Notice Of Social Security Number Template
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1
2IN THE CIRCUIT COURT OF THE
JUDICIAL CIRCUIT,
IN AND FOR
COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
NOTICE OF SOCIAL SECURITY NUMBER
I, {full legal name}
,
certify that my social security number is
, as required in section
61.052(7), sections 61.13(9) or (10), section 742.031(3), sections 742.032(1)–(3), and/or sections
742.10(1)–(2), Florida Statutes. My date of birth is
.
[/ one only]
1. This notice is being filed in a dissolution of marriage case in which the parties have no minor
children in common.
2. This notice is being filed in a paternity or child support case, or in a dissolution of marriage in
which the parties have minor children in common. The minor child(ren)'s name(s), date(s) of
birth, and social security number(s) is/are:
Name
Birth date
Social Security Number
{Attach additional pages if necessary.}
Disclosure of social security numbers shall be limited to the purpose of administration of the Title IV-D
program for child support enforcement.
Florida Supreme Court Approved Family Law Form 12.902(j), Notice of Social Security Number (9/00)
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