Cover Sheet For Family Court Cases {5}

IN THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL CIRCUIT, IN AND FOR MIAMI DADE COUNTY, FLORIDA Cover Sheet for Family Court Cases ______________________________________ Petitioner and ______________________________________ Respondent Case No.: ____________________ Judge: ____________________ Type of Action/Proceeding: Place a check beside the proceeding you are initiating. If you are simultaneously filing more than one type of proceeding against the same opposing party such as a modification and an enforcement proceeding, complete a separate cover sheet for each action being filed. If you are reopening a case, choose one of the three options below it. ___ (A) Initial Action/Petition ___ (B) Reopening Case ___ 1. Modification/Supplemental Petition ___ 2. Motion for Civil Contempt/Enforcement ___ 3. Other Type of Case: If the case fits more than one type of case, select the most definitive. ___ (A) Simplified Dissolution of Marriage ___ (K) Other Family Court ___ (B) Dissolution of Marriage ___ (L) Adoption Arising Out Of Chapter 63 ___ (C) Domestic Violence ___ (M) Name Change ___ (D) Dating Violence ___ (N) Paternity/Disestablishment of Paternity ___ (E) Repeat Violence ___ (O) Juvenile Delinquency ___ (F) Sexual Violence ___ (P) Petition for Dependency ___ (G) Support IV-D (Department of Revenue, ___ (Q) Shelter Petition Child Support Enforcement) ___ (R) Termination of Parental Rights Arising ___ (H) Support Non IV-D (not Department of Out Of Chapter 39 Revenue, Child Support Enforcement) ___ (S) Adoption Arising Out Of Chapter 39 ___ (I) UIFSA IV-D (Department of Revenue, ___ (T) CINS/FINS Child Support Enforcement) ___ (J) UIFSA Non IV-D (not Department of Revenue, Child Support Enforcement) Rule of Judicial Administration 2.545(d) requires that a Notice of Related Cases Form, Family Law Form 12.900(h), be filed with the initial pleading/petition by the filing attorney or self-represented litigant in order to notify the court of related cases. Is Form 12.900(h) being filed with this Cover Sheet for Family Court Cases and initial pleading/petition? ___ No, to the best of my knowledge, no related cases exist. ___ Yes, all related cases are listed on Family Law Form 12.900(h). CLK/CT 5 Rev.1/10 Clerk's web address: www.miami-dadeclerk.com American LegalNet, Inc. www.FormsWorkFlow.com ATTORNEY OR PARTY SIGNATURE I CERTIFY that the information I have provided in this cover sheet is accurate to the best of my knowledge and belief. Signature _____________________________________________ Attorney or Party Name (If attorney include Bar No.) Date: _________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] I {full legal name and trade name of non lawyer} _____________________________________ , a nonlawyer, whose address is {street} ________________________________ {city} ______________ {state} _______ {phone} _____________ , helped {name} ______________________________ , who is the [choose one only] ___ petitioner or ___ respondent, fill out this form. American LegalNet, Inc. www.FormsWorkFlow.com Florida Family Law Rules of Procedure Form 12.928, Cover Sheet for Family Court Cases (01/10) The Cover Sheet for Family Court Cases and the information contained in it neither replace nor supplement the filing and service of pleadings or other documents as required by law. This form shall be filed by the petitioner/party opening or reopening a case for the use of the clerk of the circuit court for the purpose of reporting judicial workload data pursuant to Florida Statutes section 25.075. This form should be typed or printed in black ink. The petitioner must file this cover sheet with the first pleading or motion filed to open or reopen a case in all domestic and juvenile cases. Follow these instructions for completing the form: I. Case Style. Enter the name of the court, the appropriate case number assigned at the time of filing of the original petition, the name of the judge assigned (if applicable), and the name (last, first, middle initial) of the petitioner(s) and respondent(s). II. Type of Action /Proceeding. Place a check beside the proceeding you are initiating. If you are simultaneously filing more than one type of proceeding against the same opposing party, such as a modification and an enforcement proceeding, complete a separate cover sheet for each action being filed. (A) Initial Action/Petition (B) Reopening Case. If you check "Reopening Case," indicate whether you are filing a modification or supplemental petition or an action for enforcement by placing a check beside the appropriate action/petition. . Modification/Supplemental Petition . Motion for Civil Contempt/ Enforcement . Other ­ All reopening actions not involving modification/supplemental petitions or petition enforcement. III. Type of Case. Place a check beside the appropriate case. If the case fits more than one category, select the most definitive. Definitions of the categories are provided below. (A) Simplified Dissolution of Marriage - petitions for the termination of marriage pursuant to Florida Family Law Rule of Procedure 12.105. (B) Dissolution of Marriage - petitions for the termination of marriage pursuant to Chapter 61, Florida Statutes, other than simplified dissolution. (C) Domestic Violence - all matters relating to injunctions for protection against domestic violence pursuant to section 741.30, Florida Statutes. (D) Dating Violence - all matters relating to injunctions for protection against dating violence pursuant to section 784.046, Florida Statutes. (E) Repeat Violence - all matters relating to injunctions for protection against repeat violence pursuant to section 784.046, Florida Statutes. (F) Sexual Violence - all matters relating to injunctions for protection against sexual violence pursuant to section 784.046, Florida Statutes. American LegalNet, Inc. www.FormsWorkFlow.com (G) Support IV-D - all matters relating to child or spousal support in which an application for assistance has been filed with the Department of Revenue, Child Support Enforcement under Title IV-D, Social Security Act, except for such matters relating to dissolution of marriage petitions (sections 409.2564, 409.2571, and 409.2597, Florida Statutes), paternity, or UIFSA. (H) Support Non IV-D - all matters relating to child or spousal support in which an application for assistance has not been filed under Title IV-D, Social Security Act. (I) UIFSA IV-D - all matte