Form 12.970(D) "Waiver of Service of Process and Consent for Concurrent Custody by Extended Family" - Florida

What Is Form 12.970(D)?

This is a legal form that was released by the Florida Circuit Court - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2021;
  • The latest edition provided by the Florida Circuit Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 12.970(D) by clicking the link below or browse more documents and templates provided by the Florida Circuit Court.

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Download Form 12.970(D) "Waiver of Service of Process and Consent for Concurrent Custody by Extended Family" - Florida

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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY
LAW FORM 12.970(d),
WAIVER OF SERVICE OF PROCESS AND CONSENT FOR CONCURRENT
CUSTODY BY EXTENDED FAMILY
(06/21)
This form is to be completed and signed by a parent who agrees to grant concurrent custody of a minor child
or child(ren) to an extended family member and who agrees to waive service of process. Service of process
occurs when a summons and a copy of the petition (or other pleading) that has been filed with the court are
delivered by a deputy or private process server. “Concurrent custody” means that an eligible extended family
member is awarded custodial rights to care for a child or children concurrently with the child(ren)’s parent
or parents.
An Extended Family Member is:
A relative of a minor child within the third degree by blood or marriage to the parent;
OR
The stepparent of a minor child if the stepparent is currently married to the parent of the child and is not a
party in a pending dissolution, separate maintenance, domestic violence, or other civil or criminal
proceeding in any court of competent jurisdiction involving one or both of the child(ren)’s parents as an
adverse party;
OR
An individual who qualifies as “fictive kin.” As defined in section 39.01, Florida Statutes, fictive kin means a
person unrelated by birth, marriage, or adoption who has an emotionally significant relationship, which
possesses the characteristics of a family relationship, to a child.
This form should be typed or printed in black ink. After completing this form, you should sign the form before
a notary public or deputy clerk. You should file the original with the clerk of the circuit court in the county
where the Petition for Concurrent Custody by Extended Family, Florida Supreme Court Approved Family Law
Form 12.970(b) is filed and keep a copy for yourrecords.
IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of General Practice and Judicial Administration now require that all petitions, pleadings,
and documents be filed electronically except in certain circumstances. Self-represented litigants may file
petitions or other pleadings or documents electronically; however, they are not required to do so. If you
choose to file your pleadings or other documents electronically, you must do so in accordance with Florida
Rule of General Practice and Judicial Administration 2.525, and you must follow the procedures of the judicial
circuit in which you file. The rules and procedures should be carefully read and followed.
Special notes…
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these
forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of
Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms must
also put his or her name, address, and telephone number on the bottom of the last page of every form he
or she helps you complete.
Instructions for Florida Supreme Court Approved Family Law Form 12.970(d), Waiver of Service of Process and
Consent for Concurrent Custody by Extended Family (06/21)
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY
LAW FORM 12.970(d),
WAIVER OF SERVICE OF PROCESS AND CONSENT FOR CONCURRENT
CUSTODY BY EXTENDED FAMILY
(06/21)
This form is to be completed and signed by a parent who agrees to grant concurrent custody of a minor child
or child(ren) to an extended family member and who agrees to waive service of process. Service of process
occurs when a summons and a copy of the petition (or other pleading) that has been filed with the court are
delivered by a deputy or private process server. “Concurrent custody” means that an eligible extended family
member is awarded custodial rights to care for a child or children concurrently with the child(ren)’s parent
or parents.
An Extended Family Member is:
A relative of a minor child within the third degree by blood or marriage to the parent;
OR
The stepparent of a minor child if the stepparent is currently married to the parent of the child and is not a
party in a pending dissolution, separate maintenance, domestic violence, or other civil or criminal
proceeding in any court of competent jurisdiction involving one or both of the child(ren)’s parents as an
adverse party;
OR
An individual who qualifies as “fictive kin.” As defined in section 39.01, Florida Statutes, fictive kin means a
person unrelated by birth, marriage, or adoption who has an emotionally significant relationship, which
possesses the characteristics of a family relationship, to a child.
This form should be typed or printed in black ink. After completing this form, you should sign the form before
a notary public or deputy clerk. You should file the original with the clerk of the circuit court in the county
where the Petition for Concurrent Custody by Extended Family, Florida Supreme Court Approved Family Law
Form 12.970(b) is filed and keep a copy for yourrecords.
IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of General Practice and Judicial Administration now require that all petitions, pleadings,
and documents be filed electronically except in certain circumstances. Self-represented litigants may file
petitions or other pleadings or documents electronically; however, they are not required to do so. If you
choose to file your pleadings or other documents electronically, you must do so in accordance with Florida
Rule of General Practice and Judicial Administration 2.525, and you must follow the procedures of the judicial
circuit in which you file. The rules and procedures should be carefully read and followed.
Special notes…
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these
forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of
Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms must
also put his or her name, address, and telephone number on the bottom of the last page of every form he
or she helps you complete.
Instructions for Florida Supreme Court Approved Family Law Form 12.970(d), Waiver of Service of Process and
Consent for Concurrent Custody by Extended Family (06/21)
IN THE CIRCUIT COURT OF THE _______________ JUDICIAL CIRCUIT,
IN AND FOR _______________________________ COUNTY, FLORIDA
Case No: _______________________
IN RE: THE INTEREST OF
Division: _______________________
_________________________________
Children
__________________________________,
Petitioner,
and
__________________________________,
Respondent/_______________________,
__________________________________,
Respondent/_______________________.
WAIVER OF SERVICE OF PROCESS AND CONSENT FOR CONCURRENT
CUSTODY BY EXTENDED FAMILY
I, {full legal name}
, the legal parent of {children’s names}
, having received a copy of the Petition for
Concurrent Custody by Extended Family filed herein and waived service of process, freely and voluntarily
consent to the Petition filed by {Petitioner’s Name}
.
I realize that by signing this document, I am consenting to the Petitioner having temporary concurrent
custody of the minor children and that such concurrent custody is in the best interest of the children.
Upon entry of an Order, the Petitioner shall be able to:
1. Consent to all necessary and reasonable medical and dental care for the children, including
nonemergency surgery and psychiatric care;
2. Secure copies of the child(ren)’s records, held by third parties, that are necessaryfor the care of
the children, including, but not limited to:
a. Medical, dental, and psychiatric records;
b. Birth Certificates and other records; and
c. Educational records.
3. Enroll the children in school and grant or withhold consent for the children to be tested or placed
in special school programs, including exceptional education; and
4. Do all other things necessary for the care of the children.
Instructions for Florida Supreme Court Approved Family Law Form 12.970(d), Waiver of Service of Process and
Consent for Concurrent Custody by Extended Family (06/21)
I realize that the concurrent custody of my children by the Petitioner is temporary and that I may, at any
time, petition the court to terminate the order granting concurrent custody. I understand and
acknowledge that I may have to comply with a reasonable transition plan prior to the court returning full
custody to me.
Dated:
Signature of Parent
Printed Name:
Address:
City, State, Zip Code:
Telephone Number:
Fax Number:
Designated E-mail Address(es):
STATE OF FLORIDA
COUNTY OF __________________________
Sworn to or affirmed and signed before me by means of {choose one} _____ physical presence or
_____ online notarization on _____________________ by {name of person making statement}
__________________________________.
_________________________________________
NOTARY PUBLIC OR DEPUTY CLERK
_________________________________________
{Print, type, or stamp commissioned name of notary or
deputy clerk.}
____ Personally known
____ Produced identification
Type of identification produced _________________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:
[fill in all blanks] This form was prepared for the {choose only one} _____ Petitioner _____ Respondent.
This form was completed with the assistance of:
{name of individual} ____________________________________________________________________,
{name of business} _____________________________________________________________________,
{address} ____________________________________________________________________________,
{city} _________________, {state} _____, {zip code} __________, {telephone number} ______________.
Instructions for Florida Supreme Court Approved Family Law Form 12.970(d), Waiver of Service of Process and
Consent for Concurrent Custody by Extended Family (06/21)
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