                                     Printed Name:
                                                     Address:
                                                     City, State, Zip:
                                                     Telephone Number:
                                                     Fax Number:
                                                     Designated E-Mail Address(es):

STATE OF FLORIDA
COUNTY OF

Sworn to (or affirmed) and subscribed before me by means of  physical presence or  online notarization, this
    day of                 20 , by                                  .

                                                     NOTARY PUBLIC or DEPUTY CLERK

                                                     {Print, type, or stamp commissioned name of notary or clerk.}

 Personally Known OR  Produced Identification
Type of Identification Produced:

Florida Supreme Court Approved Family Law Form 12.980(f), Petition for Injunction for Protection Against Repeat
Violence (08/23)
                                                      -23-
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
                        FORM 12.980(n)
    PETITION FOR INJUNCTION FOR PROTECTION AGAINST DATING
                       VIOLENCE (08/23)

                                     When should this form be used?

If you are a victim of dating violence, and have reasonable cause to believe you are in imminent danger of becoming
the victim of another act of dating violence, or if you have reasonable cause to believe that you are in imminent
danger of becoming a victim of dating violence, you can use this form to ask the court for a protective order
prohibiting dating violence. Dating violence means violence between individuals who have or have had a continuing
and significant relationship of a romantic or intimate nature. The dating relationship must have existed within the
past six months, the nature of the relationship must have been characterized by the expectation of affection or
sexual involvement between the parties, and the frequency and type of interaction must have included that the
persons have been involved over time and on a continuous basis during the course of the relationship. Dating
violence does not include violence in a casual acquaintanceship or violence between individuals who only have
engaged in ordinary fraternization in a business or social context. Dating violence includes assault, aggravated
assault, battery, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, or false
imprisonment, or any criminal offense resulting in physical injury or death. Because you are making a request to the
court, you are called the petitioner. The person whom you are asking the court to protect you from is called the
respondent. If you are under the age of eighteen and have never been married or had the disabilities of nonage
removed by a court, one of your parents or your legal guardian must sign this petition on your behalf.

                           If you are filing on behalf of a child or children

The parent or legal guardian of any minor child who is living at home may seek an injunction for protection against
dating violence on behalf of the minor child. With respect to a minor child who is living at home, if the party against
whom the protective injunction is sought is also a parent, stepparent, or legal guardian, you, as the parent or legal
guardian filing the petition, must have been an eye-witness to, or have direct physical evidence or affidavits from
eye-witnesses of, the specific facts and circumstances that form the basis of the petition. If the party against whom
the protective injunction is sought is a person OTHER THAN a parent, stepparent, or legal guardian of the minor
child, you, as the parent or legal guardian filing the petition, must state why you have reasonable cause to believe
that the minor child is a victim of dating violence.

                                           Additional Information

If the respondent is your spouse, former spouse, related to you by blood or marriage, living with you now or has
lived with you in the past (if you are or were living as a family), or the other parent of your child(ren), whether or
not you have ever been married or ever lived together, you should use Petition for Injunction for Protection Against
Domestic Violence, Florida Supreme Court Approved Family Law Form 12.980(a), rather than this form.

This form should be typed or printed in black ink. You should complete this form (giving as much detail as possible)
and sign it the presence of a notary or in front of the clerk of the circuit court in the county where you live. The
clerk will take your completed petition to a judge. You should keep a copy for your records. If you have any questions
or need assistance completing this form, the clerk or family law intake staff will help you.

                         What should I do if the judge grants my petition?

If the facts contained in your petition convince the judge that an immediate and present danger of dating violence

Instructions for Florida Supreme Court Approved Family Law Form 12.980(n), Petition for Injunction for Protection
Against Dating Violence (08/23)
                                                        -24-
exists, the judge will sign a Temporary Injunction for Protection Against Dating Violence, Florida Supreme Court
Approved Family Law Form 12.980(o). A temporary injunction is issued without notice to the respondent. The clerk
will give your petition, the temporary injunction, and any other papers filed with your petition to the sheriff or other
law enforcement officer for personal service on the respondent. The temporary injunction will take effect
immediately after the respondent is served with a copy of it. It lasts until a full hearing can be held or for a period
of 15 days, whichever comes first. The court may extend the temporary injunction beyond 15 days for a good reason,
which may include failure to obtain service on the respondent.

The temporary injunction is issued ex parte. This means that the judge has considered only the information
presented by one side—YOU. Section I of the temporary injunction gives a date that you should appear in court for
a hearing. You will be expected to testify about the facts in your petition. The respondent will be given the
opportunity to testify at this hearing, also. At the hearing, the judge will decide whether to issue a Final Judgment
of Injunction for Protection Against Dating Violence (After Notice), Florida Supreme Court Approved Family Law
Form 12.980(p), which will remain in effect for a specific time period or until modified or dissolved by the court. If
you and/or the respondent do not appear, the temporary injunction may be continued in force, extended, or
dismissed, and/or additional orders may be granted, including entry of a permanent injunction and the imposition
of court costs. You and respondent will be bound by the terms of any injunction or order issued at the final
hearing.

IF EITHER YOU OR RESPONDENT DO NOT APPEAR AT THE FINAL HEARING, YOU WILL BOTH BE BOUND BY THE
TERMS OF ANY INJUNCTION OR ORDER ISSUED IN THIS MATTER.

If the judge signs a temporary or final injunction, the clerk will provide you with the necessary copies. Make sure
that you keep one certified copy of the injunction with you at all times!

                           What can I do if the judge denies my petition?

If your petition is denied on the grounds that it appears to the court that no immediate and present danger of dating
violence exists, the court will set a full hearing on your petition. The respondent will be notified by personal service
of your petition and the hearing. If your petition is denied, you may: amend your petition by filing a Supplemental
Affidavit in Support of Petition for Injunction for Protection, Florida Supreme Court Approved Family Law Form
12.980(g); attend the hearing and present facts that support your petition; and/or dismiss your petition.

                               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. The words that are in bold underline are defined in that section. The clerk of the circuit court or family
law intake staff will help you complete any necessary forms. For further information, see Section 784.046, Florida
Statutes, and Rule 12.610, Florida Family Law Rules of Procedure.

                        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

Instructions for Florida Supreme Court Approved Family Law Form 12.980(n), Petition for Injunction for Protection
Against Dating Violence (08/23)
                                                        -25-
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 Rules of General Practice and Judicial
Administration and you must review Florida Rule of General Practice and Judicial Administration 2.516. You may
find this rule at www.flcourts.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 MUST SERVE DOCUMENTS BY E-MAIL UNLESS EXCUSED PURSUANT TO FLORIDA
RULES OF GENERAL PRACTICE AND JUDICIAL ADMINISTRATION 2.516(b)(1)(D). If a self-represented litigant has
been excused from serving documents by e-mail and then elects to serve and receive documents by e-mail, the
procedures must always be followed once that 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 and Judicial Administration 2.516.

Instructions for Florida Supreme Court Approved Family Law Form 12.980(n), Petition for Injunction for Protection
Against Dating Violence (08/23)
                                                        -26-
                             IN THE CIRCUIT COURT OF THE               JUDICIAL CIRCUIT,
                                   IN AND FOR                     COUNTY, FLORIDA

                                                                 Case No.:
                                                                 Division:
                                               ,
                                          Petitioner,

                  and

                                              ,
                                          Respondent.

         PETITION FOR INJUNCTION FOR PROTECTION AGAINST DATING
                                VIOLENCE
I, {full legal name}                                                                 , being sworn, certify that the
following statements are true:

SECTION I. PETITIONER
(This section is about you. It must be completed.)

    1.   Petitioner currently lives at the following address: {address, city, state, zip code}
                                                                                                                   .
         Date of Birth of Petitioner:                                      .

         {Indicate if applicable}
                  Petitioner seeks an injunction for protection on behalf of a minor child. Petitioner is the parent
                  or legal guardian of {full legal name}                                          , a minor child
                  who is living at home.

    2.   Petitioner’s attorney’s name, address, and telephone number is:
                                                                                                                   .
         (If you do not have an attorney, write “none.”)

SECTION II. RESPONDENT
(This section is about the person you want to be protected from. It must be completed.)

    1.   Respondent currently lives at the following address: {address, city, state, and zip code}

         Respondent’s Driver’s License number is: {if known}

    2.   Petitioner has known Respondent since: {date}                                                             .

    3.   Respondent’s last known place of employment:
         Employment address:
         Working hours:

    4.   Physical description of Respondent:
         Race:              Sex: Male        Female                 Date of Birth:

Florida Supreme Court Approved Family Law Form 12.980(n), Petition for Injunction for Protection Against Dating
Violence (08/23)
                                                         -27-
         Height:           Weight:              Eye Color:                   Hair Color:
         Distinguishing marks and/or scars:
         Vehicle: (make/model)                               Color:                   Tag Number:

    5.   Other names Respondent goes by (aliases or nicknames):
                                                                                                                     .

    6.   Respondent’s attorney’s name, address, and telephone number is:

         (If you do not know whether Respondent has an attorney, write “unknown.” If Respondent does not have
         an attorney, write “none.”)

    7.   If Respondent is a minor, the address of Respondent’s parent or legal guardian is:

SECTION III. CASE HISTORY AND REASON FOR SEEKING PETITION (This section must be completed.)

    1.   Have the Petitioner and Respondent been involved in a dating relationship within the past six months?
              Yes         No

    2.   Describe the nature of the relationship between the Petitioner and Respondent {Include the length of time
         of the relationship, the romantic or intimate nature of the relationship, the frequency or type of
         interaction, and any other facts that characterize the relationship}

                                                                                                                     .
              Please indicate here if you are attaching additional pages to continue these facts.

    3.   Has Petitioner ever received or tried to get an injunction for protection against domestic violence, dating
         violence, repeat violence, or sexual violence, or stalking against Respondent in this or any other court?
               Yes        No If yes, what happened in that case? {Include case number, if known}

                                                                                                                   .

    4.   Has Respondent ever received or tried to get an injunction for protection against domestic violence, dating
         violence, repeat violence, or sexual violence, or stalking against Petitioner in this or any other court?
               Yes        No If yes, what happened in that case? {Include case number, if known}

                                                                                                                     .

    5.   Describe any other court case that is either going on now or that happened in the past between Petitioner
         and Respondent {Include case number, if known}:

                                                                                                                   .
Florida Supreme Court Approved Family Law Form 12.980(n), Petition for Injunction for Protection Against Dating
Violence (08/23)
                                                      -28-
    6.   Respondent has directed an incident of violence, meaning assault, aggravated assault, battery, aggravated
         battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, or false imprisonment, or
         any criminal offense resulting in physical injury or death against Petitioner or a minor child living at home.
         The incident (including date and location) is described below.
         On {date}                                      , at {location}                                    ,
         Respondent

                                                                                                                      .
              Please indicate here if you are attaching additional pages to continue these facts.

    7.   Other prior incidents (including dates and location) are described below:
         On {date(s)}                                 , at {location(s)}                                 ,
         Respondent

                                                                                                                      .
              Please indicate here if you are attaching additional pages to continue these facts.

    8.   Imminent Danger
         {Please complete either paragraph a or b below}
         a.      Petitioner is a victim of dating violence and has reasonable cause to believe he or she is in imminent
         danger of becoming a victim of another act of dating violence. {Explain what Respondent has done to make
         you a victim of dating violence and to make you fear that you are in imminent danger of becoming a victim
         of another act of dating violence.}

                                                                                                                      .

                      OR

         b.      Petitioner has reasonable cause to believe he or she is in imminent danger of becoming a victim of
         dating violence as demonstrated by the fact that Respondent has: {Explain what Respondent has done that
         makes you fear that you are in imminent danger of becoming a victim of dating violence.}
Florida Supreme Court Approved Family Law Form 12.980(n), Petition for Injunction for Protection Against Dating
Violence (08/23)
                                                       -29-
                                                                                                                      .

    9.   Additional Information
         {Indicate all that apply}
         a.      Respondent owns, has, and/or is known to have guns or other weapons.
         Describe weapon(s):
                                                                                                                  .

         b.      This or prior acts of dating violence have been previously reported to: {person or agency}

                                                                                                                  .

SECTION IV. INJUNCTION
(This section must be completed.)

    1.   Petitioner asks the Court to enter a TEMPORARY INJUNCTION for protection against dating violence that
         will be in place from now until the scheduled hearing in this matter.

    2.   Petitioner asks the Court to enter an injunction prohibiting Respondent from committing any acts of
         violence against Petitioner and:
         a. prohibiting Respondent from going to or within 500 feet of any place Petitioner lives;
         b. prohibiting Respondent from going to or within 500 feet of Petitioner’s place(s) of employment or the
         school that Petitioner attends; the address of Petitioner’s place(s) of employment and/or school is:

                                                                                                                  ;
          c. prohibiting Respondent from contacting Petitioner by telephone, mail, by e-mail, in writing, through
          another person, or in any other manner;
          d. ordering Respondent not to use or possess any guns or firearms;
         {Indicate all that apply}
          e.      prohibiting Respondent from going to or within 500 feet of the following place(s) Petitioner or
          Petitioner’s immediate family must go to often:

         ______________________________________________________________________________________;
         f.      prohibiting Respondent from knowingly and intentionally going to or within 100 feet of
         Petitioner’s motor vehicle; and any other terms the Court deems necessary for the safety of Petitioner and
         Petitioner’s immediate family.

I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT TO HOLD A HEARING ON THIS PETITION,
THAT BOTH THE RESPONDENT AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST APPEAR AT THE
HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR I FAIL TO APPEAR AT THE FINAL HEARING, WE WILL
BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED AT THAT HEARING.

I HAVE READ EVERY STATEMENT MADE IN THIS PETITION, AND EACH STATEMENT IS TRUE AND CORRECT. I
Florida Supreme Court Approved Family Law Form 12.980(n), Petition for Injunction for Protection Against Dating
Violence (08/23)
                                                      -30-
UNDERSTAND THAT THE STATEMENTS MADE IN THIS PETITION ARE BEING MADE UNDER PENALTY OF PERJURY,
PUNISHABLE AS PROVIDED IN SECTION 837.02, FLORIDA STATUTES.

THIS PETITION MUST BE SIGNED BY THE PETITIONER BUT IT IS NOT REQUIRED TO BE NOTARIZED IF IT IS FILED
DURING THE SCOPE AND DURATION OF A STATE OF EMERGENCY DECLARED BY A GOVERNMENTAL ENTITY.

Dated:
                                                    Signature of Petitioner
                                                    Printed Name:
                                                    Address:
                                                    City, State, Zip:
                                                    Telephone Number:
                                                    Fax Number:
                                                    Designated E-Mail Address(es):

STATE OF FLORIDA
COUNTY OF

Sworn to (or affirmed) and subscribed before me by means of  physical presence or  online notarization, this
    day of                    20 , by                               .

                                                    NOTARY PUBLIC or DEPUTY CLERK

                                                    {Print, type, or stamp commissioned name of notary or clerk.}

 Personally Known OR  Produced Identification
Type of Identification Produced:

Florida Supreme Court Approved Family Law Form 12.980(n), Petition for Injunction for Protection Against Dating
Violence (08/23)
                                                    -31-
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
                       FORM 12.980(q)
                 PETITION FOR INJUNCTION FOR
         PROTECTION AGAINST SEXUAL VIOLENCE (08/23)

                                     When should this form be used?

If you are a victim of sexual violence or the parent or legal guardian of a minor child who is living at home and is a
victim of sexual violence, you can use this form to ask the court for a protective order prohibiting sexual violence.
Sexual violence means any one incident of:
• sexual battery, as defined in Chapter 794, Florida Statutes;

•   a lewd or lascivious act, as defined in Chapter 800, Florida Statutes, committed upon or in the presence of a
    person younger than 16 years of age;

•   luring or enticing a child, as described in Chapter 787, Florida Statutes;

•   sexual performance by a child, as described in Chapter 827, Florida Statutes; or

•   any other forcible felony wherein a sexual act is committed or attempted.

In order to get an injunction, you must have reported the sexual violence to a law enforcement agency and be
cooperating in the criminal proceeding if there is one. It does not matter whether criminal charges based on the
sexual violence have been filed, reduced, or dismissed by the state attorney’s office. You may also seek an injunction
for protection against sexual violence if the respondent was sent to prison for committing one of the sexual violence
crimes listed above against you or your minor child living at home and respondent is out of prison or is getting out
of prison within 90 days of your petition. Attach the notice of inmate release to your petition.

Because you are making a request to the court, you are called the petitioner. The person whom you are asking the
court to protect you from is called the respondent. If you are seeking an injunction for protection against sexual
violence on behalf of a minor child who is living at home, the parent or legal guardian must have been an eyewitness
to, or have direct physical evidence or affidavits from eyewitnesses of, the specific facts and circumstances that form
the basis of the petition. If you are under the age of eighteen and have never been married or had the disabilities
of nonage removed by a court, one of your parents or your legal guardian must sign this petition on your behalf.

If the respondent is your spouse, former spouse, related to you by blood or marriage, living with you now or has
lived with you in the past (if you are or were living as a family), or is the other parent of your child(ren) whether or
not you have ever been married or ever lived together, you should use Petition for Injunction for Protection Against
Domestic Violence, Florida Supreme Court Approved Family Law Form 12.980(a), rather than this form.

This form should be typed or printed in black ink. You should complete this form (giving as much detail as possible)
and sign it the presence of a notary or in front of the clerk of the circuit court in the county where you live. The
clerk will take your completed petition to a judge. You should keep a copy for your records. If you have any questions
or need assistance completing this form, the clerk or family law intake staff will help you.

                         What should I do if the judge grants my petition?

If the facts contained in your petition convince the judge that an immediate and present danger of violence exists,
the judge will sign a Temporary Injunction for Protection Against Sexual Violence, Florida Supreme Court Approved
Family Law Form 12.980(r). A temporary injunction is issued without notice to the respondent. The clerk will give
Instructions for Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for Protection
Against Sexual Violence (08/23)
                                                        -32-
your petition, the temporary injunction, and any other papers filed with your petition to the sheriff or other law
enforcement officer for personal service on the respondent. The temporary injunction will take effect immediately
after the respondent is served with a copy of it. It lasts until a full hearing can be held or for a period of 15 days,
whichever comes first, unless the respondent is incarcerated, and in such instance the temporary injunction is
effective for 15 days following the date the respondent is released from incarceration. The court may extend the
temporary injunction beyond 15 days for a good reason, which may include failure to obtain service on the
respondent.

The temporary injunction is issued ex parte. This means that the judge has considered only the information
presented by one side—YOU. Section I of the temporary injunction gives a date that you should appear in court for
a hearing. You will be expected to testify about the facts in your petition. The respondent will be given the
opportunity to testify at this hearing, also. At the hearing, the judge will decide whether to issue a Final Judgment
of Injunction for Protection Against Sexual Violence (After Notice), Florida Supreme Court Approved Family Law
Form 12.980(s), which will remain in effect for a specific time period or until modified or dissolved by the court. If
you and/or the respondent do not appear, the temporary injunction may be continued in force, extended, or
dismissed, and/or additional orders may be granted, including entry of a permanent injunction and the imposition
of court costs. You and respondent will be bound by the terms of any injunction or order issued at the final
hearing.

IF EITHER YOU OR RESPONDENT DO NOT APPEAR AT THE FINAL HEARING, YOU WILL BOTH BE BOUND BY THE
TERMS OF ANY INJUNCTION OR ORDER ISSUED IN THIS MATTER.

If the judge signs a temporary or final injunction, the clerk will provide you with the necessary copies. Make sure
that you keep one certified copy of the injunction with you at all times!

                           What can I do if the judge denies my petition?

If your petition is denied on the grounds that it appears to the court that no immediate and present danger of sexual
violence exists, the court will set a full hearing on your petition. The respondent will be notified by personal service
of your petition and the hearing. If your petition is denied, you may: amend your petition by filing a Supplemental
Affidavit in Support of Petition for Injunction for Protection, Florida Supreme Court Approved Family Law Form
12.980 (g); attend the hearing and present facts that support your petition; and/or dismiss your petition.

                               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. The words that are in bold underline are defined in that section. The clerk of the circuit court or family
law intake staff will provide you with necessary forms. For further information, see section 784.046, Florida
Statutes.

                        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

Instructions for Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for Protection
Against Sexual Violence (08/23)
                                                        -33-
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 Rules of General Practice and Judicial
Administration and you must review Florida Rule of General Practice and Judicial Administration 2.516. You may
find this rule at www.flcourts.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 MUST SERVE DOCUMENTS BY E-MAIL UNLESS EXCUSED PURSUANT TO FLORIDA
RULES OF GENERAL PRACTICE AND JUDICIAL ADMINISTRATION 2.516(b)(1)(D). If a self-represented litigant has
been excused from serving documents by e-mail and then elects to serve and receive documents by e-mail, the
procedures must always be followed once that 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 and Judicial Administration 2.516.

                                                 Special notes . . .

If you fear that disclosing your address would put you in danger, you should complete a Request for Confidential
Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h), and file it with the clerk of the circuit
court and write confidential in the space provided for your address on the petition.

Instructions for Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for Protection
Against Sexual Violence (08/23)
                                                        -34-
                           IN THE CIRCUIT COURT OF THE                 JUDICIAL CIRCUIT,
                               IN AND FOR                           COUNTY, FLORIDA

                                                                Case No.:
                                                                Division:
                                                ,
                                        Petitioner,

                  and

                                              ,
                                        Respondent.

PETITION FOR INJUNCTION FOR PROTECTION AGAINST SEXUAL VIOLENCE
I, {full legal name}                                                        being sworn, certify that the following
statements are true:

SECTION I. PETITIONER
(This section is about you. It must be completed; however, if you fear that disclosing your address to the
respondent would put you in danger, you should complete and file a Request for Confidential Filing of Address,
Florida Supreme Court Approved Family Law Form 12.980(h), and write confidential in the space provided on this
form for your address.)

    1. Petitioner currently lives at the following address: {address, city, state, zip code}
                                                                                                                  .
         Date of Birth of Petitioner:

         {Indicate if applicable}
               Petitioner seeks an injunction for protection on behalf of a minor child.
         Petitioner is the parent or legal guardian of {full legal name}                                          ,
          a minor child who is living at home.

    2.   Petitioner’s attorney’s name, address, and telephone number is:

         (If you do not have an attorney, write “none.”)

SECTION II. RESPONDENT
(This section is about the person you want to be protected from. It must be completed.)

    1.   Respondent currently lives at the following address: {address, city, state, and zip code}

         Respondent’s Driver’s License number is: {if known}

Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for Protection Against Sexual
Violence (08/23)
                                                       -35-
    2.    Respondent’s last known place of employment:
          Employment address:
          Working hours:

    3.    Physical description of Respondent:
          Race:                   Sex: Male         Female              Date of Birth:
          Height:             Weight:                Eye Color:                      Hair Color:
          Distinguishing marks and/or scars:
          Vehicle: (make/model)                         Color:                     Tag Number:

    4.    Other names Respondent goes by (aliases or nicknames):
                                                                                                                        .

    5.    Respondent’s attorney’s name, address, and telephone number is:
                                                                                                              .
          (If you do not know whether Respondent has an attorney, write “unknown.” If Respondent does not have
          an attorney, write “none.”)

    6.    If Respondent is a minor, the address of Respondent’s parent or legal guardian is:
                                                                                                                        .

SECTION III. CASE HISTORY AND REASON FOR SEEKING PETITION
(This section must be completed.)

    1.    Petitioner has suffered sexual violence as shown by the fact that the Respondent has: {describe the acts of
          violence}

                  Please indicate here if you are attaching additional pages to continue these facts.

         {Indicate all that apply}
          a.       Petitioner reported the sexual violence to law enforcement and is cooperating in any criminal
             proceeding. The incident report number by law enforcement is:               . {If there is a criminal
             case, include case number, if known}                                      .

          b.        Respondent was sent to prison for committing sexual violence against Petitioner or Petitioner’s
               minor child living at home and Respondent is out of prison or is getting out of prison within 90 days. The
               notice of inmate release is attached.

Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for Protection Against Sexual
Violence (08/23)
                                                          -36-
    2.   Has Petitioner ever received or tried to get an injunction for protection against domestic violence, dating
         violence, repeat violence, or sexual violence against Respondent in this or any other court?
                Yes          No If yes, what happened in that case? {Include case number, if known}

                                                                                                                     .

    3.   Has Respondent ever received or tried to get an injunction for protection against domestic violence, dating
         violence, repeat violence, or sexual violence against Petitioner in this or any other court?
                Yes          No If yes, what happened in that case? {Include case number, if known}

                                                                                                                     .

    4.   Describe any other court case that is either going on now or that happened in the past between Petitioner
         and Respondent {Include case number, if known}:

    5.   Additional Information
         {Indicate all that apply}
         a.      Respondent owns, has, and/or is known to have guns or other weapons.
         Describe weapon(s):
         b.      This or prior acts of violence have been previously reported to: {person or agency}

SECTION IV. INJUNCTION
(This section must be completed.)

    1.   Petitioner asks the Court to enter a TEMPORARY INJUNCTION for protection against sexual violence that
         will be in place from now until the scheduled hearing in this matter.

   2.    Petitioner asks the Court to enter an injunction prohibiting Respondent from committing any acts of
         violence against Petitioner and:
         a. prohibiting Respondent from going to or within 500 feet of any place Petitioner lives;
         b. prohibiting Respondent from going to or within 500 feet of Petitioner’s place(s) of employment or the
         school that Petitioner attends; the address of Petitioner’s place(s) of employment and/or school is:

                                                                                                               ;
         c. prohibiting Respondent from contacting Petitioner by telephone, mail, by e-mail, in writing, through
         another person, or in any other manner;
         d. ordering Respondent not to use or possess any guns or firearms;
         {Indicate all that apply}
         e.      prohibiting Respondent from going to or within 500 feet of the following place(s) Petitioner or
         Petitioner’s immediate family must go to often:

                                                                                                                    ;
         f.     prohibiting Respondent from knowingly and intentionally going to or within 100 feet of Petitioner’s
         motor vehicle; AND any other terms the Court deems necessary for the safety of Petitioner and Petitioner’s
         immediate family.

I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT TO HOLD A HEARING ON THIS PETITION,
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for Protection Against Sexual
Violence (08/23)
                                                      -37-
THAT BOTH THE RESPONDENT AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST APPEAR AT THE
HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR I FAIL TO APPEAR AT THE FINAL HEARING, WE WILL
BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED AT THAT HEARING.

I HAVE READ EVERY STATEMENT MADE IN THIS PETITION, AND EACH STATEMENT IS TRUE AND CORRECT. I
UNDERSTAND THAT THE STATEMENTS MADE IN THIS PETITION ARE BEING MADE UNDER PENALTY OF PERJURY,
PUNISHABLE AS PROVIDED IN SECTION 837.02, FLORIDA STATUTES.

THIS PETITION MUST BE SIGNED BY THE PETITIONER BUT IT IS NOT REQUIRED TO BE NOTARIZED IF IT IS FILED
DURING THE SCOPE AND DURATION OF A STATE OF EMERGENCY DECLARED BY A GOVERNMENTAL ENTITY.

Dated:
                                                    Signature of Petitioner
                                                    Printed Name:
                                                    Address:
                                                    City, State, Zip:
                                                    Telephone Number:
                                                    Fax Number:
                                                    Designated E-Mail Address(es):

STATE OF FLORIDA
COUNTY OF

Sworn to (or affirmed) and subscribed before me by means of  physical presence or  online notarization, this
    day of                    20 , by                                       .

                                                    NOTARY PUBLIC or DEPUTY CLERK

                                                    {Print, type, or stamp commissioned name of notary or clerk.}

 Personally Known OR  Produced Identification
Type of Identification Produced:

Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for Protection Against Sexual
Violence (08/23)
                                                     -38-
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
                        FORM 12.980(t)
   PETITION FOR INJUNCTION FOR PROTECTION AGAINST STALKING
                            (08/23)

                                     When should this form be used?

If you are a victim of stalking, you can use this form to ask the court for a protective order prohibiting stalking.
Stalking means the repeated following, harassment, or cyberstalking of one person by another. Cyberstalk means
to engage in a course of conduct to communicate, or to cause to be communicated, words, images, or language by
or through the use of electronic mail or electronic communication, directed at a specific person, causing substantial
emotional distress to that person and serving no legitimate purpose.

Because you are making a request to the court, you are called the petitioner. The person whom you are asking the
court to protect you from is called the respondent. If you are under the age of eighteen and have never been married
or had the disabilities of nonage removed by a court, and are living at home, one of your parents or your legal
guardian must sign this petition on your behalf.

The parent or legal guardian of any minor child who is living at home may seek an injunction for protection against
stalking on behalf of the minor child.

If the respondent is your spouse, former spouse, related to you by blood or marriage, living with you now or has
lived with you in the past (if you are or were living as a family), or the other parent of your child(ren), whether or
not you have ever been married or ever lived together, you may, instead, choose to use the Petition for Injunction
for Protection Against Domestic Violence, Florida Supreme Court Approved Family Law Form 12.980(a), rather than
this form.

This form should be typed or printed in black ink. You should complete this form (giving as much detail as possible)
and sign it the presence of a notary or in front of the clerk of the circuit court in one of the following: the circuit
where you currently or temporarily reside; the circuit where the respondent resides; or the circuit where the stalking
occurred. The clerk will take your completed petition to a judge. You should keep a copy for your records. If have
any questions or need assistance completing this form, the clerk or family law intake staff will help you. There is no
filing fee for a petition for protection against stalking.

                         What should I do if the judge grants my petition?

If the facts contained in your petition convince the judge that stalking or cyberstalking exists, the judge will sign a
Temporary Injunction for Protection Against Stalking, Florida Supreme Court Approved Family Law Form 12.980(u).
A temporary injunction is issued without notice to the respondent. The clerk will give your petition, the temporary
injunction, and any other papers filed with your petition to the sheriff or other law enforcement officer for personal
service on the respondent. The temporary injunction will take effect immediately after the respondent is served
with a copy of it. It lasts until a hearing can be held or for a period of 15 days, whichever comes first.

The court may extend the temporary injunction beyond 15 days for a good reason, which may include failure to
obtain service on the respondent.

The temporary injunction is issued ex parte. This means that the judge has considered only the information
presented by one side—YOU. Section I of the temporary injunction gives a date that you should appear in court for
a hearing. You will be expected to testify about the facts in your petition. The respondent will be given the
opportunity to testify at this hearing also. At the hearing, the judge will decide whether to issue a Final Judgment
Instructions for Florida Supreme Court Approved Family Law Form 12.980(t), Petition for Injunction for Protection
Against Stalking (08/23)
                                                       -39-
of Injunction for Protection Against Stalking (After Notice), Florida Supreme Court Approved Family Law Form
12.980(v), which will remain in effect for a specific time period or until modified or dissolved by the court. If either
you or the respondent do not appear at the hearing, the temporary injunction may be continued in force,
extended, or dismissed, and/or additional orders may be granted, including entry of a permanent injunction and
the imposition of court costs. You and the respondent will be bound by the terms of any injunction or order issued
at the final hearing.

IF EITHER YOU OR THE RESPONDENT DO NOT APPEAR AT THE FINAL HEARING, YOU WILL BOTH BE BOUND BY THE
TERMS OF ANY INJUNCTION OR ORDER ISSUED IN THIS MATTER.

If the judge signs a temporary or final injunction, the clerk will provide you with the necessary copies. Make sure
that you keep one certified copy of the injunction with you at all times!

                          What can I do if the judge denies my petition or
                            does not issue a Temporary Injunction?

If your petition is denied, you may amend your petition by filing a Supplemental Affidavit in Support of Petition for
Injunction for Protection, Florida Supreme Court Approved Family Law Form 12.980(g). If the only ground for not
granting an ex parte temporary injunction is no appearance of immediate and present danger of stalking, the court
shall set a full hearing on your petition for injunction at the earliest possible time. The respondent will be notified
by personal service of your petition and the hearing. You must attend the hearing, present facts, and bring evidence
that supports your petition; failure to attend the hearing may result in dismissal of your petition.

                                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. The words that are in bold underline are defined in that section. The clerk of the circuit court or family
law intake staff will help you complete any necessary forms. For further information, see Section 784.0485, Florida
Statutes, and Rule 12.610, Florida Family Law Rules of Procedure.

                         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 Rules of General Practice and Judicial
Administration and you must review Florida Rule of General Practice and Judicial Administration 2.516. You may
find this rule at www.flcourts.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 MUST SERVE DOCUMENTS BY E-MAIL UNLESS EXCUSED PURSUANT TO FLORIDA
RULES OF GENERAL PRACTICE AND JUDICIAL ADMINISTRATION 2.516(b)(1)(D). If a self-represented litigant has
Instructions for Florida Supreme Court Approved Family Law Form 12.980(t), Petition for Injunction for Protection
Against Stalking (08/23)
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been excused from serving documents by e-mail and then elects to serve and receive documents by e-mail, the
procedures must always be followed once that 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 and Judicial Administration 2.516.

                                                Special notes . . .

If you require that your address be confidential for safety reasons, you should complete a Request for Confidential
Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h), and file it with the clerk of the circuit.
You should then write confidential in the space provided on the petition.

Instructions for Florida Supreme Court Approved Family Law Form 12.980(t), Petition for Injunction for Protection
Against Stalking (08/23)
                                                       -41-
                           IN THE CIRCUIT COURT OF THE                  JUDICIAL CIRCUIT,
                               IN AND FOR                            COUNTY, FLORIDA

                                                                 Case No.:
                                                                 Division:
                                              ,
                                     Petitioner,

                  and

                                            ,
                                     Respondent.

     PETITION FOR INJUNCTION FOR PROTECTION AGAINST STALKING
I, {full legal name}                                                               , being sworn, certify that the
following statements are true:

SECTION I. PETITIONER
(This section is about you. It must be completed; however, if you require that your address be confidential for
safety reasons, you should complete and file a Request for Confidential Filing of Address, Florida Supreme Court
Approved Family Law Form 12.980(h), and write confidential in the space provided on this form for your address and
telephone number.)

    1.   Petitioner resides at the following address: {address, city, state, zip code}
                                                                                                                     .
         {Indicate if applicable}
                Petitioner seeks an injunction for protection on behalf of a minor child. Petitioner is the parent or
                legal guardian of {full legal name}                                      , a minor child who is living
                at home.

    2.   Petitioner’s attorney’s name, address, and telephone number is:
                                                                                                                       .
         (If you do not have an attorney, write “none.”)

SECTION II. RESPONDENT
(This section is about the person you want to be protected from. It must be completed.)

    1.   Respondent resides at the following address: {provide last known street address, city, state, and zip code}
                                                                                                                       .

    2.   Respondent’s last known place of employment:
         Employment address:
         Working hours of Respondent:

Florida Supreme Court Approved Family Law Form 12.980(t), Petition for Injunction for Protection Against Stalking
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    3.   Physical description of Respondent:
         Race:                      Sex: Male      Female         Date of Birth:
         Height:            Weight:           Eye Color:         Hair Color:
         Distinguishing marks and/or scars:
         Vehicle: (make/model)__________ Color:_________ Tag Number (if known)________________

    4.   Other names Respondent goes by (aliases or nicknames):
                                                                                                                     .

    5.   Respondent’s attorney’s name, address, and telephone number is:
                                                                                                            .
         (If you do not know whether Respondent has an attorney, write “unknown.” If Respondent does not have
         an attorney, write “none.”)

SECTION III. CASE HISTORY AND REASON FOR SEEKING PETITION (This section must be completed.)

    1.   Has Petitioner ever received or tried to get an injunction for protection against stalking against Respondent
         in this or any other court?
               Yes        No If yes, what happened in that case? {Include case number, if known}

                                                                                                                     .

    2.   Has Respondent ever received or tried to get an injunction for protection against stalking against Petitioner
         in this or any other court?
               Yes        No If yes, what happened in that case? {Include case number, if known}
                                                                                                                     .

    3.   Describe any other court case that is either going on now or that happened in the past between Petitioner
         and Respondent {Include case number, if known}:

                                                                                                                     .

    4.   Petitioner is a victim of stalking because Respondent has: {please mark all sections that apply}
         a.      Committed stalking;
         b.      Previously threatened, harassed, stalked, cyberstalked, or physically abused the Petitioner;
         c.      Threatened to harm Petitioner or family members or individuals closely associated with Petitioner;
         d.      Intentionally injured or killed a family pet;
         e.      Used, or threatened to use, against Petitioner any weapons such as guns or knives;
         f.      A criminal history involving violence or the threat or violence, if known;
         g.      Another order of protection issued against him or her previously from another jurisdiction, if
                 known;
         h.      Destroyed personal property, including, but not limited to, telephones or other communication
                 equipment, clothing, or other items belonging to Petitioner.

Florida Supreme Court Approved Family Law Form 12.980(t), Petition for Injunction for Protection Against Stalking
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    5.   Below is a description of the specific incidents of stalking or cyberstalking: {for cyberstalking, please include
         a description of all evidence of contacts and/or threats made by Respondent in voice messages, texts, emails,
         or other electronic communication}
         On {dates}                              the following incidents of stalking occurred at the following locations:
         {the locations may include, but need not be limited to, a home, school, or place of employment}

                                                                                                                         .
              Please indicate here if you are attaching additional pages to continue these facts.

    6.   Additional Information
              Respondent owns, has, and/or is known to have guns or other weapons.
         Describe weapon(s) and where they may be located, if known:
                                                                                                                         .

SECTION IV. INJUNCTION {This section must be completed.}

    1.   Petitioner asks the Court to enter a TEMPORARY INJUNCTION for protection against stalking that will be in
         place from now until the scheduled hearing in this matter, which will immediately restrain Respondent from
         committing any acts of stalking, and which will provide any terms the Court deems necessary for the
         protection of a victim of stalking, including any injunctions or directives to law enforcement agencies.

    2.   Petitioner asks the Court to enter, after a hearing has been held on this petition, a FINAL JUDGMENT for
         protection against stalking prohibiting Respondent from committing any acts of stalking against Petitioner
         and:
         a. prohibiting Respondent from going to or within 500 feet of any place Petitioner lives, or to any specified
         place regularly frequented by Petitioner and any named family members or individuals closely associated
         with Petitioner:
                                                                                                                      ;
         b. prohibiting Respondent from going to or within 500 feet of Petitioner’s place(s) of employment or the
         school that Petitioner attends; the address of Petitioner’s place(s) of employment and/or school is:
                                                                                                                     ;
         c. prohibiting Respondent from contacting Petitioner by telephone, mail, by e-mail, in writing, through
         another person, or in any other manner;
         d. ordering Respondent that he or she shall not have in his or her care, custody, possession, or control any
         firearm or ammunition;
         e. prohibiting Respondent from knowingly and intentionally going to or within 100 feet of
         Petitioner’s motor vehicle, whether or not that vehicle is occupied;

    3.   Petitioner asks the Court to enter any other terms it deems necessary to protect Petitioner from stalking by
         Respondent.

I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT TO HOLD A HEARING ON THIS PETITION,
THAT BOTH THE RESPONDENT AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST APPEAR AT THE
HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR I FAIL TO APPEAR AT THE FINAL HEARING, WE WILL
BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED AT THAT HEARING.
Florida Supreme Court Approved Family Law Form 12.980(t), Petition for Injunction for Protection Against Stalking
(08/23)
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I HAVE READ EVERY STATEMENT MADE IN THIS PETITION, AND EACH STATEMENT IS TRUE AND CORRECT. I
UNDERSTAND THAT THE STATEMENTS MADE IN THIS PETITION ARE BEING MADE UNDER PENALTY OF PERJURY,
PUNISHABLE AS PROVIDED IN SECTION 837.02, FLORIDA STATUTES.

THIS PETITION MUST BE SIGNED BY THE PETITIONER BUT IT IS NOT REQUIRED TO BE NOTARIZED IF IT IS FILED
DURING THE SCOPE AND DURATION OF A STATE OF EMERGENCY DECLARED BY A GOVERNMENTAL ENTITY.

Dated:
                                                    Signature of Petitioner
                                                    Printed Name:
                                                    Address:
                                                    City, State, Zip:
                                                    Telephone Number:
                                                    Fax Number:
                                                    Designated E-Mail Address(es):

STATE OF FLORIDA
COUNTY OF

Sworn to (or affirmed) and subscribed before me by means of  physical presence or  online notarization, this
     day of                 20 , by                                 .

                                                    NOTARY PUBLIC or DEPUTY CLERK

                                                    {Print, type, or stamp commissioned name of notary or clerk.}

 Personally Known OR  Produced Identification
Type of Identification Produced:

Florida Supreme Court Approved Family Law Form 12.980(t), Petition for Injunction for Protection Against Stalking
(08/23)
                                                     -45-