IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT IN AND FOR COLLIER COUNTY, FLORIDA CIVIL ACTION

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Petitioner/, and CASE NO: __-DR-___

______

Respondent/. ______/

AFFIDAVITS OF NON-MILITARY SERVICE, PREGNANCY, NAME CHANGE AND GROUNDS FOR DISSOLUTION OF MARRIAGE, AND NOTICE OF RELATED CASES

AFFIDAVIT OF NON-MILITARY SERVICE

I, ______, am not now on active duty in the military service of the United States, nor have I been on active military service of the United States within a period of thirty (30) days immediately before this date, and know of my own personal knowledge that the Petitioner/Respondent, ______, is not now on active duty in the military service of the United States, nor has the Petitioner/Respondent, ______, been on active military service of the United States within a period of thirty (30) days immediately before this date.

PREGNANCY, NAME CHANGE AFFIDAVIT

I [full legal name] ______, being sworn, certify that the following information is true:

1. I am married to ______[name of spouse] and I am the ______[party] in the above styled case.

2. I am not now pregnant.

3. I am requesting that my name be changed as a part of the Final Judgment in this case to ______.[name change]

GROUNDS FOR DISSOLUTION OF MARRIAGE I [full legal name] ______, being sworn, certify that the following information is true:

1. I am married to ______[name of spouse] who is the ______[party] in the above styled case.

2. My spouse and I were married on ______[date of marriage] in ______[location of marriage].

3. I have been a resident of the State of Florida for six (6) months prior to the filing of the Petition for Dissolution of Marriage in the above-styled case. I have filed a copy of my ______[type of identification filed] in the Court file.

4. My marriage to the above spouse is irretrievably broken. There is nothing that can be done to save, correct, or restore this marriage.

5. My spouse and I have entered into a Marital Settlement Agreement that resolves all issues raised by or pertaining to the above-styled action. I entered into this Agreement freely and voluntarily.

6. [if parties have children] ____ [number] children were born of our marriage as follows: [list names and dates of birth of children born of the parties’ marriage]

7. [if parties have children] The provisions in Marital Settlement Agreement and our Parenting Plan are in the best interests of our children.

NOTICE OF RELATED CASES

COMES NOW the Petitioner/Respondent, ______, by and through undersigned counsel and hereby submits this his/her Notice of Related Cases as required by Florida Rule of Judicial Administration 2.545(d). A related case may be an open or closed civil, criminal, guardianship, domestic violence, juvenile delinquency, or domestic relations case. A case is “related” to this family law case if it involves any of the same parties, children, or issues and it is pending at the time the party files a family case; if it affects the court’s jurisdiction to proceed; if an order in the related case may conflict with an order on the same issues in the new case; or if an order in the new case may conflict with an order in the earlier litigation.

___ There are no related cases. ___ The following are the related cases (add additional pages if necessary):

Related Case No. 1 Case Name(s):______Petitioner: ______Respondent: ______Case No.: ______Division: ______Type of Proceeding: ___ Dissolution of Marriage ___ Paternity ___ Custody ___ Adoption ___ Child Support ___ Modification/Enforcement/Contempt Proceedings ___ Juvenile Dependency ___ Juvenile Delinquency ___ Termination of Parental Rights ___ Criminal ___ Domestic/Sexual/Dating/Repeat ___ Mental Health Violence Injunctions ___ Other ______

State where case was decided or is pending: ___ Florida; ___ Other ______Name of Court where case was decided or is pending (circuit name, county name): ______Title of last Court Order/Judgment (if any): ______Date of Court Order/Judgment (if any): ______

Relationship of cases: ___ pending case involves same parties, children, or issues; ___ may affect court’s jurisdiction; ___ order in related case may conflict with an order in this case; ___ order in this case may conflict with previous order in related case. Statement as to the relationship of the cases: ______

Related Case No. 2 Case Name(s):______Petitioner: ______Respondent: ______Case No.: ______Division: ______Type of Proceeding: ___ Dissolution of Marriage ___ Paternity ___ Custody ___ Adoption ___ Child Support ___ Modification/Enforcement/Contempt Proceedings ___ Juvenile Dependency ___ Juvenile Delinquency ___ Termination of Parental Rights ___ Criminal ___ Domestic/Sexual/Dating/Repeat ___ Mental Health Violence Injunctions ___ Other ______

State where case was decided or is pending: ___ Florida; ___ Other ______Name of Court where case was decided or is pending (circuit name, county name): ______Title of last Court Order/Judgment (if any): ______Date of Court Order/Judgment (if any): ______Relationship of cases: ___ pending case involves same parties, children, or issues; ___ may affect court’s jurisdiction; ___ order in related case may conflict with an order in this case; ___ order in this case may conflict with previous order in related case. Statement as to the relationship of the cases: ______

PETITIONER/RESPONDENT hereby: ___ Does not request coordination of litigation in any of the cases listed above. ___ Does request coordination of the following cases: ______Assignment to one judge ___ Coordination of existing cases will conserve judicial resources and promote an efficient determination of these cases because: ______.

The Petitioner/Respondent acknowledges a continuing duty to inform the court of any cases in this case or any other state that could affect the current proceeding.

Dated: ______CLIENT NAME

STATE OF FLORIDA COUNTY OF COLLIER

Sworn to or affirmed and signed before me on this __ day of January, 201_ by CLIENT NAME.

______NOTARY PUBLIC or DEPUTY CLERK

___ Personally known ___ Produced identification Type of identification produced: ______

I HEREBY CERTIFY that a copy of this document was delivered via electronic service to the person listed below on January __, 201_. , Esquire Address , Florida 34102

,Esquire Attorney for Address ,Florida 34102

______,Esquire Florida Bar No: 765740