Parties & Case Info

a. General Information

IN THE CIRCUIT COURT OF THE ___ JUDICIAL CIRCUIT, Write the number of the judicial circuit where you are filing. You can find this on the court's website or by calling the clerk's office. IN AND FOR ___ COUNTY, FLORIDA Write the name of the county where you are filing this case. Petitioner, Write your full name. You are the petitioner because you are asking the court for protection. Respondent. Write the full name of the person you want protection from. Case No.: Leave this blank if you are just starting the case. The clerk will fill in the number for you. Division: Leave this blank unless the clerk tells you what to write here. I, {full legal name} Write your complete legal name as it appears on your ID. Petitioner's current address is: {street address} Write your home street address. If you are afraid the other person will find you, ask the clerk about filing your address as confidential. {city, state, and zip code} Write the city, state, and zip code for your home address. Telephone Number: {area code and number} Write your phone number, including the area code. Race: Write your race. This helps describe you on the form. Sex: Male Check this box if you are male. Female Check this box if you are female.

b. Children's Basic Information

Date of Birth: Write the date you were born. Petitioner's attorney's name, address, and telephone number is: Write your lawyer's name, address, and phone number. If you do not have a lawyer, write 'none'. Respondent's current address is: {street address, city, state, and zip code} Write the home address of the person you want protection from, including street, city, state, and zip code. Respondent's Driver's License number is: {if known} Write the driver's license number of the other person if you know it. Leave blank if you do not know it. Petitioner has known Respondent since {date} Enter the date when you first met or got to know the other person. Respondent's last known place of employment: Enter the name of the company or place where the other person works or last worked. Employment address: Enter the street address of the other person's workplace. Working hours: Enter the days and times the other person usually works, if you know them. Race: Enter the other person's race to help identify them. Sex: Male Check this if the other person is male. Female Check this if the other person is female. Date of Birth: Enter the other person's birth date if you know it. Height: Enter how tall the other person is, like 5 feet 10 inches. Weight: Enter about how much the other person weighs in pounds. Eye Color: Enter the color of the other person's eyes. Hair Color: Enter the color of the other person's hair. Distinguishing marks or scars: Describe any tattoos, scars, or other marks that help identify the other person. Vehicle: (make/model) Enter the make and model of the car the other person drives, like Honda Civic. Color: Enter the color of the other person's car. Tag Number: Enter the license plate number of the other person's car if you know it. Other names Respondent goes by (aliases or nicknames): List any other names, nicknames, or fake names the other person uses. Respondent's attorney's name, address, and telephone number is: Enter the name, address, and phone number of the other person's lawyer. Write 'unknown' if you don't know, or 'none' if they have no lawyer. Has Respondent ever received or tried to get an injunction for protection against domestic violence against Petitioner in this or any other court? Check Yes if the other person has ever asked any court for a protection order against you. Check No if they have not. If yes, what happened in that case? {Include case number, if known} If you checked Yes, explain what happened in that case. Add the case number if you know it.

c. Pregnancy & Paternity

Describe any other court case that is either going on now or that happened in the past, including a dissolution of marriage, paternity action, or child support enforcement action, between Petitioner and Respondent {Include city, state, and case number, if known} List any other court cases between you and the other person, like a divorce, paternity, or child support case. Include the city, state, and case number if you know them.