In Re: Amendments to Florida Supreme Court Approved Family Law Form

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)
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___________________________________________________________________________________
____________________________________________________________________________________.
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)
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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)
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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)
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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)
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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)
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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)
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______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________.
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)
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______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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)
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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)
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______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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)
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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)
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________________________________________________________________________________.
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)
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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)
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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