WPC RCa RadyWö$n!Ƭ)ߧa7X>aP9[=2JR,VGP>>Ըr+X*5- 7ۼݤ+fdYmmBE %oIE2vF0 WMӊ·}x# (I#e6)^(U+W݌KFUtxl0HQS0jσX,Xz{1Ӏw[=2 Y]   Child(ren)smedical/dental  $( L)$@   Life   `  $( r*%B   Other: `    $( +&D Ї E. = OTHEREXPENSESNOTLISTEDABOVE  R D  = Clothing     x $(#(#K(# x F Medical/Dental(uninsured) x $(#(#K(#  H  = Grooming     x $(#(#K(#  J  = Entertainment   x $(#(#K(# : L  = Gifts     x $(#(#K(# ` N  = Church/Charities   x $(#(#K(# 6 P  = Miscellaneous   x $(#(#K(# \R  = Other:     x $(#(#K(# T  =  p      x $(#(#K(# V #X;X GD# XX; =  p      x $(#(#K(# X #X;X J# XX; =  p      x $(#(#K(# DZ #X;X ϸK# XX; =  p      x $(#(#K(# j\ #X;X uL# XX; =  p      x $(#(#K(# @^ #X;X 2M# XX; =  p      x $(#(#K(# f` #X;X M# XX; F. = PAYMENTSTOCREDITORS #X;X ϬN#CVXX; D(#MONTHLY#X;XCVO#Ԉ d CVXX; = CREDITOR:#X;XCVO# XX; D(##X;X O#CVXX;PAYMENT#X;XCV4P#Ԉ (f  XX; =  p      x $(#(#K(# Nh #X;X ϓP# XX; =  p      x $(#(#K(# $!tj #X;X PQ# XX; =  p      x $(#(#K(# J"l #X;X  R# XX; =  p      x $(#(#K(# p#n #X;X R# XX; =  p      x $(#(#K(# $p #X;X χS# XX; =  p      x $(#(#K(# % !r #X;X DT# XX; =  p      x $(#(#K(# &2"t #X;X U# XX; =  p      x $(#(#K(# (X#v #X;X ϾU# XX; =  p      x $(#(#K(# .)~$x #X;X {V# XX; =  p      x $(#(#K(# T*%z #X;X 8W# XX; =  p      x $(#(#K(##X;X W# XX;  `     z+&|  z+&|  z+&|  z+&|   z+&| (X( 28.  TOTALMONTHLYEXPENSES  h (add ALL monthlyamountsinAthroughFabove) x $(#(#K(#   #X;X ϜX#  XX;M @SUMMARYOM#X;X [Z# XX; R 29.  TOTALPRESENTMONTHLYNETINCOME     q  q  q   q (r(#(#(  (fromline27ofSECTIONI.INCOME)  0  30.  TOTALMONTHLYEXPENSES (fromline28above) O    31.  SURPLUS (Ifline29ismorethanline30,subtractline30fromline29.      Thisistheamountofyoursurplus.Enterthatamounthere.) 32.  (DEFICIT) (Ifline30ismorethanline29,subtractline29fromline30.     Thisistheamountofyourdeficit.Enterthatamounthere.)#X;X Z# XX; #s  R 29.$!!G!  0 30.$!!G! O  31.$!!G! -}  #X;X &^# XX;32.($y!y!F! )#X;X <_#%%XX;PO؈  [   @Z(r(#X;X%%_# XX;' XFXkX' SECTIONIII:ASSETSANDLIABILITIES  w #X;X U`# @*hXXB''XX*XX;Usethenonmaritalcolumnonlyifthisisapetitionfordissolutionofmarriageandyoubelieveanitemis nonmarital,meaning  itbelongstoonlyoneofyouandshouldnotbedivided. Youshouldindicatetowhomyoubelievetheitem(s)ordebtbelongs.   (Typically,youwillonlyusethiscolumnifproperty/debtwasowned/owedbyonespousebeforethemarriage.Seetheinstructionswiththisformandsection61.075(1),FloridaStatutes,fordefinitionsof maritaland nonmaritalassetsandliabilities.)#X;X"@99 @; E996#K?"@ 6 999 6E#X;X# XX;#X;X "#XX; 799(E@99 @7 799(EA@99 @7 ;999(EB"@99 @; E996#EC"@ 6 999 6E#X;Xi# XX;#X;X ϙ#XX; 799(?D99 @7 799(?E@99 @7 ;999(?F"@99 @;#X;X#XX; E996#?G"@ 6 999 6E#X;X˃# XX;#X;X R#XX; 799(9H99 @7 799(9I@99 @7 ;999(9J"@99 @;#X;X̘#XX; E996#9K"@ 6 999 6E#X;X̃# XX;#X;X  #XX; 799(3L99 @7 799(3M@99 @7 ;999(3N"@99 @; J99;#3O"@ 6 999 6J#X;XP# XX;#X;X υ#XX;Ԁ#X;Xˇ# XX;Ԁhereifadditionalpagesareattached.#X;X #XX; 799(-}P99 @7 799(-}Q@99 @7 ;999(-}R"@99 @;#X;X}#XX; U9992@(-}S"@ 6  999 6U#X;Xh# XX; TotalAssets (addcolumnB) =9992('wT9992 =$?#X;X #XX;Ԉ 9999('wU9992 @9 ;9999('wV"@999 @;8.,'wW"@ 6  9999 8 'e'd #X;X̺# ?W &    XX;B.LIABILITIES:   *9 dd66 F6 ""FF"9(#(#,66 ,F6 ,"",FF"+  #X;X #YXX; ;9992& & x;-YY%%Y%%%%%%%%%%  <<*X $R%''XhXXB''X<  -  DESCRIPTIONOFITEM(S).Listadescriptionofeachseparatedebtowedbyyou N (and/oryourspouse,ifthisisapetitionfordissolutionofmarriage).-݌̌YYYYYYY  <hXXB''X<*X $R%''X<  k% X;XYX%! XX;!theboxnexttoanydebt(s)forwhichyoubelieveyoushouldberesponsible.#X;XՐ# XX;  p  ^  ^  ^   ^  R9992=.f  **9992 R#X;X j#YXX;CurrentAmountOwed R9992=.f"ll9992 RNonmarital N (correctcolumn)#X;XY# XX; \9992G+2" x  9992 <\ 799(P9992 7 99992$P99 9#X;X ]#CVXX;husband#X;XCVk# XX; =99992(<"9992 =#X;X ϴ#CVXX;wife#X;XCV3# XX; O99@(<" <  99992 fFOMortgagesonrealestate 799(< 99 7$ 799(< 99 7 ;999(< "99 ; J99;(< " F f 999 6JAutoloans 799(6 99 @7 799(6 @99 @7 ;999(6 "@99 @; E996#6 "@ 6 999 6E 799(0 99 @7 799(0 @99 @7 ;999(0 "@99 @; E996#0 "@ 6 999 6ECharge/creditcardaccounts =9,* z 99 = N999=.* z!9}}L9 N P999=.* z""9}}999 P V99G4* z#"9}} 6 999 6V 999($ t$99 9 799($ t%99 7 ;999($ t&"99 ; E996#$ t'" 6 999 6E 799(n (99 @7 799(n )@99 @7 ;999(n *"@99 @; E996#n +"@ 6 999 6E 799(h ,99 @7 799(h -@99 @7 ;999(h ."@99 @; E996#h /"@ 6 999 6EOther 799(b 099 @7 799(b 1@99 @7 ;999(b 2"@99 @; E996#b 3"@ 6 999 6E#X;X y#XX; 799( \ 499 @7 799( \ 5@99 @7 ;999( \ 6"@99 @; E996# \ 7"@ 6 999 6E#X;X0# XX;#X;X `#XX; 799(V 899 @7 799(V 9@99 @7 ;999(V :"@99 @; E996#V ;"@ 6 999 6E#X;X̧# XX;#X;X נ#XX; 799(P<99 @7 799(P=@99 @7 ;999(P>"@99 @; E996#P?"@ 6 999 6E#X;X# XX;#X;X N#XX; 799(J@99 @7 799(JA@99 @7 ;999(JB"@99 @; E996#JC"@ 6 999 6E#X;X̕# XX;#X;X ţ#%%XX; 799(DD99 @7 799(DE@99 @7 ;999(DF"@99 @; E996#DG"@ 6 999 6E#X;X%% # XX;#X;X <#%%XX; 799(RH99 @7 799(RI@99 @7 ;999(RJ"@99 @; E996#RK"@ 6 999 6Ehereifadditionalpagesareattached. 799(`L99 @7 799(`M@99 @7 ;999(`N"@99 @; P992;#`O"@ 6 999 6P TotalDebts (addcolumnB) =992(nP992 =$? 799(nQ992 @7 ;999(nR"@99 @;8.,nS"@ 6  999 8'ދ<XX<X5%'XhXXB''X<&  #X;X%%# XX;C.CONTINGENTASSETSANDLIABILITIES#X;X _#  >U XX;INSTRUCTIONS:Ifyouhaveany POSSIBLE assets (incomepotential,accruedvacationorsickleave,bonus,inheritance,etc.)or dW  POSSIBLEliabilities (possiblelawsuits,futureunpaidtaxes,debtsassumedbyanother),youmustlistthemhere.#X;Xީ#%%XX; rY *9% dd66 F6 ""FF"9(#(#,66 ,F6 ,"",FF"+  ;9992& [ F;#X;X%%6#YXX;ContingentAssets \ #X;XY¬#%%XX;  Ӏ#X;X%%+#YXX;theboxnexttoanycontingentasset(s)whichyouarerequestingthejudgeawardtoyou.#X;XY~#%%XX; R992=.`ssK9992 R#X;X%%#CVXX;PossibleValue R9992=.c"_992 RNonmarital d (correctcolumn)#X;XCV#%%XX; \9992G+f" F  9992 <\ 799(Bf9992 7#X;X%%#CVXX; 99992$Bf99 9husband =99992(~g"9992 =wife#X;XCVX#%%XX; O99@(~h" <  99992 fFO 799(~ i99 7$ 799(~ j99 7 ;999(~ k"99 ; J99;(~ l" F f 999 6J 799(!m99 @7 799(!n@99 @7 ;999(!o"@99 @; E996#!p"@ 6 999 6E#X;X%%# XX;TotalContingentAssets#X;X ϖ#%%XX; 799("q99 7$#X;X%%#? 799("r99 @7 ;999("s"@99 @;3)'"t"@ 6  999 3' >-& ) *&9? dd66 F6 ""FF"9%(#(#,66 ,F6 ,"",FF"+  ;9992& $8 v F;YXX;ContingentLiabilities .%~ w #X;XY}#%%XX;  #X;X%%#YXX;theboxnexttoanycontingentdebt(s)forwhichyoubelieveyoushouldberesponsible.#X;XY=#YXX; V'"{  R992=.~)$'9992 RPossibleAmountOwed#X;XYַ#YXX; R9992=.&F""SS'992 RNonmarital .%~  (correctcolumn) \9992G+&b!" F  9992 <\ 799('"9992 7#X;XY#YXX; 99992$'"99 9husband =99992(' #"9992 =wife#X;XY#%%XX; O99@(' #" <  99992 fFO 799(( $99 7$ 799(( $99 7 ;999(( $"99 ; J99;(( $" F f 999 6J 799()%99 @7 799()%@99 @7 ;999()%"@99 @; E996#)%"@ 6 999 6E#X;X%%# XX;TotalContingentLiabilities#X;X .#%%XX; 799(*'&99 7$? 799(*'&99 @7 ;999(*'&"@99 @;3)'*'&"@ 6  999 3#X;X%%#')$<  +& %%XX;SECTIONIV:CHILDSUPPORTGUIDELINESWORKSHEET   #X;X%%# XX;Ԁ(.rFloridaFamilyLawForm12.901(g),ChildSupportGuidelinesWorksheet,MUSTbefiledinallcasesinwhichthe D partieshaveaminorchildincommon,INCLUDINGmodificationsofchildsupport.)#X;X y#%%XX; j [ one only] @ 򀀀0  AChildSupportGuidelinesWorksheetISbeingfiledinthiscase. Thepartieshaveoneormore   minorchildrenincommon or oneofthepartiesisrequestingamodificationofapreviouscourtorder  $  regardingchildsupport. (#(# 򀀀0  AChildSupportGuidelinesWorksheetISNOTbeingfiledinthiscase. Therearenominorchildren b  commontothepartiesinthiscase or ,ifthiscaseinvolvesamodificationofapreviouscourtorder,child   supportisnotanissue. (#(# & &   Icertifythatacopyofthisdocumentwas[oneonly]()mailed()faxedandmailed()hand ~  deliveredtotheperson(s)listedbelowon{date}""J(#.   Otherpartyorhis/herattorney : J Name:   `   <       Address: `   <      (  City,State,Zip:  <      l" FaxNumber: `   <     '& ~#X;X%%# XX; `$   & & R#     #X;X l#%%XX;IunderstandthatIamswearingoraffirmingunderoathtothetruthfulnessoftheclaimsmade  inthisaffidavitandthatthepunishmentforknowinglymakingafalsestatementincludesfinesand/orimprisonment.  8 Dated:򀀀      `   < 0    (#(#K(#(#(#  T     `   < 0  SignatureofParty (#(#    `   < 0  PrintedName:(#(#K(#(#(#      `   < 0  Address:(#(#K(#(#(#      `   < 0  City,State,Zip:(#(#K(#(#(# d     `   < 0  TelephoneNumber:(#(#K(#(#(# X     `   < 0  FaxNumber:(#(#K(#(#(#   STATEOFFLORIDACOUNTYOF򀀀 $t Sworntooraffirmedandsignedbeforemeon     p by""J(#.     `   <   0  (#(#K(#(#(# x$    `   <   0  NOTARYPUBLIC"STATEOFFLORIDA (#(#    `   <   0  (#(#K(#(#(# D*    `   <   0  #X;X%%# XX;[Print,type,orstampcommissionednameofnotary.] ,(#(# #X;X ϻ#%%XX;򀀀0  Personallyknown6$2(#(# 򀀀0  Producedidentificationz% 4(#(#    Typeofidentificationproduced򀀀'R# &"6 &    IFANONLAWYERHELPEDYOUFILLOUTTHISFORM,HE/SHEMUSTFILLINTHEBLANKS  BELOW: [-fillin all blanks] D I,{fulllegalnameandtradenameofnonlawyer}""J(#, > anonlawyer,locatedat{street} <      p   ,{city}""J(#,  {state}   `  ,{phone} <     ,helped{name}""J(#,   whoisthe[ one only]򁁁petitioner or 򁁁respondent,filloutthisform.'#X;X%%P#  Z