Petition For Dissolution Of Marriage With Dependent Or Minor Child(Ren) Page 6
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11IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT,
IN AND FOR ______________________________ COUNTY, FLORIDA
Case No: ________________________
Division: ________________________
_________________________________,
Petitioner,
And
_________________________________,
Respondent.
PETITION FOR DISSOLUTION OF MARRIAGE
WITH DEPENDENT OR MINOR CHILD(REN)
I, {full legal name} ______________________________________________________, the
[Choose only one] ( ) Husband ( ) Wife, being sworn, certify that the following statements are true:
1. JURISDICTION/RESIDENCE
( ) Husband ( ) Wife ( ) Both has (have) lived in Florida for at least 6 months before the filing of
this Petition for Dissolution of Marriage.
2. The husband [Choose only one] ( ) is ( ) is not a member of the military service.
The wife [Choose only one] ( ) is ( ) is not a member of the military service.
3. MARRIAGE HISTORY
Date of marriage: {month, day, year} ___________________________________________________
Date of separation: {month, day, year}______________ (Please indicate if approximate)
4. DEPENDENT OR MINOR CHILD(REN)
[Choose all that apply]
a. ___ The wife is pregnant. Baby is due on: {date} ______________
b. ___ The minor (under 18) child(ren) common to both parties are:
Name
Birth date
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
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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