IN THE CIRCUIT COURT OF THE FIRST JUDICIAL CIRCUIT IN AND FOR ESCAMBIA COUNTY, FLORIDA IN RE: The Marriage of Case No.: 200___ DR________ ____________________________, Petitioner Division: “ ” and ____________________________, Respondent FINAL JUDGMENT OF DISSOLUTION OF MARRIAGE This cause came before this Court on a Petition for Dissolution of Marriage. Upon consideration thereof and based upon the evidence presented, the Court finds it has limited jurisdiction over the persons and subject matter, and that the marriage is irretrievably broken. The following children were born of the marriage: NAME ________________________________________________ ________________________________________________ ________________________________________________ DATE OF BIRTH _____________________ _____________________ _____________________ It is hereby ORDERED AND ADJUDGED as follows: 1. The bonds of marriage between the parties are dissolved. 2. The wife’s former/maiden name is restored and she shall hereafter be known as ____________________________________________________________________________________ 3. The debts of the marriage are distributed as follows:________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ The assets of the marriage are distributed as follows:_______________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 4. ( ) The parties shall have Shared Parental Responsibility of the above minor child(ren), or ( ) the petitioner shall have Sole Parental Responsibility of the above minor child(ren), with the( ) husband/father ( ) wife/mother designated as primary residential custodial parent. The Court reserves jurisdiction over the matter of visitation. 5. The Court reserves jurisdiction over child support, health care, dental care, life insurance, and/or any American LegalNet, Inc. www.FormsWorkflow.com other matters related to the care and support of the minor child(ren) of this divorce. 6. IT IS FURTHER ORDERED AS FOLLOWS:__________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 7. The Court reserves jurisdiction to enforce this final judgment. DONE AND ORDERED at Pensacola, Escambia County, Florida, this ____ day of ________________________________, 20______. __________________________________ CIRCUIT JUDGE Copies furnished to: Petitioner Respondent Clerk of Domestic Relations Division American LegalNet, Inc. www.FormsWorkflow.com