Court Opinion

ID: 2689188
Source: CourtListenerOpinion
Date Created: 2014-08-01 16:27:38.80667+00
Date Added: 2024-06-11T13:09:22.625714
License: Public Domain

Supreme Court of Florida
                                   ____________

                                   No. SC13-532
                                   ____________

     IN RE: AMENDMENTS TO THE FLORIDA SUPREME COURT
               APPROVED FAMILY LAW FORMS.

                                   [May 1, 2014]

PER CURIAM.

      Previously in this case, the Court amended four Florida Supreme Court

Approved Family Law Forms, forms 12.902(f)(1) and 12.902(f)(2), the marital

settlement agreement forms, and forms 12.990(c)(1) and 12.990(c)(2), the final

judgment of dissolution of marriage forms. These forms were amended in

response to the enactment of section 732.703, Florida Statutes (2012), entitled

“Effect of divorce, dissolution, or invalidity of marriage on disposition of certain

assets at death.” In re Amends. to the Fla. Supreme Court Approved Family Law

Forms, 122 So. 3d 320 (Fla. 2013). 1 Interested parties were given an opportunity

to file comments regarding the amended forms. Id. at 321.

      1. We have jurisdiction. See art. V, § 2(a), Fla. Const.
      Several comments were filed. Upon consideration of the comments, and

with input from the Advisory Workgroup on the Florida Supreme Court Family

Law Forms, we adopt additional amendments to the forms, as follows: (1) the

phrase “deceased’s party former spouse” is changed to “deceased party’s former

spouse” in each of the four forms; and (2) the references to tax “deductions” are

changed to tax “exemptions” in paragraph 6 of Section IV of form 12.902(f)(1).

      Accordingly, the Florida Supreme Court Approved Family Law Forms are

amended, as reflected in the appendix to this opinion. The amended forms are

fully engrossed and ready for use. The forms may also be accessed and

downloaded from the Florida State Courts’ website at

www.flcourts.org/gen_public/family/forms_rules/index.shtml. By adoption of the

amended forms, we express no opinion as to their correctness or applicability. The

forms shall become effective immediately upon release of this opinion.

      It is so ordered.

POLSTON, C.J., and PARIENTE, LEWIS, QUINCE, CANADY, LABARGA,
and PERRY, JJ., concur.

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

Original Proceeding – Florida Supreme Court Approved Family Law Forms

Lori M. Caldwell-Carr, Maitland Florida, and Elizabeth Ann Blackburn, Daytona
Beach, Florida, Co-Chairs, Family Law Section Rules Committee; Elisha D. Roy,

                                         2
Chair, Family Law Section, The Florida Bar, West Palm Beach, Florida;
Christopher M. Pratt, Palmetto, Florida; and Melvyn B. Frumkes, Miami, Florida,

      Responding with comments

                                       3
                                               APPENDIX

INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
                      FORM 12.902(f)(1)
 MARITAL SETTLEMENT AGREEMENT FOR DISSOLUTION OF MARRIAGE
        WITH DEPENDENT OR MINOR CHILD(REN) (05/14)

                                       When should this form be used?

This form should be used when a Petition for Dissolution of Marriage with Dependent or Minor
Child(ren), Florida Supreme Court Approved Family Law Form 12.901(b)(1), has been filed and the
parties have reached an agreement on some or all of the issues at hand.

This form should be typed or printed in black ink. Both parties must sign the agreement and have their
signatures witnessed by a notary public or deputy clerk. After completing this form, you should file the
original with the clerk of the circuit court in the county where the petition was filed and keep a copy for
your records. You should then refer to the instructions for your petition, answer, or answer and
counterpetition concerning the procedures for setting a hearing or trial (final hearing).

                                 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 in these instructions are defined there.
For further information, see chapter 61, Florida Statutes, and the instructions for the petition and/or
answer that were filed in this case.

                                              Special notes...

With this form you must also file a Child Support Guidelines Worksheet, Florida Family Law Rules of
Procedure Form 12.902(e), if not already filed.

This form does not act to transfer title to the property. Such transfer must be done by deed or
supplemental final judgment.

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.

Instructions for Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for
Dissolution of Marriage with Dependent or Minor Child(ren) (05/14)
                                                      4
              IN THE CIRCUIT COURT OF THE                                   JUDICIAL CIRCUIT,
                       IN AND FOR                                   COUNTY, FLORIDA

                                                                               Case No.: ________________
                                                                               Division: ________________

In re the Marriage of:

                                         ,
      Husband,

and

                                         ,
  Wife.

 MARITAL SETTLEMENT AGREEMENT FOR DISSOLUTION OF MARRIAGE
            WITH DEPENDENT OR MINOR CHILD(REN)

We, {Husband’s full legal name}_______________________________________________,and
{Wife’s full legal name},_________________________________, being sworn, certify that the following
statements are true:

      1. We were married to each other on {date}                                     .

      2. Because of irreconcilable differences in our marriage (no chance of staying together), we have
         made this agreement to settle once and for all what we owe to each other and what we can
         expect to receive from each other. Each of us states that nothing has been held back, that we
         have honestly included everything we could think of in listing our assets (everything we own and
         that is owed to us) and our debts (everything we owe), and that we believe the other has been
         open and honest in writing this agreement.

      3. We have both filed a Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form
         12.902(b) or (c). Because we have voluntarily made full and fair disclosure to each other of all
         our assets and debts, we waive any further disclosure under rule 12.285, Florida Family Law
         Rules of Procedure.

      4. Each of us agrees to execute and exchange any papers that might be needed to complete this
         agreement, including deeds, title certificates, etc.

SECTION I. MARITAL ASSETS AND LIABILITIES
A. Division of Assets. We divide our assets (everything we own and that is owed to us) as follows: Any
   personal item(s) not listed below is (are) the property of the party currently in possession of the

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                      5
    item(s).
    1. Wife shall receive as her own and Husband shall have no further rights or responsibilities
        regarding these assets:
               ASSETS: DESCRIPTION OF ITEM(S) WIFE SHALL RECEIVE                      Current Fair
  Please describe each item as clearly as possible. You do not need to list account  Market Value
 numbers. Where applicable, include whether the name on any title/deed/account
                   described below is wife’s, husband’s, or both.
Cash (on hand)                                                                      $
Cash (in banks/credit unions)

Stocks/Bonds

Notes (money owed to you in writing)

 Money owed to you (not evidenced by a note)

Real estate: (Home)
(Other)

 Business interests

Automobiles

 Boats
 Other vehicles

 Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)

 Furniture & furnishings in home

 Furniture & furnishings elsewhere

 Collectibles

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                      6
              ASSETS: DESCRIPTION OF ITEM(S) WIFE SHALL RECEIVE                               Current Fair
  Please describe each item as clearly as possible. You do not need to list account           Market Value
 numbers. Where applicable, include whether the name on any title/deed/account
                   described below is wife’s, husband’s, or both.
Jewelry

 Life insurance (cash surrender value)

Sporting and entertainment (T.V., stereo, etc.) equipment

 Other assets

Total Assets to Wife                                                           $
   2. Husband shall receive as his own and Wife shall have no further rights or responsibilities
       regarding these assets:
           ASSETS: DESCRIPTION OF ITEM(S) HUSBAND SHALL RECEIVE                               Current Fair
  Please describe each item as clearly as possible. You do not need to list account           Market Value
 numbers. Where applicable, include whether the name on any title/deed/account
                   described below is wife’s, husband’s or both.
 Cash (on hand)                                                                              $
 Cash (in banks/credit unions)

 Stocks/Bonds

 Notes (money owed to you in writing)

Money owed to you (not evidenced by a note)

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                      7
             ASSETS: DESCRIPTION OF ITEM(S) HUSBAND SHALL RECEIVE                             Current Fair
  Please describe each item as clearly as possible. You do not need to list account           Market Value
 numbers. Where applicable, include whether the name on any title/deed/account
                    described below is wife’s, husband’s or both.
 Real estate: (Home)
(Other)

Business interests

 Automobiles

Boats
Other vehicles

 Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)

 Furniture & furnishings in home

 Furniture & furnishings elsewhere

 Collectibles

Jewelry

Life insurance (cash surrender value)

Sporting and entertainment (T.V., stereo, etc.) equipment

Other assets

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                      8
           ASSETS: DESCRIPTION OF ITEM(S) HUSBAND SHALL RECEIVE                               Current Fair
  Please describe each item as clearly as possible. You do not need to list account           Market Value
 numbers. Where applicable, include whether the name on any title/deed/account
                   described below is wife’s, husband’s or both.

Total Assets to Husband                                                                      $

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                      9
B. Division of Liabilities/Debts. We divide our liabilities (everything we owe) as follows:
   1. Wife shall pay as her own the following and will not at any time ask Husband to pay these
       debts/bills:
        LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY WIFE
  Please describe each item as clearly as possible. You do not need to list                          Current
 account numbers. Where applicable, include whether the name on any                   Monthly        Amount
 mortgage, note, or account described below is wife’s, husband’s, or both.            Payment         Owed
Mortgages on real estate: (Home)                                                  $              $
(Other)

Charge/credit card accounts

 Auto loan
 Auto loan
 Bank/credit union loans

 Money you owe (not evidenced by a note)

Judgments

 Other

Total Debts to Be Paid by Wife                                                    $              $

    2. Husband shall pay as his own the following and will not at any time ask Wife to pay these
       debts/bills:

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                     10
     LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY HUSBAND
 Please describe each item as clearly as possible. You do not need to list                           Current
 account numbers. Where applicable, include whether the name on any                   Monthly        Amount
 mortgage, note or account described below is wife’s, husband’s, or both.             Payment         Owed
Mortgages on real estate: (Home)                                                  $              $
(Other)

 Charge/credit card accounts

Auto loan
Auto loan
Bank/credit union loans

Money you owe (not evidenced by a note)

Judgments

Other

Total Debts to Be Paid by Husband                                                 $              $

C.   Contingent Assets and Liabilities (listed in Section III of our Family Law Financial Affidavits) will be
     divided as follows:

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                     11
D. Beneficiary Designation (Complete only if beneficiary designations continue after entry of Final
   Judgment of Dissolution of Marriage.)

_____The Husband and Wife agree that the designation providing for the payment or transfer at death
of an interest in the assets set forth below to or for the benefit of the deceased party’s former spouse
SHALL NOT BE VOID as of the date of entry of the Final Judgment of Dissolution of Marriage.

The Final Judgment of Dissolution of Marriage shall provide that the designations set forth below remain
in full force and effect:

_____1. The _____Husband _____Wife shall acquire or maintain the following assets for the benefit of
the other spouse or child(ren) to be paid upon his/her death outright or in trust. This provision only
applies if other assets fulfilling such requirement for the benefit of the other spouse or child(ren) do not
exist upon his/her death and unless precluded by statute. {Describe the assets with specificity}:________
________________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.
_____2. The _____Husband _____Wife shall not unilaterally terminate or modify the ownership of the
following assets, or their disposition upon his/her death. {Describe the assets with specificity}:_________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.

SECTION II. SPOUSAL SUPPORT (ALIMONY) (If you have not agreed on this matter, write n/a on the
lines provided.)

        1. ____Each of us forever gives up any right to spousal support (alimony) that we may have.
        OR
        2. ____ ( ) HUSBAND ( ) WIFE (hereinafter “Obligor”) agrees to pay spousal support (alimony)
        in the amount of $   _____every ( ) week ( ) other week ( ) month, beginning {date}
                ____________and continuing until {date or event}     _______________________
    ________________________________________________________________________.
Explain type of alimony (such as, permanent, bridge-the-gap, durational, rehabilitative, and/or lump
sum) and any other specifics:

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                     12
  3. _____Other provisions relating to alimony, including any tax treatment and consequences:
___________________________________________________________________________
________________________________________________________________________

4. _____Husband _____Wife will provide life insurance in the amount of $__________ to secure the
above support.

SECTION III. PARENTING PLAN ESTABLISHING PARENTAL RESPONSIBILITY AND TIME-SHARING

   1. The parties’ minor child(ren) are:
Name                                               Birth date

    2. The parties shall have time-sharing and parental responsibility in accordance with the Parenting
       Plan attached as Exhibit _____.

SECTION IV. CHILD SUPPORT

      1. ____ Wife ____ Husband (hereinafter “Obligor”) will pay child support, under Florida’s child
          support guidelines, section 61.30, Florida Statutes, to the other parent. The Child Support
          Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e), is completed and
          attached.
 Child support established at the rate of $_________per month for the ________children {total number
of parties’ minor or dependent children} shall be paid commencing_________________ {month, day,
year} and terminating _____________________ {month, day, year}. Child support shall be paid in the
amount of $________ per ___________ {week, month, other} which is consistent with the Obligor’s
current payroll cycle.

Upon the termination of the obligation of child support for one of the parties’ children, child support in
the amount of $_______ for the remaining ______ children {total number of remaining children} shall
be paid commencing_____________________ {month, day, year} and terminating
_______________________ {month, day, year}.This child support shall be paid in the amount of
$_________ per _____________ {week, month, other} consistent with Obligor’s current payroll cycle.

{Insert schedule for the child support obligation, including the amount, and commencement and

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                     13
termination dates, for the remaining minor or dependent children, which shall be payable as the
obligation for each child ceases. Please indicate whether the schedule ____appears below or ____is
attached as part of this form.}
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

The Obligor shall pay child support until all the minor or dependent child(ren): reach the age of 18;
become emancipated, marry, join the armed services, die, or become self-supporting; or until further
order of the court or agreement of the parties. The child support obligation shall continue beyond the
age of 18 and until high school graduation for any child who is: dependent in fact; between the ages of
18 and 19; and is still in high school, performing in good faith with a reasonable expectation of
graduation before the age of 19.

If the child support amount above deviates from the guidelines by 5% or more, explain the reason(s)
here: ______________________________________________________________________________

    2. Child Support Arrearage. There currently is a child support arrearage of:
    $ ______for retroactive child support and/or
    $            ___ for previously ordered unpaid child support.
The total of $            _ in child support arrearage shall be repaid at the rate of $        _________
 every ( ) week ( ) other week ( ) month, beginning {date}                   _______________, until paid in
full including statutory interest.

     3. Health Insurance. ____ Wife ____ Husband will maintain health insurance for the parties’
         minor child(ren). The party providing coverage will provide insurance cards to the other party
         showing coverage. OR _____ Health insurance is either not reasonable in cost or accessible to
         the child(ren) at this time. Any uninsured/ unreimbursed medical costs for the minor child(ren)
         shall be assessed as follows:
        a. _____Shared equally by husband and wife.
        b. _____Prorated according to the child support guideline percentages.
        c. _____Other {explain}:          __________________________________________________
As to these uninsured/unreimbursed medical expenses, the party who incurs the expense shall submit a
request for reimbursement to the other party within 30 days, and the other party, within 30 days of
receipt, shall submit the applicable reimbursement for that expense, according to the schedule of
reimbursement set out in this paragraph.

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                     14
    4. Dental Insurance. ____ Wife ____ Husband will maintain dental insurance for the parties’
        minor child(ren). The party providing coverage will provide insurance cards to the other party
        showing coverage. OR _____ dental insurance is either not reasonable in cost or accessible to
        the child(ren) at this time. Any uninsured/ unreimbursed dental costs for the minor child(ren)
        shall be assessed as follows:
        a. _____Shared equally by husband and wife.
        b. _____Prorated according to the child support guideline percentages.
        c. _____Other {explain}:         __________________________________________________
As to these uninsured/unreimbursed dental expenses, the party who incurs the expense shall submit a
request for reimbursement to the other party within 30 days, and the other party, within 30 days of
receipt, shall submit the applicable reimbursement for that expense, according to the schedule of
reimbursement set out in this paragraph.

     5. Life Insurance. _____ Wife _____ Husband will maintain life insurance for the benefit of the
         parties’ minor child(ren) in the amount of $ __________until the youngest child turns 18,
         becomes emancipated, marries, joins the armed services, or dies.

     6. IRS Income Tax Exemptions(s). The assignment of any tax exemptions for the child(ren) shall be
         as follows: {explain} ______________________________________________________
_________________________________________________________________________
The other parent will convey any applicable IRS form regarding the income tax exemption.

     7. Other provisions relating to child support (e.g., uninsured medical/dental expenses, health or
         dental insurance, life insurance to secure child support, orthodontic payments, college fund,
         etc.):

________________________________________________________________________

SECTION V. OTHER

                            _________________________________________________________
________________________________________________________________________
_________________________________________________________________________

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                     15
SECTION VI. We have not agreed on the following issues:

I certify that I have been open and honest in entering into this settlement agreement. I am satisfied
with this agreement and intend to be bound by it.

Dated:
                                          Signature of Husband
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
Email Address: ______________________________

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] This form was prepared for the: {choose only one} ( ) Husband ( ) Wife
This form was completed with the assistance of:
{name of individual} ____________________________________________________________,
{name of business} _____________________________________________________________,
{address}                                  ______________________________________________,
{city} _______________________,{state}               __, {telephone number} _____________________.

 I certify that I have been open and honest in entering into this settlement agreement. I am satisfied
with this agreement and intend to be bound by it.

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                     16
Dated:
                                                   Signature of Wife
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
                                                   Email Address: ______________________________
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] This form was prepared for the: {choose only one} ( ) Husband ( ) Wife
This form was completed with the assistance of:
{name of individual}_____________________________________________________________,
{name of business}______________________________________________________________,
{address}                    ___________________________________________________________,
{city}                          ____{state} _______, {telephone number},_______________________.

Florida Supreme Court Approved Family Law Form 12.902(f)(1), Marital Settlement Agreement for Dissolution of
Marriage with Dependent or Minor Child(ren) (05/14)
                                                     17
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW
                      FORM 12.902(f)(2)
 MARITAL SETTLEMENT AGREEMENT FOR DISSOLUTION OF MARRIAGE
 WITH PROPERTY BUT NO DEPENDENT OR MINOR CHILD(REN) (05/14)

                                  When should this form be used?

This form should be used when a Petition for Dissolution of Marriage with Property but no Dependent
or Minor Child(ren), Florida Supreme Court Approved Family Law Form 12.901(b)(2), has been filed and
the parties have reached an agreement on some or all of the issues at hand.

This form should be typed or printed in black ink. Both parties must sign the agreement and have their
signatures witnessed by a notary public or deputy clerk. After completing this form, you should file the
original with the clerk of the circuit court in the county where the petition was filed and keep a copy for
your records.

You should then refer to the instructions for your petition, answer, or answer and counterpetition
concerning the procedures for setting a hearing or trial (final hearing).

                             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 in these instructions are defined there.
For further information, see chapter 61, Florida Statutes, and the instructions for the petition and/or
answer that were filed in this case.

                                              Special notes...

This form does not act to transfer title to the property. Such transfer must be done by deed or
supplemental final judgment.

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.

Instructions for Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for
Dissolution of Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     18
              IN THE CIRCUIT COURT OF THE                                   JUDICIAL CIRCUIT,
                       IN AND FOR                                   COUNTY, FLORIDA

                                                                                Case No.: _______________
                                                                                Division: _______________
In re the Marriage of:

                      _________________,
 Husband,

and

                     ______________,
Wife.

MARITAL SETTLEMENT AGREEMENT FOR DISSOLUTION OF MARRIAGE
    WITH PROPERTY BUT NO DEPENDENT OR MINOR CHILD(REN)
We, {Husband’s full legal name}______________________________________________, and
{Wife’s full legal name} _____________________________________________________, being sworn,
certify that the following statements are true:

      1. We were married to each other on {date}                                     .

      2. Because of irreconcilable differences in our marriage (no chance of staying together), we have
         made this agreement to settle once and for all what we owe to each other and what we can
         expect to receive from each other. Each of us states that nothing has been held back, that we
         have honestly included everything we could think of in listing our assets (everything we own and
         that is owed to us) and our debts (everything we owe), and that we believe the other has been
         open and honest in writing this agreement.

      3. We have both filed a Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form
         12.902(b) or (c). Because we have voluntarily made full and fair disclosure to each other of all
         our assets and debts, we waive any further disclosure under rule 12.285, Florida Family Law
         Rules of Procedure.

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     19
    4. Each of us agrees to execute and exchange any papers that might be needed to complete this
       agreement, including deeds, title certificates, etc.

SECTION I. MARITAL ASSETS AND LIABILITIES
A. Division of Assets. We divide our assets (everything we own and that is owed to us) as follows: Any
   personal item(s) not listed below is (are) the property of the party currently in possession of the
   item(s).
   1. Wife shall receive as her own and Husband shall have no further rights or responsibilities
       regarding these assets:

                ASSETS: DESCRIPTION OF ITEM(S) WIFE SHALL RECEIVE                             Current Fair
                                                                                              Market Value
   Please describe each item as clearly as possible. You do not need to list account
                  numbers. Where applicable, include whether the
   name on any title/deed/account described below is wife’s, husband’s, or both.
 Cash (on hand)                                                                              $
 Cash (in banks/credit unions)

 Stocks/Bonds

Notes (money owed to you in writing)

 Money owed to you (not evidenced by a note)

 Real estate: (Home)
 (Other)

 Business interests

 Automobiles

 Boats

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     20
 Other vehicles

 Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)

 Furniture & furnishings in home

 Furniture & furnishings elsewhere

 Collectibles

 Jewelry

 Life insurance (cash surrender value)

 Sporting and entertainment (T.V., stereo, etc.) equipment

 Other assets

Total Assets to Wife                                                                         $

    2. Husband shall receive as his own and Wife shall have no further rights or responsibilities
       regarding these assets:

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     21
           ASSETS: DESCRIPTION OF ITEM(S) HUSBAND SHALL RECEIVE                               Current Fair
  Please describe each item as clearly as possible. You do not need to list account           Market Value
 numbers. Where applicable, include whether the name on any title/deed/account
                   described below is wife’s, husband’s, or both.
 Cash (on hand)                                                                              $
 Cash (in banks/credit unions)

 Stocks/Bonds

 Notes (money owed to you in writing)

 Money owed to you (not evidenced by a note)

 Real estate: (Home)
 (Other)

 Business interests

 Automobiles

 Boats
 Other vehicles

 Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)

 Furniture & furnishings in home

 Furniture & furnishings elsewhere

 Collectibles

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     22
 Jewelry

 Life insurance (cash surrender value)

 Sporting and entertainment (T.V., stereo, etc.) equipment

 Other assets

Total Assets to Husband                                                                      $

B. Division of Liabilities/Debts. We divide our liabilities (everything we owe) as follows:
   1. Wife shall pay as her own the following and will not at any time ask Husband to pay these
       debts/bills:

       LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY WIFE
 Please describe each item as clearly as possible. You do not need to list                           Current
 account numbers. Where applicable, include whether the name on any                   Monthly        Amount
 mortgage, note, or account described below is wife’s, husband’s, or both.            Payment         Owed
 Mortgages on real estate: (Home)                                                 $              $
 (Other)

 Charge/credit card accounts

 Auto loan
 Auto loan
 Bank/credit union loans

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     23
 Money you owe (not evidenced by a note)

 Judgments

 Other

Total Debts to Be Paid by Wife                                                    $              $

    2. Husband shall pay as his own the following and will not at any time ask Wife to pay these
       debts/bills:

       LIABILITIES: DESCRIPTION OF DEBTS TO BE PAID BY HUSBAND
  Please describe each item as clearly as possible. You do not need to list                          Current
  account numbers. Where applicable, include whether the name on any          Monthly                Amount
 mortgage, note or account described below is wife’s, husband’s, or both.     Payment                 Owed
 Mortgages on real estate: (Home)                                           $                    $
 (Other)

 Charge/credit card accounts

 Auto loan
 Auto loan
 Bank/credit union loans

 Money you owe (not evidenced by a note)

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     24
 Judgments

 Other

Total Debts to Be Paid by Husband                                                $               $

C. Contingent Assets and Liabilities (listed in Section III of our Family Law Financial Affidavits) will be
   divided as follows:

D. Beneficiary Designation (Complete only if beneficiary designations continue after entry of Final
Judgment of Dissolution of Marriage.)

_____The Husband and Wife agree that the designation providing for the payment or transfer at death
of an interest in the assets set forth below to or for the benefit of the deceased party’s former spouse
SHALL NOT BE VOID as of the date of entry of the Final Judgment of Dissolution of Marriage.

The Final Judgment of Dissolution of Marriage shall provide that the designations set forth below
remain in full force and effect:

_____1. The _____Husband _____Wife shall acquire or maintain the following assets for the benefit of
the other spouse or child(ren) to be paid upon his/her death outright or in trust. This provision only
applies if other assets fulfilling such requirement for the benefit of the other spouse or child(ren) do not
exist upon his/her death and unless precluded by statute. {Describe the assets with specificity}:_______
__________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________.
_____2. The _____Husband _____Wife shall not unilaterally terminate or modify the ownership of the
following assets, or their disposition upon his/her death. {Describe the assets with specificity}:_________
___________________________________________________________________________________

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     25
___________________________________________________________________________________
____________________________________________________________________________________.

SECTION II. SPOUSAL SUPPORT (ALIMONY) (If you have not agreed on this matter, write n/a on the
lines provided.)

1. _____ Each of us forever gives up any right to spousal support (alimony) that we may have.

OR

2.____ ( ) HUSBAND ( ) WIFE (hereinafter “Obligor”) agrees to pay spousal support (alimony) in the
amount of $    ____every ( ) week ( ) other week ( ) month, beginning
    {date}     __________ __________________________________and continuing until {date or
        event}________________________________________________________________________.

Explain type of alimony (permanent, bridge-the-gap, durational, rehabilitative, and/or lump sum) and
any other specifics:
____________________________________________________________________________
______________________________________________________________________________

     3._____Other provisions relating to alimony, including any tax treatment and consequences:
      ______________________________________________________________________________
      ______________________________________________________________________________
         ______________________________________________________________________________.

4. _____Husband _____ Wife will provide life insurance in the amount of $__________________
             to secure the above support.

SECTION III. OTHER

SECTION IV. We have not agreed on the following issues:

______________________________________________________________________________
______________________________________________________________________________.

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     26
I certify that I have been open and honest in entering into this settlement agreement. I am satisfied
with this agreement and intend to be bound by it.

Dated:             ________                                          ___________           _____________
                                                   Signature of Husband
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
Email Address: _________________________________

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:
[Please fill in all blanks] This form was prepared for the: {choose only one} ( ) Husband ( ) Wife
This form was completed with the assistance of:
 {name of individual} ______________________________________________________________,
{name of business} ________________________________________________________________,
{address}                                   _______________________________________________,
{city} ______________________,{state}              ___, {telephone number}         _______________.

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     27
I certify that I have been open and honest in entering into this settlement agreement. I am satisfied
with this agreement and intend to be bound by it.

Dated:
                                              Signature of Wife
Printed name:__________________________________
Address:______________________________________
City, State, Zip:_________________________________
Telephone number:_____________________________
Fax number____________________________________________
Email Address: ________________________________

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] This form was prepared for the: {choose only one} ( ) Husband ( ) Wife
This form was completed with the assistance of:
{name of individual}                                                                                  ,
{name of business} _____________________________________________________________________,
{address}_____________________________________________________________________________,
{city} ___________              ____,{state}        __, {telephone number} _________________________.

Florida Supreme Court Approved Family Law Form 12.902(f)(2), Marital Settlement Agreement for Dissolution of
Marriage with Property but No Dependent or Minor Child(ren) (05/14)
                                                     28
                     IN THE CIRCUIT COURT OF THE                     JUDICIAL CIRCUIT,
                       IN AND FOR                                   COUNTY, FLORIDA

                                                              Case No.:______________________________
                                                              Division: ______________________________

In re the Marriage of:

                                         ,
Husband ,

and

                                         ,
Wife.

                 FINAL JUDGMENT OF DISSOLUTION OF MARRIAGE
                    WITH DEPENDENT OR MINOR CHILD(REN)
This cause came before this Court for a trial on a Petition for Dissolution of Marriage. The Court, having
reviewed the file and heard the testimony, makes these findings of fact and reaches these conclusions of
law:

1. The Court has jurisdiction over the subject matter and the parties.
2. At least one party has been a resident of the State of Florida for more than 6 months immediately
   before filing the Petition for Dissolution of Marriage.
3. The marriage between the parties is irretrievably broken. Therefore, the marriage between the
   parties is dissolved, and the parties are restored to the status of being single.

SECTION I. MARITAL ASSETS AND LIABILITIES
A. Date of Valuation of Property. The assets and liabilities listed below are divided as indicated. The
   date of valuation of these assets and liabilities is, unless otherwise indicated:
   a. _____ date of filing petition for dissolution of marriage.
   b. _____ date of separation .
   c. _____ date of final hearing .
   d. _____ other: {specify date}_____________________________________________

B. Division of Assets.
   1. The assets listed below are nonmarital assets. Each party shall keep, as his or her own, the
       assets found to be nonmarital, and the other party shall have no further rights or responsibilities

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     29
        regarding these assets.

                                                                           Current      Wife’s      Husband’s
                ASSETS: DESCRIPTION OF ITEM(S)                             Fair         Non-        Non-
          Please describe each item as clearly as possible.                Market       marital     Marital
            You do not need to list account numbers.                       Value        Property    Property
                                                                           $            $           $

Total Nonmarital Assets                                                    $            $           $

2. The assets listed below are marital assets. Each party shall keep, as his or her own, the assets
   awarded in this section, and the other party shall have no further rights or responsibilities regarding
   these assets. Any personal item(s) not listed below are awarded to the party currently in
   possession or control of the item(s).

                                                                            Current
             ASSETS: DESCRIPTION OF ITEM(S)                                   Fair       Wife       Husband
        Please describe each item as clearly as possible.                   Market       Shall       Shall
          You do not need to list account numbers.                           Value      Receive     Receive
Cash (on hand or in banks/credit unions)                                   $           $           $

Stocks/bonds

Notes
Business interests

Real estate: (Home)

Automobiles

Boats

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     30
                                                                            Current
            ASSETS: DESCRIPTION OF ITEM(S)                                    Fair       Wife       Husband
       Please describe each item as clearly as possible.                    Market       Shall       Shall
         You do not need to list account numbers.                            Value      Receive     Receive
Furniture & furnishings

Jewelry

Life Insurance (cash surrender value)
Retirement Plans (Profit sharing, Pension, IRA, 401(k)(s) etc)

Other assets

Total Marital Assets                                                       $           $            $

C. Division of Liabilities/Debts.
   1. The liabilities listed below are nonmarital liabilities and, therefore, are owed as indicated. Each
       party shall owe, as his or her own, the liabilities found to be nonmarital, and the other party
       shall have no responsibilities regarding these debts.

                                                                                        Wife’s      Husband’s
           LIABILITIES: DESCRIPTION OF DEBTS                               Current      Non-        Non-
       Please describe each item as clearly as possible.                   Amount       Marital     Marital
         You do not need to list account numbers.                          Owed         Liability   Liability

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     31
                                                                                        Wife’s      Husband’s
            LIABILITIES: DESCRIPTION OF DEBTS                              Current      Non-        Non-
        Please describe each item as clearly as possible.                  Amount       Marital     Marital
          You do not need to list account numbers.                         Owed         Liability   Liability
                                                                           $            $           $

Total Nonmarital Liabilities                                               $            $           $

    2. The liabilities listed below are marital liabilities and are divided as indicated. Each party shall
       hold the other party harmless and pay, as his or her own, the marital liabilities awarded below.

          LIABILITIES: DESCRIPTION OF DEBTS                                Current
      Please describe each item as clearly as possible.                    Amount       Wife      Husband
        You do not need to list account numbers.                           Owed         Shall Pay Shall Pay
Mortgages on real estate: (Home)                                           $            $           $
(Other)
Charge/Credit card accounts

Auto loan
Auto loan
Bank/Credit Union loans

Other

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     32
          LIABILITIES: DESCRIPTION OF DEBTS                                Current
      Please describe each item as clearly as possible.                    Amount       Wife      Husband
        You do not need to list account numbers.                           Owed         Shall Pay Shall Pay

Total Marital Liabilities                                                  $            $           $

D. Contingent assets and liabilities will be divided as follows: _________________________________
________________________________________________________________________________
________________________________________________________________________________

E. The distribution of assets and liabilities in this final judgment is equitable; if each party does not
   receive approximately one-half, the distribution is based on the following facts and reasoning:
________________________________________________________________________________
________________________________________________________________________________

F. Beneficiary Designation (By completing this section, the beneficiary designations continue after
entry of Final Judgment of Dissolution of Marriage.)

The designation providing for the payment or transfer at death of an interest in the assets described
below to or for the benefit of the deceased party’s former spouse is NOT VOID as of the date of entry of
the Final Judgment of Dissolution of Marriage.

The Final Judgment of Dissolution of Marriage shall provide that the designations set forth below
remain in full force and effect:

_____1. The _____Husband _____Wife shall acquire or maintain the following assets for the benefit of
the other spouse or child(ren), to be paid upon his/her death outright or in trust. This provision only
applies if other assets fulfilling such requirement for the benefit of the other spouse or child(ren) do not
exist upon his/her death and unless precluded by statute. {Describe the assets with specificity}:_______
________________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.

_____2. The _____Husband _____Wife shall not unilaterally terminate or modify the ownership of the
following assets, or their disposition upon his/her death. {Describe the assets with specificity}:_________

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     33
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.

SECTION II. EXCLUSIVE USE AND POSSESSION OF HOME
[Indicate all that apply]
1. _____The ____ Husband ____Wife, as a condition of support, shall have exclusive use and
    possession of the dwelling located at the following
    address:________________________________________________________________________
 until: {date or event} ______________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

2. _____The _____ Husband _____Wife may make visits to the premises described in the paragraph
   above for the purpose of obtaining any items awarded in this Final Judgment. These visits shall occur
   after notice to the person granted exclusive use and possession of the dwelling and at the earliest
   convenience of both parties or as ordered in paragraph 4 below.

3. ____Upon the termination of the right of exclusive use and possession, the dwelling shall be sold
   and the net proceeds divided    _% to Husband and        _% to Wife, with the following credits
   and/or setoffs being allowed:
   ________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

4. ____Other: ______________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

SECTION III. PARENTING PLAN ESTABLISHING PARENTAL RESPONSIBILITY AND TIME-SHARING WITH
DEPENDENT OR MINOR CHILD(REN)
1. Jurisdiction. The Court has jurisdiction to determine parental responsibility, to establish or adopt a
   Parenting Plan, and a time-sharing schedule with regard to the minor child(ren) listed in paragraph 2
   below.

2. The parties’ dependent or minor child(ren) is (are):
Name                                                    Birth date
______________________________________________________________________________

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     34
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

3. Parenting Plan. The parties shall comply with the Parenting Plan which is attached and incorporated
   herein as Exhibit _____.

SECTION IV. ALIMONY
1. _____ The Court denies the request(s) for alimony;
               OR
2. _____ The Court finds that the _____Husband _____Wife, (hereinafter Obligee), has an actual need
for, and that the _____Husband _____Wife (hereinafter Obligor), has the present ability to pay, alimony
as follows:

[Indicate all that apply]
        a._____Permanent Periodic.

               1. The Court finds that no other form of alimony is fair and reasonable under the
        circumstances of the parties.

                 2.   As a marriage of: (Choose only one)

        _______ Long Duration (17 years or greater) alimony is appropriate upon consideration of all
relevant factors;

       _______Moderate Duration (greater than 7 years but less than 17) alimony is appropriate
based upon clear and convincing evidence after consideration of all relevant factors; or

        _______Short Duration (less than 7 years) alimony is appropriate based upon the
        following exceptional circumstances:__________________________________________
        ________________________________________________________________________
        ________________________________________________________________________
        ________________________________________________________________________
        _______________________________________________________________________.

                3. Obligor shall pay permanent periodic alimony to Obligee in the amount of
                $             per month, payable ( ) in accordance with Obligor’s employer’s
                payroll cycle, and in any event, at least once a month or ( ) other {explain}
                ______________________________________________________________________
                beginning {date} ___________________. This alimony shall continue until: modified by

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     35
        court order; the death of either party; or remarriage of Obligee, whichever occurs first.
        The alimony may be modified or terminated based upon either a substantial change in
        circumstances, or the existence of a supportive relationship in accordance with section
        61.14, Florida Statutes.

        b.____ Bridge-the-Gap. Obligor shall pay bridge-the-gap alimony to Obligee in the amount of
$_______ per month, payable ( ) in accordance with Obligor’s employer’s payroll cycle, and in any
event, at least once a month or ( ) other {explain}_________________________________
beginning {date}_____________________and continuing until :{date}______________________
{a period not to exceed two (2) years}; death of either party; or remarriage of the Obligee, whichever
occurs first.

        c.___ _ Rehabilitative. Obligor shall pay rehabilitative alimony to Obligee in the amount of
$______________ per month, payable ( ) in accordance with Obligor’s employer’s payroll cycle, and
in any event, at least once a month or ( ) other {explain}_______________________
beginning {date}_________________________. This rehabilitative alimony shall continue until: modified
by court order; the death of either party; or until {date/event} __________________,
whichever occurs first. The rehabilitative plan presented demonstrated the following: ________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.

        d.____Durational. Obligor shall pay durational alimony to Obligee in the amount of $________
 per month payable ( ) in accordance with Obligor’s employer’s payroll cycle, and in any event, at least
once a month or ( ) other {explain}_________________________________________
beginning {date}_____________________and terminating on: {date}_____________________, the
death of either party; remarriage of the Obligee; or until modified by court order in accordance with
section 61.08(7), Florida Statutes; whichever occurs first.

        e.____Lump Sum. Obligor shall pay lump sum alimony to Obligee in the amount of $_________,
        which shall be paid as follows:_____________________________________________________.

        f. ____Retroactive. Obligor shall pay retroactive alimony in the amount of $      _ for the
period of {date}_______________, through {date} __________________, which shall be paid pursuant
to paragraph 4 below.

3.      Reasons for ( ) Awarding ( ) Denying Alimony. The Court has considered all of the following
         in awarding/denying alimony:
     a. The standard of living established during the marriage;
     b. The duration of the marriage;
         c. The age and the physical and emotional condition of each party;
         d. The financial resources of each party, including the nonmarital and marital assets and
         liabilities distributed to each;

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     36
        e. The earning capacities, educational levels, vocational skills, and employability of the parties
and, when applicable, the time necessary for either party to acquire sufficient education or training to
enable such party to find appropriate employment;
        f. The contribution of each party to the marriage, including, but not limited to, services rendered
in homemaking, child care, education, and career building of the other party;
        g. The responsibilities each party will have with regard to any minor or dependent children they
have in common;
        h. The tax treatment and consequences to both parties of any alimony award, including the
designation of all or a portion of the payment as a nontaxable, nondeductible payment;
        i. All sources of income available to either party, including income available to either party
        through investments of any asset held by that party and
        j. Any other factor necessary to do equity and justice between the parties: {explain}
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.
_______ Please indicate here if additional pages are attached.

4.     Arrearage/Retroactive Alimony.

        a.____There is no alimony arrearage at the time of this Final Judgment.

OR

        b. _____The _____Husband _____ Wife shall pay to the other spouse the alimony arrearage of:
$            ______ for retroactive alimony, as of {date}_______________________________;
$            ____ for previously ordered unpaid alimony, as of {date} ____________________.
The total of $ _________ in alimony arrearage shall be repaid in the amount of $   _ ____ per
month, payable ( ) in accordance with Obligor’s employer’s payroll cycle, and in any event at least
once a month or ( ) other {explain} __________________________________________
______________________________________________________________________________
______________________________________________________________________________
        beginning {date}____________________________, until paid in full including statutory interest.

5.     ____ Life Insurance (to secure payment of support). To secure the alimony obligations set forth
       in this judgment, Obligor shall maintain life insurance on his/her life naming Obligee as the sole
       irrevocable beneficiary, so long as reasonably available. This insurance shall be in the amount of
       at least $_________ _____and shall remain in effect until the obligation for alimony terminates.

6.      _____Other provisions relating to alimony, including any tax treatment and consequences:
        a. The award of alimony ( ) does not ( ) does leave the Obligor with significantly less net
           income than the net income of the recipient/Obligee. If the award does leave the Obligor
           with significantly less net income than that of the Obligee, the Court finds the following

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     37
            exceptional circumstances:___________________________________________________
     __________________________________________________________________________
     ___________________________________________________________________________.

         b. Other______________________________________________________________________
            ___________________________________________________________________________
            ___________________________________________________________________________.

SECTION V. CHILD SUPPORT
1. _____The Court finds that there is a need for child support and that the ____ Wife ____ Husband
   (hereinafter Obligor) has the present ability to pay child support. The amounts in the Child Support
   Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e), filed by the ____ Wife
   ____ Husband are correct;

OR

______The Court makes the following findings:
The Wife’s net monthly income is $           ____, (Child Support Guidelines ____%).
The Husband’s net monthly income is $           ____ (Child Support Guidelines ____%).
Monthly child care costs are $          ____.
Monthly health/dental insurance costs are $           ___.

2. Amount.
Child support established at the rate of $_________ per month for the _____ children {total number of
parties’ minor or dependent children} shall be paid commencing __________________________ {month,
day, year} and terminating ____________________________ {month, day, year}. Child support shall be
paid in the amount of $_________ per ________________ {week, month, other} consistent with the
Obligor’s current payroll cycle.

Upon the termination of the obligation of child support for one of the parties’ children, child support in
the amount of $__________ for the remaining_________children {total number of remaining children}
shall be paid commencing _______________________________ {month, day, year} and
terminating____________________________________ {month, day, year}. This child support shall be
paid in the amount of $_________ per _____________ {week, month, other} consistent with the
Obligor’s current payroll cycle.

{Insert schedule for the child support obligation, including the amount, and commencement and
termination dates, for the remaining minor or dependent children, which shall be payable as the
obligation for each child ceases. Please indicate whether the schedule ____appears below or
 ____ is attached as part of this form.}
______________________________________________________________________________
______________________________________________________________________________

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     38
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

The Obligor shall pay child support until all of the minor or dependent children: reach the age of 18;
become emancipated, marry, join the armed services, die, or become self-supporting; or until further
order of the court or agreement of the parties. The child support obligation shall continue beyond the
age of 18 and until high school graduation for any child who is dependent in fact, between the ages of
18 and 19, and is still in high school, performing in good faith with a reasonable expectation of
graduation before the age of 19.

If the child support ordered deviates from the guidelines by more than 5%, the factual findings which
support that deviation are: ______________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________.

3. Arrearage/Retroactive Child Support.

     a. ____There is no child support arrearage at the time of this Final Judgment.

OR
    b. ____The ____ Wife ____ Husband shall pay to the other spouse the child support arrearage of:
         $           ___for retroactive child support, as of {date} __________________;
         $           ___ for previously ordered unpaid child support, as of {date}              ______.
        The total of $           ____ in child support arrearage shall be repaid in the amount of
        $             per month, payable ( ) in accordance with Obligor’s employer’s payroll cycle, and
        in any event at least a month or ( ) other {explain} ___________________________________
beginning {date}____________________________, until paid in full including statutory interest.

4. Insurance.

            a. ____Health/Dental Insurance. _____ Wife _____ Husband shall be required to
                maintain
_____ health and/or _____ dental insurance for the parties’ minor child(ren), so long as reasonable in
cost and accessible to the child(ren). The party providing insurance shall be required to convey
insurance cards demonstrating said coverage to the other party;
OR
_____ health and/or _____ dental insurance is not reasonable in cost or accessible to the child(ren) at
this time.

             b. _____Reasonable and necessary uninsured medical/dental/prescription drug costs for

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     39
               the minor child(ren) shall be assessed as follows:
_____ Shared equally by husband and wife.
_____ Prorated according to the child support guideline percentages.
_____ Other {explain}:
______________________________________________________________________________
   As to these uninsured medical/dental/prescription drug expenses, the party who incurs the
       expense shall submit request for reimbursement to the other party within 30 days, and the
       other party, within 30 days of receipt, shall submit the applicable reimbursement for that
       expense, according to the schedule of reimbursement set out in this paragraph.

5. _____Life Insurance (to secure payment of support). To secure the child support obligations in this
   judgment, _____ Husband _____ Wife _____ Each party shall maintain life insurance, in an amount
   of at least $_________________, on _____ his life _____ her life, naming _____ minor child(ren) as
   the beneficiary(ies) OR naming the _____ Wife _____ Husband or _____ other
   {name}____________________________ asTrustee for the minor child(ren), so long as reasonably
   available. The obligation to maintain the life insurance shall continue until the youngest child turns
   18, becomes emancipated, marries, joins the armed services, dies, or becomes self-supporting.

6. _____IRS Income Tax Exemption(s). The assignment of any tax exemption(s) for the child(ren) shall
   be as follows: _____________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________.
Each party shall execute any and all IRS forms necessary to effectuate the provisions of this paragraph.

7. Other provisions relating to child support: ______________________________________________
__________________________________________________________________________________
_________________________________________________________________________________.

SECTION VI. METHOD OF PAYMENT
Obligor shall pay court-ordered child support/alimony and arrears, if any, as follows:

1. Place of Payment.

            a. ____Obligor shall pay court-ordered support directly to either the State Disbursement
               Unit, or the central depository, as required by statute, along with any fee required by
               statute.

            b. ____Both parties have requested and the Court finds that it is in the best interests of
               the child(ren) that support payments need not be directed through either the State
               Disbursement Unit or the central depository at this time; however, either party may
               subsequently apply, pursuant to section 61.13(1)(d)3, Florida Statutes, to require
               payment through either the State Disbursement Unit or the central depository.

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     40
2. Income Deduction.

    a. ____Immediate. Obligor shall pay through income deduction, pursuant to a separate Income
       Deduction Order which shall be effective immediately. Obligor is individually responsible for
       paying this support obligation until all of said support is deducted from Obligor’s income. Until
       support payments are deducted from Obligor’s paycheck, Obligor is responsible for making
       timely payments directly to the State Disbursement Unit or the Obligee, as previously set forth
       in this order.

   b. ____Deferred. Income deduction is ordered this day, but it shall not be effective until a
       delinquency of $__________, or, if not specified, an amount equal to one month’s obligation
       occurs. Income deduction is not being implemented immediately based on the following
       findings: Income deduction is not in the best interests of the child(ren) because: {explain}
       ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________,
                                                 AND
   There is proof of timely payment of a previously ordered obligation without an Income
       Deduction Order in cases of modification,
                                                AND

    _____ There is an agreement by the Obligor to advise the Title IV-D agency, the clerk of court,
       and the Obligee of any change in Payor and/or health insurance
               OR
    _____ there is a signed written agreement providing an alternative arrangement between the
       Obligor and the Obligee and, at the option of the IV-D agency, by the IV-D agency in IV-D cases
       in which there is an assignment of support rights to the state, reviewed and entered in the
       record by the court.

3. Bonus/one-time payments. ( ) All ( ) _____% ( ) No income paid in the form of a bonus or
   other similar one-time payment, up to the amount of any arrearage or the remaining balance
   thereof owed pursuant to this order, shall be forwarded to Obligee pursuant to the payment
   method prescribed above.

4. Other provisions relating to method of payment. _________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

SECTION VII. ATTORNEY’S FEES, COSTS, AND SUIT MONEY
1. ____( ) Husband’s ( ) Wife’s request(s) for attorney’s fees, costs, and suit money is (are) denied
   because _________________________________________________________________________
________________________________________________________________________________

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     41
________________________________________________________________________________.

OR

2. ____The Court finds there is a need for and an ability to pay attorney’s fees, costs, and suit money.
 _____ Husband _____ Wife is hereby ordered to pay to the other spouse $__________ in attorney’s
fees, and $ ___________ in costs. The Court further finds that the attorney’s fees awarded are based on
the reasonable rate of $ ________ per hour and ________ reasonable hours. Other provisions relating
to attorney’s fees, costs, and suit money are as follows:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________.

SECTION VIII. OTHER PROVISIONS
1. Former Name. The wife’s former name of {full legal name} _________________________________
   is restored.

2. Other Provisions. ___________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________.

3. The Court reserves jurisdiction to modify and enforce this Final Judgment

DONE AND ORDERED at                                ____, Florida, on ________________________.

                                                           ________________________________
                                                                                      CIRCUIT JUDGE

A copy of this Final Order was{Choose one only} ( ) mailed ( ) faxed and mailed ( ) hand delivered
to the parties listed below on {date} _________________________by {clerk of court or designee}
_________________________________.

____Husband (or his attorney)
____Wife (or her attorney)
____Central Depository
____State Disbursement Unit
____Other __________________________________

Florida Supreme Court Approved Family Law Form 12.990(c)(1), Final Judgment of Dissolution of Marriage with
Dependent or Minor Child(ren) (05/14)
                                                     42
                          IN THE CIRCUIT COURT OF THE    JUDICIAL CIRCUIT,
                              IN AND FOR              COUNTY, FLORIDA

                                                                   Case No.:
                                                                   Division:
In re the Marriage of:

_________________
           Husband,

and

                ___
              Wife.

            FINAL JUDGMENT OF DISSOLUTION OF MARRIAGE WITH
            PROPERTY BUT NO DEPENDENT OR MINOR CHILD(REN)
This cause came before this Court for a trial on a Petition for Dissolution of Marriage. The Court, having
reviewed the file and heard the testimony, makes these findings of fact and reaches these conclusions of
law:
    1. The Court has jurisdiction over the subject matter and the parties.
    2. At least one party has been a resident of the State of Florida for more than 6 months
        immediately before filing the Petition for Dissolution of Marriage.
    3. The parties have no minor children in common, and the wife is not pregnant.
    4. The marriage between the parties is irretrievably broken. Therefore, the marriage between the
        parties is dissolved and the parties are restored to the status of being single.

SECTION I. MARITAL ASSETS AND LIABILITIES
A.      Date of Valuation of Property. The assets and liabilities listed below are divided as
        indicated. The date of valuation of these assets and liabilities is, unless otherwise indicated:
        1.____ date of filing petition for dissolution of marriage                   .
        2.____ date of separation                                  .
        3. ____ date of final hearing                              .
        4. _____other: {specify date}____________________________________________.

B. Division of Assets.
   1. The assets listed below are nonmarital assets. Each party shall keep, as his or her own, the
       assets found to be nonmarital, and the other party shall have no further rights or responsibilities
       regarding these assets.

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     43
                                                                            Current     Wife’s       Husband’s
                  ASSETS: DESCRIPTION OF ITEM(S)                              Fair       Non            Non
           Please describe each item as clearly as possible.                Market      marital        marital
              You do not need to list account numbers.                       Value     Property       Property
                                                                           $           $             $

Total Nonmarital Assets                                                    $           $             $

    2. The assets listed below are marital assets. Each party shall keep, as his or her own, the assets
       awarded in this section, and the other party shall have no further rights or responsibilities
       regarding these assets. Any personal item(s) not listed below are awarded to the party
       currently in possession or control of the item(s).

                                                                            Current                  Husband
                  ASSETS: DESCRIPTION OF ITEM(S)                              Fair          Wife      Shall
           Please describe each item as clearly as possible.                Market          Shall    Receive
              You do not need to list account numbers.                       Value         Receive
Cash (on hand or in banks/credit unions)                                   $           $             $

Stocks/bonds

Notes
Business interests

Real estate: (Home)

Automobiles

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     44
Boats
Furniture & furnishings

Jewelry

Life insurance (cash surrender value)
Retirement Plans (Profit sharing, Pension, IRA, 401(k)s, etc.)

Other assets

Total Marital Assets                                                       $           $           $

C. Division of Liabilities/Debts.
   1. The liabilities listed below are nonmarital liabilities and, therefore, are owed as indicated. Each
       party shall owe, as his or her own, the liabilities found to be nonmarital, and the other party
       shall have no responsibilities regarding these debts.

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     45
                                                                                          Wife’s Husband’s
                 LIABILITIES: DESCRIPTION OF DEBT(S)                        Current        Non-      Non-
            Please describe each item as clearly as possible.               Amount       marital   marital
               You do not need to list account numbers.                      Owed        Liability Liability
                                                                           $            $           $

Total Nonmarital Liabilities                                               $            $           $

    2. The liabilities listed below are marital liabilities and are divided as indicated. Each party shall
       hold the other party harmless and pay, as his or her own, the marital liabilities awarded below.

                 LIABILITIES: DESCRIPTION OF DEBT(S)                        Current
            Please describe each item as clearly as possible.               Amount        Wife    Husband
               You do not need to list account numbers.                      Owed       Shall Pay Shall Pay
Mortgages on real estate: (Home)                                           $            $           $
(Other)

Charge/credit card accounts

Auto loan
Auto loan
Bank/Credit Union loans

Other

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     46
Total Marital Liabilities                                                  $            $           $

D. Contingent assets and liabilities will be divided as follows:________________________________
   __________________________________________________________________________________

E. The distribution of assets and liabilities in this final judgment is equitable; if each party does not
   receive approximately one-half, the distribution is based on the following facts and reasoning:

F. Beneficiary Designation (By completing this section, the beneficiary designations continue after
  Entry of Final Judgment of Dissolution of Marriage.)

  The designation providing for the payment or transfer at death of an interest in the assets described
  below to or for the benefit of the deceased party’s former spouse is NOT VOID as of the date of
  entry of the Final Judgment of Dissolution of Marriage.

The Final Judgment of Dissolution of Marriage shall provide that the designations set forth below
remain in full force and effect.

_____ 1. The _____ Husband _____Wife shall acquire or maintain the following assets for the benefit of
the other spouse or child(ren) to be paid upon his/her death outright or in trust. This provision only
applies if other assets fulfilling such requirement for the benefit of the other spouse or child(ren) do not
exist upon his/her death and unless precluded by statute. {Describe the assets with
specificity}____________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
________________________________________________________________________________.

_____2. The _____ Husband _____ Wife shall not unilaterally terminate or modify the ownership of the

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     47
following assets, or their disposition upon his/her death. {Describe the assets with specificity}
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________.

SECTION II. EXCLUSIVE USE AND POSSESSION OF HOME
[Indicate all that apply]
  1._____ The _____Husband _____ Wife, as a condition of support, shall have exclusive
   use and possession of the dwelling located at the following address: ________________________
________________________________________________________________ until {date or event}
_________________________________________________________________________________.

2. _____ The _____Husband _____ Wife may make visits to the premises described in the paragraph
above for the purpose of obtaining any items awarded in this Final Judgment. These visits shall occur
after notice to the person granted exclusive use and possession of the dwelling and at the earliest
convenience of both parties or as ordered in paragraph 4 below.

3. _____Upon the termination of the right of exclusive use and possession, the dwelling shall be sold
and the net proceeds divided     % to Husband and         % to Wife,with the following credits and/or
setoffs         being        allowed:____________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________________________________________.

4._____Other__________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_______________________________________________________________________.

SECTION III. ALIMONY
    1. _____ The Court denies the request(s) for alimony
                 OR
    2. _____ The Court finds that there is an actual need for, and that _____ Husband _____ Wife
        (hereinafter Obligor) has/had the present ability to pay, alimony as follows:
[Indicate all that apply]

            a. _____ Permanent Periodic.

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     48
  1. The Court finds that no other form of alimony is fair and reasonable under the           circumstances
of the parties.

    2. As a marriage of: (Choose only one)

               _____Long Duration (17 years or greater) alimony is appropriate upon
        consideration of all relevant factors;

                _____Moderate Duration (greater than 7 years but less than 17) alimony is
                appropriate based upon clear and convincing evidence after consideration of all
        relevant factors; or

    _____Short Duration (less than 7 years) alimony is appropriate based upon the
       following exceptional circumstances:__________________________________
           _________________________________________________________________
           _________________________________________________________________
           __________________________________________________________________.

                 3. Obligor shall pay permanent periodic alimony to Obligee in the amount of
         $            per month, payable ( ) in accordance with Obligor’s employer’s              payroll
cycle, and in any event, at least once a month or ( ) other {explain}:
          ___________________________________________________________________,
         beginning {date}                 __. This alimony shall continue until modified by court
         order, the death of either party, or remarriage of Obligee, whichever occurs first. The
         alimony may be modified or terminated based upon either a substantial change
         in circumstances or the existence of a supportive relationship in accordance
         with section 61.14, Florida Statutes.

        b.____Bridge-the-Gap. Obligor shall pay bridge-the-gap alimony to Obligee in the amount of
$________ per month, payable ( ) in accordance with Obligor’s employer’s payroll cycle, and in any
event, at least once a month or ( ) other {explain}_______________________
beginning {date}__________________and continuing until {date}______________________
{a period not to exceed two years}, the death of either party, or remarriage of the Obligee,
whichever occurs first.

         c.______Rehabilitative. Obligor shall pay rehabilitative alimony to Obligee in the amount            of $   ___ per mo
  any event, at least once a month or ( ) other {explain} ______________________________
beginning {date} ___________. This rehabilitative alimony shall continue until modified by
court order, the death of either party ,or until {date/event} _________________________
__________________________________________________________________________,
whichever occurs first. The rehabilitative plan presented demonstrated the following:
___________________________________________________________________________

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     49
___________________________________________________________________________.

           d._____Durational. Obligor shall pay durational alimony to Obligee in the amount of
  $______per month ( ) payable in accordance with Obligor’s employer’s payroll cycle, and
  in any event, at least once a month or ( ) {explain}_______________________________
  beginning {date}____________ and terminating on {date}______________________, the
  death of either party, remarriage of Obligee;,or until modified by court order in accordance
  with section 61.08(7), Florida Statutes, whichever occurs first.

           e._____Lump Sum. Obligor shall pay lump sum alimony to Obligee in the amount of
   $_____________,which shall be paid as follows:______________________________
   ____________________________________________________________________.

f.____Retroactive. Obligor shall pay retroactive alimony in the amount of $
for the period of {date}_________________, through {date} ____________________,
which shall be paid pursuant to paragraph 4 below.

    3. Reasons for ( ) Awarding ( ) Denying Alimony. The Court has considered all of the following
       in awarding/denying alimony:
       a. The standard of living established during the marriage;
       b. The duration of the marriage;
       c. The age and the physical and emotional condition of each party;
       d. The financial resources of each party, including, the nonmarital and the marital assets and
           liabilities distributed to each;
       e. The earning capacities, educational levels, vocational skills, and employability of the parties
           and, when applicable, the time necessary for either party to acquire sufficient education or
           training to enable such party to find appropriate employment;
       f. The contribution of each party to the marriage, including, but not limited to, services
           rendered in homemaking, child care, education, and career building of the other party;
       g. The tax treatment and consequences to both parties of any alimony award, including the
           designation of all or a portion of the payment as a nontaxable, nondeductible payment;
       h. All sources of income available to either party, including income available to either party
           through investments of any asset held by the party; and
       i. Any other factor necessary to do equity and justice between the parties: {explain}________

______ Please indicate here if additional pages are attached.

    4. Arrearage/Retroactive Alimony.

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     50
         a. ____ There is no alimony arrearage at the time of this Final Judgment.

OR

         b. _____ The ____ _Husband _____ Wife shall pay to the other party the alimony arrearage of:
         $            _ for retroactive alimony, as of {date}                         .
         $            _ for previously ordered unpaid alimony, as of {date}                   .
         The total of $             in alimony arrearage shall be repaid in the amount of $         per
         month, payable ( ) in accordance with Obligor’s employer’s payroll cycle, and in any event at
         least once a month ( ) other {explain}______________________________________________
         _____________________________________________________________________________
         beginning {date}                  ______, until paid in full including statutory interest.

     5. ______Life Insurance (to secure payment of support). To secure the alimony obligations set
        forth in this judgment, Obligor shall maintain life insurance coverage on his/her life naming
        Obligee as the sole irrevocable beneficiary, so long as reasonably available. This insurance shall
        be in the amount of at least $ ________ and shall remain in effect until the obligation for
        alimony terminates.

     6. ______Other provisions relating to alimony, including any tax treatment and consequences:

      a. The award of alimony ( ) does not ( ) does leave the Obligor with significantly less net
      income than the net income of the recipient/Obligee. If yes, the court finds the following
      exceptional circumstances:________________________________________________________
 _______________________________________________________________________________
 ______________________________________________________________________________
      b. Other:_______________________________________________________________________
 ______________________________________________________________________________.

SECTION IV. METHOD OF PAYMENT
Obligor shall pay court-ordered alimony and arrears, if any, as follows:

     1. Place of Payment.

         a. ____ Obligor shall pay court-ordered support directly to either the State Disbursement Unit
            or the central depository, as required by statute, along with any fee required by statute.

         b. ____ Both parties have requested and the court finds that support payments need not be
            directed through either the State Disbursement Unit or the central depository at this time;
            however, either party may subsequently apply, pursuant to section 61.13(1)(d)3, Florida

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     51
            Statutes, to require payments through either the State Disbursement Unit or the central
            depository.

    2. Income Deduction.

        a. _____Immediate. Obligor shall pay through income deduction, pursuant to a separate
           Income Deduction Order which shall be effective immediately. Obligor is individually
           responsible for paying this support obligation until all of said support is deducted from
           Obligor’s income. Until support payments are deducted from Obligor’s paycheck, Obligor is
           responsible for making timely payments directly to the State Disbursement Unit or the
           Obligee, as previously set forth in this order.

        b. _____ Deferred. Income Deduction is ordered this day, but it shall not be effective until a
           delinquency of $            , or, if not specified, an amount equal to one month’s obligation
           occurs. Income deduction is not being implemented immediately based on the following
           findings:

  There are no minor or dependent child(ren) common to the parties,
                                                   AND
There is proof of timely payment of a previously ordered obligation without an Income Deduction Order
in cases of modification,
                                                   AND
_____ There is an agreement by the Obligor to advise the Title IV-D agency, the clerk of court, and the
Obligee of any change in Payor and/or health insurance
OR
_____ there is a signed written agreement providing an alternative arrangement between the Obligor
and the Obligee and, at the option of the IV-D agency, by the IV-D agency in IV-D cases in which there is
an assignment of support rights to the state, reviewed and entered in the record by the court.

    3. Bonus/one-time payments. ( ) All ( )                     % ( ) No income paid in the form of a
       bonus or other similar one-time payment, up to the amount of any arrearage or the remaining
       balance thereof owed pursuant to this order, shall be forwarded to Obligee pursuant to the
       payment method prescribed above.

    4. Other provisions relating to method of payment. _____________________________________

SECTION V. ATTORNEY’S FEES, COSTS, AND SUIT MONEY
            1. ____( ) Husband’s ( ) Wife’s request(s) for attorney’s fees, costs, and suit money is
               (are) denied because _____________________________________________________
                                                                                                              .

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     52
        OR
               2. ____ The Court finds there is a need for and an ability to pay attorney’s fees, costs, and
                  suit money. ( ) Husband ( ) Wife is hereby ordered to pay to the other spouse
                  $____________ in attorney’s fees, and $                  ___ in costs. The Court further
                  finds that the attorney’s fees awarded are based on the reasonable rate of $
                  per hour and             reasonable hours. Other provisions relating to attorney’s fees,
                  costs,             and             suit           money                are              as
                  follows:_________________________________________________________________
                                                                                                           .

SECTION VI. OTHER PROVISIONS
               1. Former   Name.    The   wife’s          former      name      of    {full    legal    name}
                  ______________________________
is restored.
               2. Other Provisions.

                                                                                                              .

               3. The Court reserves jurisdiction to modify and enforce this Final Judgment

DONE AND ORDERED on ___________ in __________________________, Florida.

CIRCUIT JUDGE

A copy of this Final Order was [Choose one only] ( ) mailed ( ) faxed and mailed ( ) hand- delivered to
the parties listed below on {date} _______________________ by {clerk of court or
designee}_____________________________________.

____Husband (or his attorney)
____Wife (or her attorney)
____Central depository
____State Disbursement Unit

____Other:

Florida Supreme Court Approved Family Law Form 12.990(c)(2), Final Judgment of Dissolution of Marriage with
Property but No Dependent or Minor Child(ren) (05/14)
                                                     53