Florida-Motion-to-Deviate-from-Guidelines

 

IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA

Case No.:

Division::


Petitioner

and


Respondent
MOTION TO DEVIATE FROM CHILD SUPPORTGUIDELINES
Petitioner Respondent requests that the Court enter an order granting the following:
SECTION I
[Choose A or B]
A.

[Choose all that apply to yoursituation]
1.
2.
3.
4.
5.
6.
7.
8.
9.
10. Explain any items marked above:
B.
[Choose all that apply to yoursituation]
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12. Explain any items marked above:
SECTION II. INCOME AND ASSETS OF CHILD(REN) COMMON TO BOTH PARTIES
List the total of any independent income or assets of the child(ren) common to both parties (incomefrom Social Security, gifts, stocks/bonds, employment, trust fund(s), investment(s), etc.). Attach an explanation.
TOTAL VALUE OF ASSETS OF CHILD(REN)     $

TOTAL MONTHLY INCOME OF CHILD(REN)     $

SECTION III. EXPENSES FOR CHILD(REN) COMMON TO BOTHPARTIES
All amounts must be MONTHLY. See the instructions with this form to figure out money amounts for anything that is NOT paid monthly. Attach more paper, if needed. Items included under “other” should be listed separately with separate dollar amounts.
1. $ Monthly nursery, babysitting, or other child care
2. $ Monthly after-school care
3. $ Monthly school tuition
4. $ Monthly school supplies, books, and fees
5. $ Monthly after-school activities
6. $ Monthly lunch money
7. $ Monthly private lessons/tutoring
8. $ Monthly allowance
9. $ Monthly clothing
10. $ Monthly uniforms
11. $ Monthly entertainment (movies, birthday parties, etc.)
12. $ Monthly health and dental insurance premiums
13. $ Monthly medical, dental, prescription charges(unreimbursed)
14. $ Monthly psychiatric/psychological/counselor(unreimbursed)
15. $ Monthly orthodontic (unreimbursed)
16. $ Monthly grooming
17. $ Monthly non-prescriptionmedications/cosmetics/toiletries/sundries
18. $ Monthly gifts from children to others (other children, relatives, teachers, etc.)
19. $ Monthly camp or other summer activities
20. $ Monthly clubs (Boy/Girl Scouts, etc.) or recreational fees
21. $ Monthly visitation expenses (for nonresidential parent) {Explain}
22. $ Monthly insurance (life, etc.)
{explain}:
23.
24.
25.
26. $ TOTAL EXPENSES FOR CHILD(REN) COMMON TO BOTHPARTIES
(add lines 1 through 25)
I have filed, will file, or am filing with this form the following additionaldocuments:
1. Florida Family Law Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c).
2. Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e).
I certify that a copy of this document was () () () () listed below on {date} .
Other party or his/her attorney:
Name:
Address:
City,State,Zip:
Fax Number:
Designated E – mail Address(es):
I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this motion and that the punishment for knowingly making a false statement includes fines and/or imprisonment.
Dated:

Signature of Party or his/her attorney
Printed Name:
Address:
City,State,Zip:
Fax Number:
Designated E – mail Address(es):
STATE 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]

 

This form was prepared for the: {choose only one} ( ) Petitioner ( ) Respondent.This form was completed with the assistance of:
{name of individual}
{name of business}
{address}
{city} {state} {telephone number}

 

Contact Information

 

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