Lee County, Florida Special Interrogatories for Dissolution of Marriage Cases Download Fillable PDF

IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT, IN AND FOR

LEE COUNTY, FLORIDA

CIVIL DIVISION

Petitioner

No: ___________________________

Case

vs.

Respondent

SPECIAL INTERROGATORIES FOR DISSOLUTION OF MARRIAGE CASES

NOTE: You must answer every question correctly, either by typing or printing legibly in ink. If a

question does not apply to your case, write “N/A” in the blank or select “NO”.

STATE OF FLORIDA COUNTY OF LEE

I, the undersigned, under oath and under penalty of perjury, swear or affirm as follows:

1. (a) List your full legal name __________________________________________________________

(b) List the name of the person you are married to _________________________________________

(d) List the date you were married _____________________________________________________

2. If everything said in the Petition for Dissolution of Marriage is true and correct to the best of your

knowledge, state that below. If there is anything you need to correct in your Petition, briefly state the

corrections below.

Everything is true and correct

Petition needs corrections listed below:

_________________________________________________________________________________

3. Are you or your spouse a member of the armed forces?

Yes

4. (a) Your Petition for Dissolution of Marriage was filed on __________________________________.

(Date)

(b) Have either you or your spouse resided in the State of Florida continuously as a permanent

resident for more than six months before the date the petition was filed?

Yes

Husband

Wife

Both

5. (a) “Irretrievably broken” means that the marriage cannot be put back together or salvaged in any

way, not even with the help of marriage counseling. Is your marriage irretrievably broken?

Yes

Rev. 1/20/15

IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT, IN AND FOR

LEE COUNTY, FLORIDA

CIVIL DIVISION

Petitioner

No: ___________________________

Case

vs.

Respondent

SPECIAL INTERROGATORIES FOR DISSOLUTION OF MARRIAGE CASES

NOTE: You must answer every question correctly, either by typing or printing legibly in ink. If a

question does not apply to your case, write “N/A” in the blank or select “NO”.

STATE OF FLORIDA COUNTY OF LEE

I, the undersigned, under oath and under penalty of perjury, swear or affirm as follows:

1. (a) List your full legal name __________________________________________________________

(b) List the name of the person you are married to _________________________________________

(d) List the date you were married _____________________________________________________

2. If everything said in the Petition for Dissolution of Marriage is true and correct to the best of your

knowledge, state that below. If there is anything you need to correct in your Petition, briefly state the

corrections below.

Everything is true and correct

Petition needs corrections listed below:

_________________________________________________________________________________

3. Are you or your spouse a member of the armed forces?

Yes

4. (a) Your Petition for Dissolution of Marriage was filed on __________________________________.

(Date)

(b) Have either you or your spouse resided in the State of Florida continuously as a permanent

resident for more than six months before the date the petition was filed?

Yes

Husband

Wife

Both

5. (a) “Irretrievably broken” means that the marriage cannot be put back together or salvaged in any

way, not even with the help of marriage counseling. Is your marriage irretrievably broken?

Yes

Rev. 1/20/15

(b) State very briefly why your marriage is irretrievably broken:

_________________________________________________________________________________

6. (a) Are there children born of this marriage who are still minors (under 18)?

Yes

(b) If so, state their full names and dates of birth.

Name

Date of Birth

_________________________________________________

__________________

_________________________________________________

__________________

_________________________________________________

__________________

_________________________________________________

__________________

Yes

7. (a) Have both you and your spouse signed a written agreement settling all issues in this case?

Yes

(b) Do you recognize both your signature and the signature of your spouse on that agreement?

Yes

8. (a) Do you believe the agreement is fair?

Yes

(b) Have both of you fully disclosed all assets, liabilities, and incomes to each other?

Yes

(d) Do you want the judge to adopt the agreement as a part of the Final Judgment?

Yes

9. Is the Wife asking the court to restore her prior name or maiden name?

Yes

(The court can only restore a legal name the wife once had, either by birth or marriage. The court

cannot grant a new name the wife has never had before.)

If so, state the full restored name desired:______________________________________________

(Print the Full Name Requested)

Rev. 1/20/15

10. If there is anything you believe the court ought to know that has not been covered above, briefly state

it below.

Everything is true and correct

Court should know the following:

_________________________________________________________________________________

11. I hereby waive my right to a trial, the filing of a Notice for Trial, entry of a Trial Order, and all time

periods and waiting periods required by law in connection with my Petition for Dissolution of

Marriage filed ______________ (date of filing), and request that a copy of the Final Judgment of

Dissolution of Marriage entered in this case be provided to me at the address provided below.

NOTE: You must show separate proof that you have been a permanent and continuous resident of the

State of Florida for at least six months before the date of filing for divorce. You may do this in one of two

ways:

1. Submitting an enlarged, readable photocopy of either your driver’s licenses or voter’s registration

card. Remember, the date of issue must prove your residency. If it does not, you have failed to prove

residency and your case will be held up until proper proof is received; OR

2. Submitting an Affidavit from a witness who can prove your residency. The witness must be an adult

who is a Florida resident.

______________________________________________________

______________________

Petitioner’s Signature

Date

________________________________________ Address Line 1

________________________________________ Address Line 2

________________________________________ Address Line 3

STATE OF FLORIDA

COUNTY OF LEE

Sworn to or affirmed and signed before me on _______________ by______________________________________.

_______________________________________

NOTARY PUBLIC or DEPUTY CLERK

[Print, Type, or Stamp commissioned name of notary or clerk]

_____Personally Known

_____Produced Identification

Type of ID Produced________________________________

Rev. 1/20/15

"Special Interrogatories for Dissolution of Marriage Cases" - Lee County, Florida

Download "Special Interrogatories for Dissolution of Marriage Cases" - Lee County, Florida

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