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 ( ) 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: X ____ 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 Marital Settlement Agreement(s) filed in this proceeding was/were executed voluntarily after full disclosure and is/are approved and incorporated into this judgment by reference. The parties are ordered to comply therewith. American LegalNet, Inc. www.FormsWorkflow.com ____ 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 ( ) husband/father ( ) wife/mother will have visitation pursuant to ( ) the standard visitation schedule or as follows: ______________________________________________________________________________ ______________________________________________________________________________ ____ 5. Child support shall be paid by the non-custodial parent to the ( ) wife/mother ( ) husband/father for the support of the minor child(ren) pursuant to Florida child support guidelines in the amount of $ per . Payments will be ( ) paid directly to the custodial parent or ( ) paid through the Clerk of the Circuit Court, Domestic Relations Division, 2251 North Palafox Street, Pensacola, Florida, 32501. Payments that are made to the clerk’s office, shall include the appropriate clerk’s processing fee of 4%, not to be less than $1.00 nor greater than $5.25. The first payment is due on the day of , 200____, and shall continue as ordered until the youngest of the above named child(ren) marries, reaches majority or becomes self-supporting, whichever first occurs unless otherwise ordered by the court. Majority shall be defined as 18 years of age or graduation from high school, whichever occurs last, but not to exceed 19 years of age or ( )child support shall continue to be paid in accordance with the order entered on __________________________ in case number ____________________ or ( ) the Court reserves jurisdiction over the matter of child support. ____ 6. ( ) Health insurance ( ) Dental Insurance for the minor child(ren) shall be provided by ( ) wife ( ) husband. Medical and dental expenses not covered by insurance shall be divided equally between the parties or paid as follows:__________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ____ 7. The ( ) husband ( ) wife shall maintain a life insurance policy, to secure the child support obligation, naming the ( ) wife ( ) husband as the irrevocable beneficiary for the benefit of the minor child(ren). ____ 8. Alimony is awarded to the ( ) wife ( ) husband, in the amount of $_______________________ per . The first payment is due on the ______day of__________________, 200____ and will be ( ) paid directly to the recipient or ( ) paid to the office of the Clerk of the Circuit Court, Domestic Relations Division, 2251 North Palafox Street, Florida 32501. Payments to the clerk's office shall include the appropriate processing fee. The foregoing alimony award is ( ) temporary and shall be paid for a period of _____ months or until _________________, 200____. The foregoing alimony award is ( ) permanent and shall be paid as ordered above until American LegalNet, Inc. www.FormsWorkflow.com such time as the recipient remarries or dies, unless otherwise ordered by the court. ____ 9. The custodial parent/alimony recipient is entitled to an income deduction pursuant to Chapter 61, Florida Statutes. ____ 10. The non-custodial parent/payor is responsible for making child support and/or alimony payments directly to ( ) the Clerk’s office ( ) the custodial parent/alimony recipient as ordered above until and/or unless they see the deduction being made from their paycheck. 11. IT IS FURTHER ORDERED AS FOLLOWS: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 12. The Court reserves jurisdiction to enforce this final judgment. T h e w i f e ’ s c u r r e n t a d d r e s s is _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , a n d th e h u s b a n d ’s c u r r e n t a d d r e s s is _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . E a c h p a r ty is r e q u ir e d to k e e p th e C o u r t in fo r m e d o f a n y c h a n g e o f a d d r e s s b y filin g a w r itte n n o tic e w ith th e C le r k o f C o u r t, F a m ily L a w D iv is io n , a n d p r o v id in g a c o p y to th e o th e r p a r ty . E a c h p a r ty w ill b e d e e m e d to h a v e b e e n p r o p e r ly n o tic e d o f fu tu r e p r o c e e d in g s b y u s e o f th e a d d r e s s th a t w a s la s t p r o v id e d to th e C o u r t. 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