IN THE CIRCUIT COURT OF THE FIFTH JUDICIAL CIRCUIT, COUNTY, FLORIDA IN AND FOR
, Former Husband or Petitioner, and , Former Wife or Respondent.
CASE NO.
NOTICE OF INTENT TO RELOCATE WITH CHILD(REN) I, {full legal name} _________________________________________________, give notice to {full legal name} __________________________________________________ of my intention to relocate the principal residence of the following child(ren): Name _______________________ _______________________ _______________________ Birth Date ________________ ________________ ________________ Current Address ________________________________ ________________________________ ________________________________
I am providing the following information required by section 61.13001(2), Florida Statutes:
1.
The location of the intended new residence, including the state, city, and physical address, if known, is: ____________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _______________________________________________________________________________ The mailing address of the new physical residence, if not the same as the physical address, is: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ The home telephone number of the intended new residence, if known, is: ___________________ The date of the intended move or proposed relocation is:_________________________________ a. The specific reasons for the proposed relocation of the child(ren) are: ____________________ ______________________________________________________________________________ ______________________________________________________________________________ _______________________________________________________________________________ Attach additional sheets if necessary.
2.
3. 4. 5.
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b. One of the reasons for the proposed relocation is a job offer. [/one only] ( ) Yes ( ) No. The job offer is in writing. [/one only] ( ) Yes ( ) No. A copy of the written job offer is attached to this notice. 6. a. The proposed post-relocation schedule of visitation is as follows:________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Attach additional sheets if necessary. b. The proposed post-relocation transportation arrangements necessary to effectuate visitation with the child(ren) are as follows: _______________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Attach additional sheets if necessary. AN OBJECTION TO THE PROPOSED RELOCATION MUST BE MADE IN WRITING, FILED WITH THE COURT, AND SERVED ON THE PARENT OR OTHER PERSON SEEKING TO RELOCATE WITHIN 30 DAYS AFTER SERVICE OF NOTICE OF THIS INTENT TO RELOCATE. IF YOU FAIL TO TIMELY OBJECT TO THE RELOCATION, THE RELOCATION WILL BE ALLOWED WITHOUT FURTHER NOTICE AND WITHOUT A HEARING, UNLESS IT IS NOT IN THE BEST INTERESTS OF THE CHILD. 7. The mailing address of the parent seeking to relocate to whom the objection, if any, must be sent is listed below. Parent Seeking to Relocate: Name: _______________________________________________ Address: _____________________________________________ City, State, Zip: _______________________________________ Fax Number: __________________________________________ I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this Notice of Intent to Relocate and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Dated: ______________________________________________ Signature of Parent Seeking to Relocate Printed Name: __________________________________ Address: ______________________________________ City, State, Zip: ________________________________ Telephone Number: _____________________________ Fax Number: ___________________________________
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STATE OF FLORIDA COUNTY OF _____________ Sworn to (or affirmed) and subscribed before me on {date} _________________________, 20 ___ by {name} ______________________________. ______________________________________________ NOTARY PUBLIC -- STATE OF __________________ ______________________________________________ [Print, type, or stamp commissioned name of notary] [/one only] _____ Personally known _____ Produced identification Type of identification produced ___________________________
CERTIFICATE OF SERVICE I HEREBY CERTIFY that I furnished a true copy of this motion to {name} _______________________ {address} ___________________________________________ by (hand delivery) (U.S. mail) (fax) on _____________________, 20_____. ________________________________________________ Signature of party providing notice
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IN THE CIRCUIT COURT OF THE FIFTH JUDICIAL CIRCUIT, COUNTY, FLORIDA IN AND FOR
, Former Husband or Petitioner, and , Former Wife or Respondent.
CASE NO.
NOTICE OF INTENT TO RELOCATE WITH CHILD(REN) I, {full legal name} _________________________________________________, give notice to {full legal name} __________________________________________________ of my intention to relocate the principal residence of the following child(ren): Name _______________________ _______________________ _______________________ Birth Date ________________ ________________ ________________ Current Address ________________________________ ________________________________ ________________________________
I am providing the following information required by section 61.13001(2), Florida Statutes:
1.
The location of the intended new residence, including the state, city, and physical address, if known, is: ____________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _______________________________________________________________________________ The mailing address of the new physical residence, if not the same as the physical address, is: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ The home telephone number of the intended new residence, if known, is: ___________________ The date of the intended move or proposed relocation is:_________________________________ a. The specific reasons for the proposed relocation of the child(ren) are: ____________________ ______________________________________________________________________________ ______________________________________________________________________________ _______________________________________________________________________________ Attach additional sheets if necessary.
2.
3. 4. 5.
1
b. One of the reasons for the proposed relocation is a job offer. [/one only] ( ) Yes ( ) No. The job offer is in writing. [/one only] ( ) Yes ( ) No. A copy of the written job offer is attached to this notice. 6. a. The proposed post-relocation schedule of visitation is as follows:________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Attach additional sheets if necessary. b. The proposed post-relocation transportation arrangements necessary to effectuate visitation with the child(ren) are as follows: _______________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Attach additional sheets if necessary. AN OBJECTION TO THE PROPOSED RELOCATION MUST BE MADE IN WRITING, FILED WITH THE COURT, AND SERVED ON THE PARENT OR OTHER PERSON SEEKING TO RELOCATE WITHIN 30 DAYS AFTER SERVICE OF NOTICE OF THIS INTENT TO RELOCATE. IF YOU FAIL TO TIMELY OBJECT TO THE RELOCATION, THE RELOCATION WILL BE ALLOWED WITHOUT FURTHER NOTICE AND WITHOUT A HEARING, UNLESS IT IS NOT IN THE BEST INTERESTS OF THE CHILD. 7. The mailing address of the parent seeking to relocate to whom the objection, if any, must be sent is listed below. Parent Seeking to Relocate: Name: _______________________________________________ Address: _____________________________________________ City, State, Zip: _______________________________________ Fax Number: __________________________________________ I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this Notice of Intent to Relocate and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Dated: ______________________________________________ Signature of Parent Seeking to Relocate Printed Name: __________________________________ Address: ______________________________________ City, State, Zip: ________________________________ Telephone Number: _____________________________ Fax Number: ___________________________________
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STATE OF FLORIDA COUNTY OF _____________ Sworn to (or affirmed) and subscribed before me on {date} _________________________, 20 ___ by {name} ______________________________. ______________________________________________ NOTARY PUBLIC -- STATE OF __________________ ______________________________________________ [Print, type, or stamp commissioned name of notary] [/one only] _____ Personally known _____ Produced identification Type of identification produced ___________________________
CERTIFICATE OF SERVICE I HEREBY CERTIFY that I furnished a true copy of this motion to {name} _______________________ {address} ___________________________________________ by (hand delivery) (U.S. mail) (fax) on _____________________, 20_____. ________________________________________________ Signature of party providing notice
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IN THE CIRCUIT COURT OF THE FIFTH JUDICIAL CIRCUIT, COUNTY, FLORIDA IN AND FOR
, Former Husband or Petitioner, and , Former Wife or Respondent.
CASE NO.
NOTICE OF INTENT TO RELOCATE WITH CHILD(REN) I, {full legal name} _________________________________________________, give notice to {full legal name} __________________________________________________ of my intention to relocate the principal residence of the following child(ren): Name _______________________ _______________________ _______________________ Birth Date ________________ ________________ ________________ Current Address ________________________________ ________________________________ ________________________________
I am providing the following information required by section 61.13001(2), Florida Statutes:
1.
The location of the intended new residence, including the state, city, and physical address, if known, is: ____________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _______________________________________________________________________________ The mailing address of the new physical residence, if not the same as the physical address, is: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ The home telephone number of the intended new residence, if known, is: ___________________ The date of the intended move or proposed relocation is:_________________________________ a. The specific reasons for the proposed relocation of the child(ren) are: ____________________ ______________________________________________________________________________ ______________________________________________________________________________ _______________________________________________________________________________ Attach additional sheets if necessary.
2.
3. 4. 5.
1
b. One of the reasons for the proposed relocation is a job offer. [/one only] ( ) Yes ( ) No. The job offer is in writing. [/one only] ( ) Yes ( ) No. A copy of the written job offer is attached to this notice. 6. a. The proposed post-relocation schedule of visitation is as follows:________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Attach additional sheets if necessary. b. The proposed post-relocation transportation arrangements necessary to effectuate visitation with the child(ren) are as follows: _______________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Attach additional sheets if necessary. AN OBJECTION TO THE PROPOSED RELOCATION MUST BE MADE IN WRITING, FILED WITH THE COURT, AND SERVED ON THE PARENT OR OTHER PERSON SEEKING TO RELOCATE WITHIN 30 DAYS AFTER SERVICE OF NOTICE OF THIS INTENT TO RELOCATE. IF YOU FAIL TO TIMELY OBJECT TO THE RELOCATION, THE RELOCATION WILL BE ALLOWED WITHOUT FURTHER NOTICE AND WITHOUT A HEARING, UNLESS IT IS NOT IN THE BEST INTERESTS OF THE CHILD. 7. The mailing address of the parent seeking to relocate to whom the objection, if any, must be sent is listed below. Parent Seeking to Relocate: Name: _______________________________________________ Address: _____________________________________________ City, State, Zip: _______________________________________ Fax Number: __________________________________________ I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this Notice of Intent to Relocate and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Dated: ______________________________________________ Signature of Parent Seeking to Relocate Printed Name: __________________________________ Address: ______________________________________ City, State, Zip: ________________________________ Telephone Number: _____________________________ Fax Number: ___________________________________
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STATE OF FLORIDA COUNTY OF _____________ Sworn to (or affirmed) and subscribed before me on {date} _________________________, 20 ___ by {name} ______________________________. ______________________________________________ NOTARY PUBLIC -- STATE OF __________________ ______________________________________________ [Print, type, or stamp commissioned name of notary] [/one only] _____ Personally known _____ Produced identification Type of identification produced ___________________________
CERTIFICATE OF SERVICE I HEREBY CERTIFY that I furnished a true copy of this motion to {name} _______________________ {address} ___________________________________________ by (hand delivery) (U.S. mail) (fax) on _____________________, 20_____. ________________________________________________ Signature of party providing notice
3