Instructions For Florida Supreme Court Approved Family Law Form 12.905(A), Supplemental Petition To Modify Parentalresponsibility, Visitation Or Parenting Plan/ Time-Sharing Schedule And Other Relief (11/15) Page 5

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IN THE CIRCUIT COURT OF THE _______________________ JUDICIAL CIRCUIT,
IN AND FOR ________________________ COUNTY, FLORIDA
Case No.: ___________________________
Division: __________________________________________________________________________________
__________________________________,
Petitioner,
and
__________________________________,
Respondent,
SUPPLEMENTAL PETITION TO MODIFY PARENTAL RESPONSIBILITY,
VISITATION, OR PARENTING PLAN/TIME-SHARING SCHEDULE AND
OTHER RELIEF
I, {full legal name} ______________________________________ being sworn, certify that the following
information is true:
1.
The parties to this action were granted a final judgment of _____ dissolution of marriage
_____ paternity on {date} _____. A copy of the final judgment and any modification(s) is attached.
2.
Paragraph(s) _____ of the _____ final judgment or _____ most recent modification thereof
describes the present parental responsibility, visitation, or Parenting Plan/Time-Sharing schedule.
3.
Since the final judgment or last modification thereof, there has been a substantial, material and
unanticipated change in circumstances, requiring a modification of the parental responsibility, visitation,
or Parenting Plan/Time-Sharing schedule. Those changes are as follows: {explain}
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
4.
I ask the Court to modify the parental responsibility, visitation, Parenting Plan or Time-Sharing
schedule as follows: {explain}
_____________________________________________________________________________________
Florida Supreme Court Approved Family Law Form 12.905(a), Supplemental Petition to Modify Parental
Responsibility, Visitation, or Parenting Plan/Time-Sharing Schedule and Other Relief (11/15)

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