Court Opinion

ID: 2536436
Source: CourtListenerOpinion
Date Created: 2013-10-30 10:14:45.189619+00
Date Added: 2024-06-11T09:31:54.295859
License: Public Domain

50 So. 3d 547 (2010)
In re AMENDMENTS TO THE FLORIDA SUPREME COURT APPROVED FAMILY LAW FORMSFORMS 12.982(A), 12.982(C), AND 12.982(F).
No. SC10-828.
Supreme Court of Florida.
June 24, 2010.
Jack A. Moring, Chair, The Family Law Rules Committee, Moring and Moring, P.A., Crystal River, FL, John F. Harkness, Executive Director, and Ellen H. Sloyer, Bar Liaison, The Florida Bar, Tallahassee, FL, for Petitioner.
PER CURIAM.
This matter is before the Court for consideration of amendments to the Florida Supreme Court Approved Family Law Forms. We have jurisdiction. See art. V, § 2(a), Fla. Const.
Under Amendments to the Florida Family Law Rules of Procedure and Family Law Forms, 810 So. 2d 1, 13-14 (Fla.2000), the Court internally reviews and maintains the Florida Supreme Court Approved Family Law Forms. Revisions to Florida Supreme Court Approved Family Law Forms 12.982(a), Petition for Change of Name (Adult), 12.982(c), Petition for Change of Name (Minor Child(ren)), and 12.982(f), Petition for Change of Name (Family), have become necessary as a result of 2009 amendments to section 68.07, Florida Statutes. See Ch. 2009-173, Laws of Fla. The amendments are meant to reflect the new fingerprinting and criminal history records check requirements and the clarified hearing and costs provisions under the amended statute. Other minor and editorial amendments are also made.
Accordingly, the Florida Supreme Court Approved Family Law Forms are hereby amended as set forth in the appendix to this petition, fully engrossed and ready for use. The amendments shall become effective immediately upon release of this opinion. Because the amendments were not published for comment prior to adoption, interested persons shall have sixty days from the date of this opinion in which to file comments with the Court.[1] By adoption of these forms, we express no opinion as to their correctness or applicability, or on the substance of the relevant legislation. The forms discussed herein may also be accessed and downloaded from the Florida State Courts website at www. flcourts.org/gen_public/family/forms_rules/ index.shtml.
It is so ordered.
QUINCE, C.J., and PARIENTE, LEWIS, CANADY, POLSTON, LABARGA, and PERRY, JJ., concur.

APPENDIX
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.982(a), PETITION FOR CHANGE OF NAME (ADULT) (06/10)

When should this form be used?
This form should be used when an adult wants the court to change his or her name. This form is not to be used in connection *548 with a dissolution of marriage or for adoption of child(ren). If you want a change of name because of a dissolution of marriage or adoption of child(ren) that is not yet final, the change of name should be requested as part of that case.
This form should be typed or printed in black ink and must be signed before a notary public or deputy clerk. You should file the original with the clerk of the circuit court in the county where you live and keep a copy for your records

What should I do next?
Unless you are seeking to restore a former name, you must have fingerprints submitted for a state and national criminal records check. The fingerprints must be taken in a manner approved by the Department of Law Enforcement and must be submitted to the Department for a state and national criminal records check. You may not request a hearing on the petition until the clerk of court has received the results of your criminal history records check. The clerk of court can instruct you on the process for having the fingerprints taken and submitted, including information on law enforcement agencies or service providers authorized to submit fingerprints electronically to the Department of Law Enforcement. The process may take several weeks and you will have to pay for the cost of processing the fingerprints and conducting the state and national criminal history records check.
Next, you must obtain a hearing date for the court to consider your request. If you are seeking to restore a former name, a hearing on the petition MAY be held immediately after the petition is filed. The final hearing on any other petition for a name change may be held immediately after the clerk of court receives the results of your criminal history records check. You should ask the clerk of court, family law intake staff, or judicial assistant about the local procedure for setting a hearing. You may be required to attend the final hearing. Included in these forms is a Final Judgment of Change of Name (Adult), Florida Supreme Court Approved Family Law Form 12.982(b), which the judge may use. You should check with the clerk, family law intake staff, or judicial assistant, to see if you need to bring a final judgment form with you. If so, you should type or print the heading, including the circuit, county, case number, division, and the parties' names, and leave the rest blank for the judge to complete at your hearing or trial.
If the judge grants your petition, he or she will sign this order. This officially changes your name. The clerk can provide you with certified copies of the signed order. There will be charges for the certified copies, and the clerk can tell you the amount of the charges.

Where can I look for more information?
Before proceeding, you should read General Information for Self-Represented Litigants found at the beginning of these forms. For further information, see Section 68.07, Florida Statutes.

Special notes...
The heading of the form calls for the name of the petitioner. Your current name should go there, as you are the one who is asking the court for something. The judicial circuit, case number, and division may be obtained from the clerk of court's office when you file the petition.
It may be helpful to compile a list of all of the people and/or places that will need a copy of your final judgment. This list may include the driver's license office, social security office, banks, schools, etc. A list *549 will help you know how many copies of your order you should get from the clerk of court after your hearing.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete.
                 IN THE CIRCUIT COURT OF THE _________________ JUDICIAL CIRCUIT,
                        IN AND FOR ______________________ COUNTY, FLORIDA
                                                                        Case No.: _____________
                                                                        Division: _____________
____________________________,
                  Petitioner.
                       PETITION FOR CHANGE OF NAME (ADULT)
    I, {full legal name} _____________, being sworn, certify that the
following information is true:
1. My complete present name is: __________________________________________.
   I request that my name be changed to: _________________________________.
2. I live in ____________ County, Florida, at {street address} ________________
   _______________________________________________________________________.
3. I was born on {date} ____________, in {city} __________________, {county} ______________,
   {state} ________________, {country} __________________.
4. My father's full legal name: ______________________________________________.
   My mother's full legal name: ______________________________________________.
   My mother's maiden name: __________________________________________________.
5. I have lived in the following places since birth:
   Dates (to/from)               Address
   __________/__________         ___________________________________________
   __________/__________         ___________________________________________
   __________/__________         ___________________________________________
   __________/__________         ___________________________________________
   (______ Please indicate here if you are continuing these facts on an attached page.)
6. Family
   [Choose all that apply]
   a. ______ I am not married.
   b. ______ I am married. My spouse's full legal name is: __________________________
   c. ______ I do not have child(ren).
   d. ______ The name(s), age(s), and address(es) of my child(ren) are as follows (all children, including
      those over 18, must be listed):
*550
  Name {last, first, middle initial}     Age          Address, City, State
  _______________________________________________________________________________________
  _______________________________________________________________________________________
  _______________________________________________________________________________________
  _______________________________________________________________________________________
  _______________________________________________________________________________________
  (______ Please indicate here if you are continuing these facts on an attached page.)
7. Former names
  [Choose all that apply]
  ______ My name has never been changed by a court.
  ______ My name previously was changed by court order from _____________________________
  to ______________________ on {date} __________________,
  by {court, city, and state} __________________________________________.
A copy of the court order is attached.
  ______ My name previously was changed by marriage from _______________________.
  to ________________________ on {date} __________________________________________,
  in {city, county, and state} ___________________________________________________.
  A copy of the marriage certificate is attached.
  ______ I have never been known or called by any other name.
  ______ I have been known or called by the following other name(s): {list name(s) and explain where you
         were known or called by such name(s)} _________________________________________________
8. Occupation
  My occupation is: ___________________________________________________________________.
  I am employed at: {company and address} _____________________________________________
  _____________________________________________________________________________________.
  During the past 5 years, I have had the following jobs:
  Dates (to/from)                 Employer and employer's address
  __________/__________     _____________________________________________________________
  __________/__________     _____________________________________________________________
  __________/__________     _____________________________________________________________
  __________/__________     _____________________________________________________________
  __________/__________     _____________________________________________________________
  (______ Please indicate here if you are continuing these facts on an attached page.)
9. Business
   [Choose one only]
   ______ I do not own and operate a business.
   ______ I own and operate a business. The name of the business is: _______________________.
   The street address is: __________________________________________________________________.
   My position with the business is: _______________________________________________________.
   I have been involved with the business since: {date} ___________________________.
*551
10. Profession
    [Choose one only]
    ______ I am not in a profession.
    ______ I am in a profession. My profession is: __________________________________________.
    I have practiced this profession:
    Dates (to/from)              Place and address
  __________/__________     _____________________________________________________________
  __________/__________     _____________________________________________________________
  __________/__________     _____________________________________________________________
  __________/__________     _____________________________________________________________
  __________/__________     _____________________________________________________________
  (______ Please indicate here if you are continuing these facts on an attached page.)
11. Education
  I have graduated from the following school(s):
  Degree          Date of
  Received       Graduation      School
  __________   _____________     ________________________________________________________
  __________   _____________     ________________________________________________________
  __________   _____________     ________________________________________________________
  (________ Please indicate here if you are continuing these facts on an attached page.)
12. Criminal History
  [Choose one only]
  ______ I have never been arrested for or charged with, pled guilty or nolo contendere to, or been
  found to have committed a criminal offense, regardless of adjudication.
  ______ I have a criminal history. In the past I have been arrested for or charged with, pled guilty or
  nolo contendere to, or been found to have committed a criminal offense, regardless of adjudication.
  The details of my criminal history are:
  Date          City/State           Event (arrest, charge, plea, or adjudication)
  __________   _________________   ______________________________________________________
  __________   _________________   ______________________________________________________
  __________   _________________   ______________________________________________________
  (_______ Please indicate here if you are continuing these facts on an attached page.)
13. Bankruptcy
  [Choose one only]
  ______ I have never been adjudicated bankrupt.
  ______ I was adjudicated bankrupt on {date} __________, in {city} ______________________,
  {county} __________, {state} _______________.
  (______ Please indicate here if you have filed additional bankruptcies, and explain on an attached
  page.)
*552
  14. Creditor(s)' Judgments
  [Choose one only]
  ______ I have never had a money judgment entered against me by a creditor.
  ______ The following creditor(s)' money judgment(s) have been entered against me:
  Date         Amount        Creditor      Court entering judgment and case number if Paid {date}
  __________   __________    __________     ______________________________________________________
  __________   __________    __________     ______________________________________________________
  __________   __________    __________     ______________________________________________________
  __________   __________    __________     ______________________________________________________
  (_______ Please indicate here if these facts are continued on an attached page.)
15. Fingerprints and Criminal History Records Check
  Unless I am seeking to restore a former name, a copy of my fingerprints has been taken in a manner
  approved by the Department of Law Enforcement and submitted for a state and national criminal
  history records check. I understand that I cannot request a hearing on my Petition until the Clerk
  of Court receives the results of the criminal history records check.
16. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner
  invade the property rights of others, whether partnership, patent, good will, privacy, trademark, or
  otherwise.
17. My civil rights have never been suspended, or, if my civil rights have been suspended, they have
  been fully restored.
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this
motion and that the punishment for knowingly making a false statement includes fines and/or
imprisonment.
Dated: _______________          _________________________________________________________
                                Signature of PETITIONER
                                Printed Name: ___________________________________________
                                Address: ________________________________________________
                                City, State, Zip: _______________________________________
                                Telephone Number: _______________________________________
                                Fax Number: _____________________________________________
*553
  STATE OF FLORIDA
  COUNTY OF _____________________
  Sworn to or affirmed and signed before me on __________ by ____________________________.
                                    _____________________________________________________.
                                    NOTARY PUBLIC or DEPUTY CLERK
                                    _____________________________________________________
                                    [Print, type, or stamp commissioned name of notary or
                                    deputy clerk.]
  ______ Personally known
  ______ Produced identification
  ______ Type of identification produced ____________________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in
all blanks]
I, {full legal name and trade name of nonlawyer} ________________________________________,
a nonlawyer, whose address is {street} __________________, {city} ______________,
{state} ______________, {phone} ____________, helped {name} ______________________, who is
the petitioner, fill out this form.
*554 INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.982(c), PETITION FOR CHANGE OF NAME (MINOR CHILD(REN)) (06/10)

When should this form be used?
This form should be used when parents want the court to change the name of their minor child(ren). For the purposes of this proceeding, a person under the age of 18 is a minor. This form is not to be used in connection with an adoption, dissolution of marriage, or paternity action. If you want a change of name for your child(ren) because of an adoption or paternity action that is not yet final, the change of name should be requested as part of that case.
This form should be typed or printed in black ink and must be signed before a notary public or deputy clerk. You should file the original with the clerk of the circuit court, in the county where you live and keep a copy for your records. The Petition should only be completed by one Petitioner for one child. If you wish to change the name of more than one child or if there is more than one Petitioner, you should complete and file a Supplemental Form for Petition for Change of Name (Minor Child) for each child and/or a Supplemental Form for Petition for Change of Name. The supplemental form(s) is an attachment to the petition. Be sure that the bottom of each page of each supplemental form is initialed by the petitioner(s).

What should I do next?
Unless you are seeking to restore a former name, each adult petitioner(s)'s fingerprints must be submitted for a state and national criminal history records check. The fingerprints must be taken in a manner approved by the Department of Law Enforcement. The fingerprints must be submitted to the Department of Law Enforcement for a state and national criminal history records check. The Petitioner(s) may not request a hearing on the Petition until the copy of the fingerprints are filed and the clerk of court has received the results of the criminal history records check. The clerk of court can instruct you on the process for having the fingerprints taken and submitted, including information on law enforcement agencies or service providers authorized to submit fingerprints electronically to the Department of Law Enforcement. The process may take several weeks and the parent or guardian of the minor must pay the cost of processing the fingerprints and conducting the state and national history records check.
If both parents agree to the change of name and live in the county where the change of name is sought, you may both file as petitioners. In this situation, service is not necessary, and you need only to set a hearing. You should ask the clerk of court, family law intake staff, or judicial assistant about the local procedure for setting a hearing.
If only one parent is a resident of the county where the change of name(s) is sought or only one parent asks for the child(ren)'s name(s) to be changed, the other parent must be notified and his or her consent obtained, if possible. If the other parent consents to the change of name, a Consent for Change of Name (Minor Child(ren)), Florida Supreme Court Approved Family Law Form 12.982(d), should be filed.
If the other parent does not consent to the change of name, you may still have a hearing on the petition if you have properly notified the other parent about your petition and the hearing. If you know where he or she lives, you must use personal *555 service. If you absolutely do not know where he or she lives, you may use constructive service. For more information about personal and constructive service, you should refer [to] the "General Instructions for Self-Represented Litigants" found at the beginning of these forms and the instructions to Florida Family Law Rules of Procedure Forms 12.910(a) and 12.913(b) and Florida Supreme Court Approved Family Law Form 12.913(a). However, the law regarding constructive service is very complex and you may wish to consult an attorney regarding that issue.
Next, you must obtain a final hearing date for the court to consider your request. If you are seeking to restore a former name, a hearing on the petition MAY be held immediately after the petition is filed. The final hearing on any other petition for a name change may be held immediately after the clerk of court receives the results of your criminal history records check. You should ask the clerk of court, family law intake staff, or judicial assistant about the local procedure for setting a hearing. You may be required to attend the hearing. Included in these forms is a Final Judgment of Change of Name (Minor Child(ren)), Florida Supreme Court Approved Family Law Form 12.982(e), which may be used when a judge grants a change of name for a minor child(ren). If you attend the hearing, you should take the final judgment with you. You should complete the top part of the form, including the circuit, county, case number, division, and the name(s) of the petitioner(s) and leave the rest blank for the judge to complete. It should be typed or printed in black ink. If the judge grants your petition, he or she will sign this order. This officially changes your child(ren)'s name(s). The clerk can provide you with certified copies of the signed order. There will be charges for the certified copies, and the clerk can tell you the amount of the charges.

Where can I look for more information?
Before proceeding, you should read "General Information for Self-Represented Litigants" found at the beginning of these forms. For further information, see section 68.07, Florida Statutes.

Special notes...
The heading of the form calls for the name(s) of the petitioner(s). This means the parent(s) who is (are) requesting the change of their child(ren)'s name(s). The judicial circuit, case number, and division may be obtained from the clerk of court's office when you file the petition.
It may be helpful to compile a list of all of the people and places that will need a copy of the final judgment. This list may include the driver's license office, social security office, banks, schools, etc. A list will help you know how many copies of your order you should get from the clerk of court after your hearing.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete.
*556
                   IN THE CIRCUIT COURT OF THE _______________ JUDICIAL CIRCUIT,
                          IN AND FOR ________________ COUNTY, FLORIDA
                                                            Case No.: ____________________
                                                            Division: ____________________
IN RE: THE NAME CHANGE OF
__________________________________,
                 Petitioner/Father,
__________________________________,
                 Petitioner/Mother.
                      PETITION FOR CHANGE OF NAME (MINOR CHILD(REN))
    I/We, {full legal name(s)} ____________________________________________, being sworn,
certify that the following information is true:
    I am/We are the birth or legal parent(s) or guardian of the minor child(ren) named in this
petition.
[Choose only one]
    a. _______ There is only one minor child named in this petition.
    b. _______ There are {enter number of children} _____________ children named in this petition. The
       information on the first child is entered below. I/We have attached the completed
       supplemental forms for each other child.
The adult petitioner(s)'s fingerprints have been taken in a manner approved by the Department of Law
Enforcement and submitted for a state and national criminal history records check. I/We understand
that I/we cannot request a hearing on my/our Petition until the clerk of court receives the results of
the criminal history records check.
A. THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD #         1 :
  1. Minor child's complete present name is:
     ____________________________________________________________________________________
     I/We request that this minor child's name be changed to:
     ____________________________________________________________________________________
  2. The minor child lives in ___________ County, Florida, at {street address} __________
     _____________________________________________________________________________________________.
*557
  3. The minor child was born on {date} __________, in {city, county, state, country} ___
     ____________________________________________________________________________________.
  4. The minor child's father's full legal name: ________________________________________.
     The minor child's mother's full legal name: ________________________________________.
     The minor child's mother's maiden name: ____________________________________________.
  5. The minor child has lived in the following places since birth:
     Dates (to/from)       Address
  __________/__________    _____________________________________________________________
  __________/__________    _____________________________________________________________
  __________/__________    _____________________________________________________________
  __________/__________    _____________________________________________________________
  __________/__________    _____________________________________________________________
  (_______ Please indicate here if you are continuing these facts on an attached page.)
  6. [Choose one only]
     ______ The minor child is not married.
     ______ The minor child is married to: {full legal name} ___________________.
  7. [Choose one only]
     ______ The minor child has no children.
     ______ The minor child is the parent of the following child(ren): {enter full name(s) and date(s) of
            birth} ______________________________________________________________________.
  8. Former names.
     [Choose all that apply]
     ______ The minor child's name has never been changed by a court.
     ______ The minor child's name previously was changed by court order from ___________
     to _________________ on {date} _____________________________________,
     by {court, city, and state} ________________________________________.
     A copy of the court order is attached.
     ______ The minor child's name previously was changed by marriage from ________
            to _________________________ on {date} _____________________________,
            in {city, county, and state} _______________________________________.
     A copy of the marriage certificate is attached.
     _______ The minor child has never been known or called by any other name.
     _______ The minor child has been known or called by the following other name(s): {list name(s)
             and explain where child was known or called by such name(s)} _______________
             ____________________________________________________________________________
             ____________________________________________________________________________
  9. The minor child is not employed in an occupation or profession, does not own and operate a
*558
  business, and has received no educational degrees. If the minor child has a job, explain: ______
  _______________________________________________________________________________________
  10. Criminal History.
  [Choose one only]
      ______ The minor child has never been arrested for or charged with, pled guilty or nolo
             contendere to, or been found to have committed a criminal offense, regardless of
             adjudication.
      ______ The minor child has a criminal history. In the past, the minor child was arrested for or
             charged with, pled guilty or nolo contendere to, or been found to have committed a
             criminal offense, regardless of adjudication. The details of the criminal history are:
            Date      City/State       Event (arrest, charge, plea, or adjudication)
      ___________________________________________________________________________________
      ___________________________________________________________________________________
      ___________________________________________________________________________________
      (______ Please indicate here if you are continuing these facts on an attached page.)
11. Money Judgments.
  [Choose one only]
  ______ The minor child has never been adjudicated bankrupt, and no money judgment has ever
         been entered against him or her.
  ______ The following money judgment(s) has been entered against him or her:
  Date        Amount      Creditor    Court entering judgment and case number     Indicate if Paid
    ____________  _________   __________  _______________________________________          [ ]
    ____________  _________   __________  _______________________________________          [ ]
B. THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER(S):
  ( ) FATHER ( ) MOTHER ( ) GUARDIAN
  ( ) A Supplemental Form has been attached for the other parent or petitioner.
  1. My complete present name is: _______________________________________________________
     ____________________________________________________________________________________
  2. I live in __________ County, Florida, at {street address} _________________
     ____________________________________________________________________________________.
  3. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner
     invade the property rights of others, whether partnership, patent, good will, privacy, trademark,
     or otherwise.
  4. My civil rights have never been suspended, or, if ever suspended, they have been fully restored.
*559
  I understand that I am swearing or affirming under oath to the truthfulness of the claims
made in this petition and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
Dated: ___________                              _________________________________________
                                                Signature of Petitioner
                                                Printed Name: ___________________________
                                                Address: ________________________________
                                                City, State, Zip: _______________________
                                                Telephone Number: _______________________
                                                Fax Number: _____________________________
STATE OF FLORIDA
COUNTY OF _____________
Sworn to or affirmed and signed before me on __________ by ______________________________.
                                    ____________________________________________________
                                    NOTARY PUBLIC or DEPUTY CLERK
                                    ____________________________________________________
                                    [Print, type, or stamp commissioned name of notary or
                                    clerk.]
______ Personally known
______ Produced identification
       Type of identification produced _____________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in
all blanks]
I, {full legal name and trade name of nonlawyer} __________________________________________,
a nonlawyer, whose address is {street} ___________, {city} _______________________,
{state} ___________, {phone} ____________, helped {name(s)} _____________,
who is (are) the petitioner(s), fill out this form.
*560
ADULT SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (MINOR CHILDREN)
                                                Case No.: ________________________
THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER(S):
( ) FATHER ( ) MOTHER ( ) GUARDIAN
1. My complete present name is: ________________________________________________________
   _____________________________________________________________________________________
2. I live in _________________ County, Florida, at {street address} ____________
   ______________________________________________________________________________________.
3. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner
   invade the property rights of others, whether partnership, patent, good will, privacy, trademark,
   or otherwise.
4. My civil rights have never been suspended, or, if ever suspended, they have been fully restored.
    I understand that I am swearing or affirming under oath to the truthfulness of the claims
made in this petition and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
Dated: __________                           _____________________________________________
                                            Signature of Petitioner
                                            Printed Name: _______________________________
                                            Address: ____________________________________
                                            City, State, Zip: ___________________________
                                            Telephone Number: ___________________________
                                            Fax Number: _________________________________
STATE OF FLORIDA
COUNTY OF ___________
Sworn to or affirmed and signed before me on ___________ by _____________________________.
                                    _____________________________________________________
                                    NOTARY PUBLIC or DEPUTY CLERK
                                    _____________________________________________________
                                    [Print, type, or stamp commissioned name of notary or
                                    clerk.]
  ________ Personally known
  ________ Produced identification
           Type of identification produced _____________________
*561
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in
all blanks]
I, {full legal name and trade name of nonlawyer}___________________________________________________,
a nonlawyer, whose address is {street}_________________, {city}___________________________,
{state} _____________, {phone} _______________, helped {name(s)}_________________,
who is (are) the petitioner(s), fill out this form.
*562
SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (MINOR CHILD(REN))
                                                     Case No.:______________________________________________
THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD #            __________:
      1. Minor child's complete present name is:
         ___________________________________________________________________________________________________.
         I/We request that minor child's name be changed to:
         ___________________________________________________________________________________________________.
      2. The minor child lives in ___________ County, Florida, at {street address}_________________.
         ___________________________________________________________________________________________________.
      3. The minor child was born on {date}________________, in {city, county, state, country}.
         _________________________________________________________________.
      4. The minor child's father's full legal name: _______________________________________________________.
         The minor child's mother's full legal name: _______________________________________________________.
         The minor child's mother's maiden name: ___________________________________________________________.
      5. The minor child has lived in the following places since birth:
         Dates (to/from)   Address
         _______/_______   _________________________________________________________________________________
         _______/_______   _________________________________________________________________________________
         _______/_______   _________________________________________________________________________________
         _______/_______   _________________________________________________________________________________
         _______/_______   _________________________________________________________________________________
         _______/_______   _________________________________________________________________________________
         (____ Please indicate here if you are continuing these facts on an attached page.)
      6. [Choose one only]
         ____ The minor child is not married.
         ____ The minor child is married to: {full legal name} ____________________________________.
      7. [Choose one only]
         ____ The minor child has no children.
         ____ The minor child is the parent of the following child(ren): {enter name(s) and date(s) of birth}
         ___________________________________________________________________________________________________.
*563
      8. Former names
         [Choose all that apply]
         ____ The minor child's name has never been changed by a court.
         ____ The minor child's name previously was changed by court order from ____________________________
         to ____________ on {date} ________________________________________________________________,
         by {court, city, and state} ______________________________________________________________.
         A copy of the court order is attached.
         ____ The minor child's name previously was changed by marriage from _______________________________
         to ____________ on {date} ________________________________________________________________,
         in {city, county, and state} _____________________________________________________________.
         A copy of the marriage certificate is attached.
         ____ The minor child has never been known or called by any other name.
         ____ The minor child has been known or called by the following other name(s): {list name(s) and
explain where child was known or called by such name(s)} _________________________________
         ___________________________________________________________________________________________________
         ___________________________________________________________________________________________________
      9. The minor child is not employed in an occupation or profession, does not own and operate a
         business, and has received no educational degrees. If the minor child has a job, explain: _________
         ___________________________________________________________________________________________________
         ___________________________________________________________________________________________________.
     10. Criminal History
         [Choose one only]
         ____ The minor child has never been arrested for or charged with, pled guilty or nolo contendere
         to or been found to have committed a criminal offense, regardless of adjudication.
         ____ The minor child has a criminal history. In the past, the minor child was arrested for or
         charged with, pled guilty or nolo contendere to, or been found to have committed a
         criminal offense, regardless of adjudication. The details of the criminal history are:
               Date    City/State                   Event (arrest, charge, plea, or adjudication)
         ___________________________________________________________________________________________________
         ___________________________________________________________________________________________________
         ___________________________________________________________________________________________________
         (____ Please indicate here if you are continuing these facts on an attached page.)
     11. Money Judgments
         [Choose one only]
         ____ The minor child has never been adjudicated bankrupt, and no money judgment has ever
              been entered against him or her.
         ____ The following money judgment(s) has (have) been entered against him or her:
         Date Amount  Creditor   Court entering judgment and case number   Indicate if Paid
         ____ _____ ____________ _______________________________________          []
         ____ _____ ____________ ______________________________                   []

*564 INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.982(f), PETITION FOR CHANGE OF NAME (FAMILY) (06/10)

When should this form be used?
This form should be used when a family wants the court to change its name. This form is not to be used in connection with a dissolution of marriage, paternity, or adoption action. If you want a change of name because of a dissolution of marriage, paternity, or adoption action that is not yet final, the change of name should be requested as part of that case.
This form should be typed or printed in black ink and must be signed before a notary public or deputy clerk. You should file the original with the clerk of the circuit court in the county where you live and keep a copy for your records. The petition should only be completed for one adult. If you wish to change the name(s) of another adult and/or any child(ren), you should complete and file with the clerk of court the attached Supplemental Form(s) for Petition for Change of Name (Family) for each additional family member. Be sure that the bottom of each page of each supplemental form is initialed.

What should I do next?
Unless you are seeking to restore a former name, each adult petitioner must have fingerprints submitted for a state and national criminal history records check. The fingerprints must be taken in a manner approved by the Department of Law Enforcement and must be submitted to the Department for a state and national criminal history records check. You may not request a hearing on the petition until the clerk of court has received the results of your criminal history records check. The clerk of court can instruct you on the process for having the fingerprints taken and submitted, including information on law enforcement agencies or service providers authorized to submit finger prints electronically to the Department of Law Enforcement. The process may take several weeks and you will have to pay for the cost of processing the fingerprints and conducting the state and national criminal history records check.
If any of the children for whom you are requesting this change of name are not the legal children of both adults filing this petition, you must obtain the consent of the legal parent(s). A parent not named as a petitioner in this action may consent by submitting a Consent for Change of Name (Minor Child(ren)), Florida Supreme Court Approved Family Law Form 12.982(d).
If the other parent does not consent to the change of name, you may still have a hearing on the petition if you have properly notified the other parent about your petition and the hearing. If you know where he or she lives, you must use personal service. If you absolutely do not know where he or she lives, you may use constructive service. For more information about personal and constructive service, you should refer to the "General Instructions for Self-Represented Litigants" found at the beginning of these forms and the instructions to Florida Family Law Rules of Procedure Forms 12.910(a) and 12.913(b) and Florida Supreme Court Approved Family Law Form 12.913(a). The law on constructive service is very complex and you may wish to consult an attorney regarding constructive service.
Next, you must obtain a final hearing date for the court to consider your request. If you are seeking to restore a former name, hearing on the petition MAY *565 be held immediately after the petition is filed. The final hearing on any other petition for a name change may be held immediately after the clerk of court receives the results of your criminal history records check. You should ask the clerk of court, family law intake staff, or judicial assistant about the local procedure for setting a hearing. You may be required to attend the hearing. Included in these forms is a Final Judgment of Change of Name (Family), Florida Supreme Court Approved Family Law Form 12.982(g), which may be used when a judge grants a change of name for a family. If you attend the hearing, you should take the final judgment form with you. You should complete the top part of this form, including the circuit, county, case number, division, the name(s) of the petitioner(s) and leave the rest blank for the judge to complete. It should be typed or printed in black ink. If the judge grants your petition, he or she will sign this order. This officially changes your family's name. The clerk can provide you with certified copies of the signed order. There will be charges for the certified copies, and the clerk can tell you the amount of the charges.

Where can I look for more information?
Before proceeding, you should read "General Information for Self-Represented Litigants" found at the beginning of these forms. For further information, see section 68.07, Florida Statutes.

Special notes...
The heading of the form calls for the name(s) of the petitioner(s). This is (are) the parent(s) who is/are requesting the change of their family's name(s). The judicial circuit, case number, and division may be obtained from the clerk of court's office when you file the petition.
It may be helpful to compile a list of all of the people and places that will need a copy of the final judgment. This list may include the driver's license office, social security office, banks, schools, etc. A list will help you know how many copies of your order you should get from the clerk of court after your hearing.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete.
*566
       IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT,
                    IN AND FOR ____________ COUNTY, FLORIDA
                                        Case No.: ____________________
                                      Division: ______________________
IN RE: THE NAME CHANGE OF
________________________________________,
                          Petitioner/Father,
________________________________________,
                          Petitioner/Mother.
                   PETITION FOR CHANGE OF NAME (FAMILY)
   I/We, {full legal name(s)}____________________________, being sworn,
certify that the following information is true:
There are {enter number}____ adults named in this petition. A supplemental form is attached for each
adult not set out below.
There are {enter number}____ children named in this petition. I am/We are the birth or legal parents
or guardian of the minor child(ren) named in this petition. I/We have attached a completed
supplemental form for each minor child.
Unless I am seeking to restore a former name, a copy of the fingerprints of each adult person seeking a
name change in this petition has/have been taken in a manner approved by the Department of Law
Enforcement, and submitted for a state and national criminal history records check. I/We understand
that I/we cannot request a hearing on my/our Petition until the clerk of court receives the results of
the criminal history records check.
THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER:
( ) HUSBAND ( ) WIFE ( ) GUARDIAN
( ) A Supplemental Form has been attached for the other parent or petitioner.
     5. My complete present name is:
        ____________________________________________________________________________________________________.
        I request that my name be changed to:
        ____________________________________________________________________________________________________.
     6. I live in ____ County, Florida, at {street address} _______________________________________
        ____________________________________________________________________________________________________.
*567
     7. I was born on {date} ______, in {city} ________, {county} _______________,
        {state} _________, {country} _____________________________________________________.
     8. My father's full legal name:________________________________________________________________________.
        My mother's full legal name:________________________________________________________________________.
        My mother's maiden name:____________________________________________________________________________.
     9. I have lived in the following places since birth:
        Dates (to/from)   Address
        ______/________   __________________________________________________________________________________
        ______/________   __________________________________________________________________________________
        ______/________   __________________________________________________________________________________
        ______/________   __________________________________________________________________________________
        ______/________   __________________________________________________________________________________
        ______/________   __________________________________________________________________________________
        ______/________   __________________________________________________________________________________
        ______/________   __________________________________________________________________________________
        (____ Please indicate here if you are continuing these facts on an attached page.)
      10. Family
          [Choose all that apply]
          a. ___ I am not married.
          b. ___ I am married. My spouse's full legal name is:______________________________________________.
          c. ___ I do not have child(ren).
          d. ___ The name(s), age(s), and address(es) of my child(ren) are as follows (all children,
             including those over 18, must be listed):
         Name {last, first, middle initial}     Age    Address, City, State
         __________________________________   ____   _______________________________________________________
         __________________________________   ____   _______________________________________________________
         __________________________________   ____   _______________________________________________________
         __________________________________   ____   _______________________________________________________
         __________________________________   ____   _______________________________________________________
         __________________________________   ____   _______________________________________________________
         (____ Please indicate here if you are continuing these facts on an attached page.)
      11. Former names
          [Choose all that apply]
          ____ My name has never been changed by a court.
          ____ My name previously was changed by court order from __________________________________________
               to _________________ on {date} _____________________________________________________,
               by {court, city, and state} ________________________________________________________.
               A copy of the court order is attached.
          ____ My name previously was changed by marriage from _____________________________________________
*568
               to______________________ on {date} _________________________________________________,
               in {city, county, and state} _______________________________________________________.
               A copy of the marriage certificate is attached.
          ____ I have never been known or called by any other name.
          ____ I have been known or called by the following other name(s): {list name(s) and explain where
you were known or called by such name(s)} __________________________________________
               _____________________________________________________________________________________________
               _____________________________________________________________________________________________.
      12. Occupation
          My occupation is:_________________________________________________________________________________.
          I am employed at: {company and address} _________________________________________________
          __________________________________________________________________________________________________.
          During the past 5 years, I have had the following jobs:
          Dates (to/from)   Employer and employer's address
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          (____ Please indicate here if you are continuing these facts on an attached page.)
      13. Business
          [Choose one only]
          ____ I do not own and operate a business.
          ____ I own and operate a business. The name of the business is: __________________________________.
               The street address is: ______________________________________________________________________.
               My position with the business is: ___________________________________________________________.
               I have been involved with the business since: {date} _______________________________.
      14. Profession
          [Choose one only]
          ____ I am not in a profession.
          ____ I am in a profession. My profession is: _____________________________________________________.
               I have practiced this profession:
               Dates (to/from)   Place and address
               _______/_______   ___________________________________________________________________________
               _______/_______   ___________________________________________________________________________
               _______/_______   ___________________________________________________________________________
               _______/_______   ___________________________________________________________________________
               _______/_______   ___________________________________________________________________________
*569
               (____ Please indicate here if you are continuing these facts on an attached page.)
      15. Education
          I have graduated from the following school(s):
           Degree      Date of
          Received    Graduation   School
          ________    __________   _________________________________________________________________________
          ________    __________   _________________________________________________________________________
          ________    __________   _________________________________________________________________________
          (____ Please indicate here if you are continuing these facts on an attached page.)
      16. Criminal History
          [Choose one only]
          ____ I have never been arrested for or charged with, pled guilty or nolo contendere to, or
               have been found to have committed a criminal offense, regardless of adjudication.
          ____ I have a criminal history. In the past I have been arrested for or charged with, pled
               guilty or nolo contendere to, or been found to have committed a criminal offense,
               regardless of adjudication. The details of my criminal history are:
               Date   City/State              Event (arrest, charge, plea, or adjudication)
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
          (____ Please indicate here if you are continuing these facts on an attached page.)
      17. Bankruptcy
          [Choose one only]
          ____ I have never been adjudicated bankrupt.
          ____ I was adjudicated bankrupt on {date} _________, in {city} _____________,
               {county} ___________, {state} _____________.
         (____ Please indicate here if you have had additional bankruptcies, and explain on an attached
         page.)
      18. Creditor(s)' Judgments
          [Choose one only]
          ____ I have never had a money judgment entered against me by a creditor.
          ____ The following creditor(s)' money judgment(s) have been entered against me:
          Date   Amount      Creditor   Court entering judgment and case number indicate if
          Paid
          ____   _________   ________   _______________________________________________     []
          ____   _________   ________   _______________________________________________     []
          ____   _________   ________   _______________________________________________     []
          ____   _________   ________   _______________________________________________     []
          (____ Please indicate here if these facts are continued on an attached page.)
*570
      19. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner
          invade the property rights of others, whether partnership, patent, good will, privacy, trademark,
          or otherwise.
      20. My civil rights have never been suspended, or, if my civil rights have been suspended, they have
          been fully restored.
          I understand that I am swearing or affirming under oath to the truthfulness of the claims
made in this petition and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
Dated: ____________          _______________________________________________________________________________
                             Signature of Petitioner
                             Printed Name: _________________________________________________________________
                             Address: ______________________________________________________________________
                             City, State, Zip: _____________________________________________________________
                             Telephone Number: _____________________________________________________________
                             Fax Number: ___________________________________________________________________
STATE OF FLORIDA
COUNTY OF ______________
Sworn to or affirmed and signed before me on ______________ by _____________________________________________.
                                             _______________________________________________________________
                                             NOTARY PUBLIC or DEPUTY CLERK
                                             _______________________________________________________________
                                             [Print, type, or stamp commissioned name of notary or
                                             clerk.]
____   Personally known
____   Produced identification
       Type of identification produced __________________________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in
all blanks]
I, {full legal name and trade name of nonlawyer}___________________________________________________,
a nonlawyer, whose address is{street} ______________________, {city} _____________________,
{state} _______, {phone} ______, helped {name} __________________________________,
who is the petitioner, fill out this form.
*571
                ADULT SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (FAMILY)
                                                             Case No.: _____________________________________
THE FOLLOWING INFORMATION IS TRUE ABOUT PETITIONER:
( ) HUSBAND ( ) WIFE ( ) GUARDIAN
       1. My complete present name is:
          __________________________________________________________________________________________________.
          I request that my name be changed to:
          __________________________________________________________________________________________________.
       2. I live in _____ County, Florida, at {street address} ____________________________________.
          __________________________________________________________________________________________________.
       3. I was born on {date} _________, in {city} ____________, {county}________.
          {state} ____________, {country} _________________________________________________.
       4. My father's full legal name: ______________________________________________________________________.
          My mother's full legal name: ______________________________________________________________________.
          My mother's maiden name: __________________________________________________________________________.
       5. I have lived in the following places since birth:
          Dates (to/from)     Address
          _______/_________   ______________________________________________________________________________
          _______/_________   ______________________________________________________________________________
          _______/_________   ______________________________________________________________________________
          _______/_________   ______________________________________________________________________________
          _______/_________   ______________________________________________________________________________
          _______/_________   ______________________________________________________________________________
          _______/_________   ______________________________________________________________________________
          _______/_________   ______________________________________________________________________________
          _______/_________   ______________________________________________________________________________
          (____ Please indicate here if you are continuing these facts on an attached page.)
       6. Family
          [Choose all that apply]
          a. ____ I am not married.
          b. ____ I am married. My spouse's full legal name is: ____________________________________________.
          c. ____ I do not have child(ren).
          d. ____ The name(s), age(s), and address(es) of my child(ren) are as follows (all children,
             including those over 18, must be listed):
          Name {last, first, middle initial}   Age    Address, City, State
          ______________________________________________________   ______   ________________________________
*572
          ______________________________________________________   ______    _______________________________
          ______________________________________________________   ______    _______________________________
          ______________________________________________________   ______    _______________________________
          (____ Please indicate here if you are continuing these facts on an attached page.)
       7. Former names
          [Choose all that apply]
          ____ My name has never been changed by a court.
          ____ My name previously was changed by court order from __________________________________________
               to ______________________ on {date} ________________________________________________
               by {court, city, and state} ________________________________________________________.
               A copy of the court order is attached.
          ____ My name previously was changed by marriage from _____________________________________________
               to ____________________ on {date} __________________________________________________
               in {city, county, and state} _______________________________________________________.
               A copy of the marriage certificate is attached.
          ____ I have never been known or called by any other name.
          ____ I have been known or called by the following other name(s): {list name(s) and explain where
you were known or called by such name(s)} _______________________________________________
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
       8. Occupation
          My occupation is: ________________________________________________________________________________.
          I am employed at: {company and address} _________________________________________________
          __________________________________________________________________________________________________.
          During the past 5 years, I have had the following jobs:
          Dates (to/from)   Employer and employer's address
          ________/______   ________________________________________________________________________________
          ________/______   ________________________________________________________________________________
          ________/______   ________________________________________________________________________________
          ________/______   ________________________________________________________________________________
          ________/______   ________________________________________________________________________________
          ________/______   ________________________________________________________________________________
          ________/______   ________________________________________________________________________________
          (____ Please indicate here if you are continuing these facts on an attached page.)
       9. Business
          [Choose all that apply]
          ___ I do not own and operate a business.
          ___ I own and operate a business. The name of the business is: ___________________________________.
              The street address is: _______________________________________________________________________.
              My position with the business is: ____________________________________________________________.
              I have been involved with the business since: {date} ________________________________.
      10. Profession
          [Choose all that apply]
          ___ I am not in a profession.
*573
          ___ I am in a profession. My profession is: ______________________________________________________.
              I have practiced this profession:
              Dates (to/from)   Place and address
              _______/_______   ____________________________________________________________________________
              _______/_______   ____________________________________________________________________________
              _______/_______   ____________________________________________________________________________
              _______/_______   ____________________________________________________________________________
              _______/_______   ____________________________________________________________________________
              (___ Please indicate here if you are continuing these facts on an attached page.)
      11. Education
          I have graduated from the following school(s):
          Degree     Date of
          Received   Graduation     School
          ________   __________     ________________________________________________________________________
          ________   __________     ________________________________________________________________________
          ________   __________     ________________________________________________________________________
          (___ Please indicate here if you are continuing these facts on an attached page.)
      12. Criminal History
          [Choose all that apply]
          ___ I have never been arrested for or charged with, pled guilty or nolo contendere to, or been
              found to have committed a criminal offense, regardless of adjudication.
          ___ I have a criminal history. In the past I have been arrested for or charged with, pled guilty or
              nolo contendere to, or been found to have committed a criminal offense, regardless of
              adjudication. The details of my criminal history are:
                 Date    City/State           Event (arrest, charge, plea, or adjudication)
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
          (___ Please indicate here if you are continuing these facts on an attached page.)
      13. Bankruptcy
          [Choose one only]
          ___ I have never been adjudicated bankrupt.
          ___ I was adjudicated bankrupt on {date} _______________, in {city} ____________,
          {county} __________, {state} ______________.
          (___ Please indicate here if you have had additional bankruptcies, and explain on an attached
          page.)
      14. Creditors' Judgments
          [Choose one only]
          ___ I have never had a money judgment entered against me by a creditor.
          ___ The following creditor(s)' money judgment(s) have been entered against me:
*574
          Date   Amount   Creditor   Court entering judgment and case number   check if Paid
          ____   ______   ________   _______________________________________         []
          ____   ______   ________   _______________________________________         []
          ____   ______   ________   _______________________________________         []
          ____   ______   ________   _______________________________________         []
          (____ Please indicate here if these facts are continued on an attached page.)
      15. I have no ulterior or illegal purpose for filing this petition, and granting it will not in any manner
          invade the property rights of others, whether partnership, patent, good will, privacy, trademark,
          or otherwise.
      16. My civil rights have never been suspended, or, if my civil rights have been suspended, they have
          been fully restored.
          I understand that I am swearing or affirming under oath to the truthfulness of the claims
made in this petition and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
Dated: __________________              _____________________________________________________________________
                                       Signature of Petitioner
                                       Printed Name: _______________________________________________________
                                       Address: ____________________________________________________________
                                       City, State, Zip: ___________________________________________________
                                       Telephone Number: ___________________________________________________
                                       Fax Number: _________________________________________________________
STATE OF FLORIDA
COUNTY OF __________________
Sworn to or affirmed and signed before me on ________________ by ___________________________________________.
                                             _______________________________________________________________
                                             NOTARY PUBLIC or DEPUTY CLERK
                                             _______________________________________________________________
                                             [Print, type, or stamp commissioned name of notary or
                                             clerk.]
____ Personally known
____ Produced identification
     Type of identification produced  _________________________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in
all blanks]
I, {full legal name and trade name of nonlawyer} __________________________________________________,
a nonlawyer, whose address is {street} ________________, {city} __________________________,
*575
{state} _______, {phone} _______, helped {name} _________________________________,
who is the petitioner, fill out this form.
*576
              CHILD SUPPLEMENTAL FORM FOR PETITION FOR CHANGE OF NAME (FAMILY)
                                                      Case No.: ____________________________________________
THE FOLLOWING INFORMATION IS TRUE ABOUT MINOR CHILD # __________:
       1. Minor child's complete present name is:
          __________________________________________________________________________________________________
          I/We request that minor child's name be changed to:
          __________________________________________________________________________________________________
       2. The minor child lives in _______________ County, Florida, at {street address} ___________
          __________________________________________________________________________________________________
       3. The minor child was born on __________, in {city, county, state, country}
          __________________________________________________________________________________________________
       4. The minor child's father's full legal name: ______________________________________________________.
          The minor child's mother's full legal name: ______________________________________________________.
          The minor child's mother's maiden name: __________________________________________________________.
       5. The minor child has lived in the following places since birth:
          Dates (to/from)   Address
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          _______/_______   ________________________________________________________________________________
          (____ Please indicate here if continuing these facts on an attached page.)
       6. [Choose one only]
          ____ The minor child is not married
          ____ The minor child is married to: {full legal name} ___________________________________.
       7. [Choose one only]
          ____ The minor child has no children.
          ____ The minor child is the parent of the following child(ren): {enter name(s) and date(s) of birth}
          __________________________________________________________________________________________________.
       8. Former names
          [Choose all that apply]
          ____ The minor child's name has never been changed by court order.
          ____ The minor child's name previously was changed by court order from __________
               to ______________________________________ on {date} __________________ {court, city, and
state} _____________________________________________________________________________.
*577
         A copy of the court order is attached.
          ____ The minor child's name previously was changed by marriage from _________
               to ________________________________ on {date} __________, in {city,
county, and state} ______________________________________.
          ____ The minor child has never been known or called by any other name.
          ____ The minor child has been known or called by the following other name(s): {list name(s) and
explain where child was known or called by such name(s)} ____________
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________.
       9. The minor child is not employed in an occupation or profession, does not own and operate a
          business, and has received no educational degrees. If the minor child has a job, explain:
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
      10. Criminal History
          [Choose one only]
          ____ The minor child has never been arrested for or charged with, pled guilty or nolo contendere
               to, or been found to have committed a criminal offense, regardless of adjudication.
          ____ The minor child has a criminal history. In the past, the minor child was arrested for or
               charged with, pled guilty or nolo contendere to, or been found to have committed a criminal
               offense, regardless of adjudication. The details of the criminal history are:
                  Date   City/State   Event (arrest, charge, plea, or adjudication)
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
          __________________________________________________________________________________________________
          (____ Please indicate here if you are continuing these facts on an attached page.)
      11. Money Judgments
          [Choose one only]
          ____ The minor child has never been adjudicated bankrupt, and no money judgment has ever
               been entered against him or her.
          ____ The following money judgment(s) has been entered against him or her:
          Date   Amount   Creditor   Court entering judgment and case number Indicate if Paid
          ____   ______   ________   ______________________________________________   []
          ____   ______   ________   ______________________________________________   []
NOTES
[1]  An original and nine paper copies of all comments must be filed with the Court on or before August 23, 2010. A separate request for oral argument must be filed if the person filing the comment wishes to participate in oral argument, which may be scheduled in this case. Electronic copies of all comments also must be filed in accordance with the Court's administrative order in In re Mandatory Submission of Electronic Copies of Documents, Fla. Admin. Order No. AOSC04-84 (Sept. 13, 2004).