Family Law Financial Affidavit (Short Form) Page 8
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8I certify that a copy of this document was [choose only one] (
) mailed ( ) faxed and
mailed ( ) hand delivered to the person(s) listed below on {date}
.
Other party or his/her attorney:
Name:
Address:
City, State, Zip:
Fax Number:
I understand that I am swearing or affirming under oath to the truthfulness of the
claims made in this affidavit and that the punishment for knowingly making a false statement
includes fines and/or imprisonment.
Dated:
Signature of Party
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
STATE OF FLORIDA
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 deputy 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]
I, {full legal name and trade name of nonlawyer}
,
a nonlawyer, located at {street}
, {city}
,
{state}
, {phone}
, helped {name}
,
who is the [choose only one]
petitioner or
respondent, fill out this form.
Florida Family Law Rules of Procedure Form 12.902(b), Family Law Financial Affidavit (Short Form) (10/11)
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