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

• Court: Supreme Court of Florida
• Decided: May 1, 2014
• Docket: SC13-532
• Status: Published

Opinion

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)

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)

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

Jewelry

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)

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 ___________________________

[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)

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).

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.

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,

______________, 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:

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)

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.)

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)

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

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

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)

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)

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)

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

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

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

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

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

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

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

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

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

OR

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

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

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

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

SECTION III. OTHER

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

______________________________________________________________________________ ______________________________________________________________________________.

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

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

STATE OF FLORIDA COUNTY OF ___

[Print, type, or stamp commissioned name of notary or clerk.] ____ Personally known ____ Produced identification Type of identification produced

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [Please fill in all blanks] This form was prepared for the: {choose only one} ( ) Husband ( ) Wife This form was completed with the assistance of: {name of individual} ______________________________________________________________, {name of business} ________________________________________________________________, {address} _______________________________________________, {city} ______________________,{state} ___, {telephone number} _______________.

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

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

STATE OF FLORIDA COUNTY OF

[Print, type, or stamp commissioned name of notary or clerk.] _____ Personally known _____ Produced identification Type of identification produced

IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] This form was prepared for the: {choose only one} ( ) Husband ( ) Wife This form was completed with the assistance of: {name of individual} , {name of business} _____________________________________________________________________, {address}_____________________________________________________________________________, {city} ___________ ____,{state} __, {telephone number} _________________________.

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

Case No.:______________________________ Division: ______________________________

, Husband ,

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) $ $ $

Notes Business interests

Real estate: (Home)

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

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

Total Marital Assets $ $ $

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

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

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

Total Nonmarital Liabilities $ $ $

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

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

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

Total Marital Liabilities $ $ $

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

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

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

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

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

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

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

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

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

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

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

4. ____Other: ______________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

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

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

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

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

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

[Indicate all that apply] a._____Permanent Periodic.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

4. Arrearage/Retroactive Alimony.

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

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;

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

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

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

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

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

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

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

3. Arrearage/Retroactive Child Support.

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

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

4. Insurance.

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

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

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

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

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

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

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

1. Place of Payment.

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

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

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

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

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

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

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

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

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

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

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,

___ 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 $ $ $

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) $ $ $

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

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

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 $ $ $

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)

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

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

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

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

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

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

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

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

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

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

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

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

4._____Other__________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _______________________________________________________________________.

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

a. _____ Permanent Periodic.

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

_____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.

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

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:

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