Parenting Coordinator Report Of An Emergency {12.984(c)}

INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.984(c) PARENTING COORDINATOR REPORT OF AN EMERGENCY (07/14) When should this form be used? A person appointed as a parenting coordinator must immediately inform the court of an emergency situation pursuant to section 61.125(8), Florida Statutes. This form is used by the parenting coordinator to report an emergency with or without notice to the parties. It is critical to differentiate whether notice to the parties is required under the facts of any emergency. Report With Notice. A parenting coordinator, upon information and belief, must immediately inform the court by affidavit or verified report of an emergency in which a party obtains a final order or injunction of protection against domestic violence or is arrested for an act of domestic violence as provided under chapter 741, Florida Statutes Report Without Notice. A parenting coordinator must immediately inform the court by affidavit or verified report of an emergency situation if: 1. There is a reasonable cause to suspect that a child will suffer or is suffering abuse, neglect, or abandonment as provided under chapter 39, Florida Statutes; 2. There is a reasonable cause to suspect a vulnerable adult has been or is being abused, neglected, or exploited as provided under chapter 415, Florida Statutes; 3. A party, or someone acting on a party's behalf, is expected to wrongfully remove or is wrongfully removing the child from the jurisdiction of the court without prior court approval or compliance with the requirements of section 61.13001, Florida Statutes. If the parenting coordinator suspects that the parent has relocated within the state to avoid domestic violence, the coordinator may not disclose the location of the parent and child unless required by court order. This form should be typed or printed in black ink. What should I do next? After completing and signing this form, you must file the original with the clerk of the circuit court in the county in which the action is pending, provide a copy to the presiding judge, and keep a copy for your records. Report With Notice. If notice to the parties is required under section 61.125(8)(b), Florida Statutes, you must also mail or hand deliver a copy of this form to attorney(s) for the parents or, if not represented by an attorney, to the parents. Report Without Notice. If notice to the parties is not required, you must mail or hand-deliver a copy of this form to the Judge presiding over the case. Instructions for Florida Family Law Rules of Procedure Form 12.984(c), Parenting Coordinator Report of an Emergency (07/14) American LegalNet, Inc. www.FormsWorkFlow.com Where can I look for more information? Before proceeding, you should read "General Information for Self-Represented Litigants" found at the beginning of these forms. For more information, see section 61.125, Florida Statutes; Florida Family Law Rule of Procedure 12.742; Rules for Qualified and Court Appointed Parenting Coordinators; and the Order of Referral to Parenting Coordinator, Florida Family Law Rules of Procedure Form 12.984(a). Special notes 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 Family Law Rules of Procedure Form 12.984(c), Parenting Coordinator Report of an Emergency (07/14) American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT, IN AND FOR ______________________________ COUNTY, FLORIDA Case No: ________________________ Division: ________________________ _________________________________, Petitioner, and _________________________________, Respondent. PARENTING COORDINATOR REPORT OF AN EMERGENCY The undersigned parenting coordinator reports an emergency to the court: 1. _____ With notice to the parties. A party has obtained a final order or injunction of protection against domestic violence or has been arrested for an act of domestic violence as provided under chapter 741, F.S. 2. _____ Without notice to the parties pursuant to section 61.125 (8)(a), Florida Statutes, because: (choose all that apply) a. _____ There is a reasonable cause to suspect that a child will suffer or is suffering abuse, neglect, or abandonment as provided under chapter 39, Florida Statutes. b. _____ There is a reasonable cause to suspect a vulnerable adult has or is being abused, neglected, or exploited as provided under chapter 415, Florida Statutes. c. _____ A party, or someone acting on a party's behalf, is expected to wrongfully remove or is wrongfully removing the child from the jurisdiction of the court without prior approval or compliance with the requirements of section 61.13001, Florida Statutes. 3. Describe the emergency: ____________________________________________________________ _________________________________________________________________________________ ____________________________________________________________________________. VERIFICATION BY PARENTING COORDINATOR I, _______________________________________________ (name of parenting coordinator) do hereby swear or affirm that the facts contained in this Parenting Coordinator Report of an Emergency are true and correct to the best of my knowledge and belief. Florida Family Law Rules of Procedure Form 12.984(c), Parenting Coordinator Report of an Emergency (07/14) American LegalNet, Inc. www.FormsWorkFlow.com Date :________________ Signature of Parenting Coordinator:__________________ Printed Name: ____________________________________ Address: _________________________________________ City, State, Zip: ____________________________________ Telephone Number: _______________________________ E-mail: __________________________________________ Professional License # (if applicable) ___________________ Professional Certification # (if applicable) ______________ STATE OF FLORIDA COUNTY OF ______________________ Sworn to or affirmed and signed before me on __________________ by _________________________. _____________________________________________ NOTARY PUBLIC or DEPUTY CLERK _____________________________________________ [Print,