Petition For Dissolution Of Marriage With Dependent Or Minor Child(Ren) Page 7
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11c. ___The minor child(ren) born or conceived during the marriage who are not common to both
parties are:
Name
Birth date
______________________________________________________________________________
______________________________________________________________________________
The birth father(s) of the above minor child(ren) is (are) {name and address} ________________
______________________________________________________________________________
___
d.
The child(ren) common to both parties who are 18 or older but who are dependent upon
the parties due to a mental or physical disability are:
Name
Birth date
________________________________________________________________________
________________________________________________________________________
5. A completed Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form
12.902(b) or (c) ( ) is filed or ( ) will be timely filed.
6. A completed Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit, Florida
Supreme Court Approved Family Law Form 12.902(d), is filed with this petition. (You must complete
and attach this form in a dissolution of marriage with minor child(ren)).
7. A completed Notice of Social Security Number, Florida Supreme Court Approved Family Law Form
12.902(j), is filed with this petition.
8. This petition for dissolution of marriage should be granted because:
[Choose only one]
a. ___ The marriage is irretrievably broken.
b. ___ One of the parties has been adjudged mentally incapacitated for a period of 3 years prior to
the filing of this petition. A copy of the Judgment of Incapacity is attached.
SECTION I. MARITAL ASSETS AND LIABILITIES[]
1. ___ There are no marital assets or liabilities.
2. ___ There are marital assets or liabilities. All marital and nonmarital assets and liabilities are (or
will be) listed in the financial affidavits, Florida Family Law Rules of Procedure Form
2.902(b) or (c), to be filed in this case.
[Choose all that apply]
a. ___ All marital assets and liabilities have been divided by a written agreement between the
parties, which is attached, to be incorporated into the final judgment of dissolution of marriage.
(The parties may use Marital Settlement Agreement for Dissolution of Marriage with Dependent
or Minor Child(ren), Florida Supreme Court Approved Family Law Form 12.902(f)(1).
b. ___ The Court should determine how the assets and liabilities of this marriage are to be
distributed, under section 61.075, Florida Statutes.
c. ___ Petitioner should be awarded an interest in Respondent’s property because.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
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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