IN THE CIRCUIT COURT IN THE EIGHTEENTH JUDICIAL CIRCUIT IN AND FOR BREVARD COUNTY, FLORIDA. Case No.: __________________________________, Petitioner and Bar Code Label , Respondent ORDER OF DISMISSAL DUE TO RECONCILIATION The Court having been advised that the parties have RECONCILED, it is hereby: ORDERED AND ADJUDGED that the case is dismissed without prejudice. DONE AND ORDERED in Brevard County, Florida, on {date}____________________, 20____. ____________________________________ Circuit Judge Cc: Petitioner or their attorney (if represented) Respondent or their attorney (if represented) Name_____________________________ Name______________________________ Address___________________________ Address____________________________ _________________________________ City State Zip ___________________________________ City State Zip Telephone No:________________________ Telephone No:________________________ Other: Name:______________________________ Address:____________________________ ___________________________________ City State Zip Telephone No:________________________ Law 1080 - Rev. 10/2005 American LegalNet, Inc. www.FormsWorkflow.com ORDER OF DISMISSAL DUE TO RECONCILIATION Page 2 Case No.________________________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [! fill in all blanks] I, {full legal name and trade name of nonlawyer} _____________________________________, a nonlawyer, located at {street} ______________________________, {city}______________________, {state}______________, {phone}_______________, helped {Petitioner’s name} __________________, _____________________________________________, who is the [v one only] _____petitioner or _____ respondent, fill out this form. Law 1080 - Rev. 10/2005 American LegalNet, Inc. www.FormsWorkflow.com