Petition For Dissolution Of Marriage With Dependent Or Minor Child(Ren) Page 11
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11STATE 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, whose address is {street} ____________________________________________,
{city} ______________________,{state} ______________,{phone} ______,
helped {name} _______________________________, who is the petitioner, fill out this form.
Florida Supreme Court Approved Family Law Form 12.901(b)(1), Petition for Dissolution of Marriage with
Dependent or Minor Child(ren) (10/11)
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