Parenting Coordinator Request For Status Conference - Florida Circuit Court Page 3
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3WHEREFORE, the undersigned Parenting Coordinator requests that a Status Conference be set
by the Court.
_____________________
_________________________________________________
Date
Signature of Parenting Coordinator
Printed Name: ____________________________________
Address: _________________________________________
City, State, Zip: ____________________________________
Telephone Number: _______________________________
E-mail: __________________________________________
Professional License # (if applicable) ___________________
Professional Certification # (if applicable) _______________
Copies to:
_____ Presiding Judge
_____ Petitioner
_____ Attorney for Petitioner
_____ Respondent
_____ Attorney for Respondent
_____ Other: ____________________________________________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:
[fill in all blanks] This form was completed with the assistance of:
{name of individual} __________________________________________________________________,
{name of business} ____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} __________________________,{state} ______________,{telephone number} ________________.
Florida Family Law Rules of Procedure Form 12.984(d) Parenting Coordinator Request for Status Conference
(07/14)
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