Notice of Social Security Number Form

The Notice of Social Security Number is a form that has to be used for providing the court with the social security numbers for the family members.

Extracted Text for Proper Search

Instructions for Florida Supreme Court Approved Family Law Form 12.902(\
j),  Notice of Social Security Number (9/00) 	
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM12.902(j),
NOTICE OF SOCIAL SECURITY NUMBER
When should this form be used?
This form  must be completed and filed by each party in all  paternity	
, child support	, and  dissolution of	
marriage	 cases, regardless of whether the case involves a minor child(ren) and\
/or property.  
This  form should be typed or printed in black ink.  After completing this fo\
rm, you should  file	
 the original with
the  clerk of the circuit court	
 in the county where your case was filed and keep a copy for your record\
s.
What should I do next?
A copy of this form must be mailed  or hand delivered to the other party in your case, if it is not  served	
 on
him or her with your initial papers.
Where can I look for more information?
Before  proceeding, you should read “General Information for Self-Represente\
d Litigants” found
at  the beginning of these forms.   The words that are in  “bold  underline	
” in these instructions are defined
there.  For further information, see sections 61.052 and 61.13, Florida \
Statutes.
Special notes...
If  this is a domestic violence case and you want to keep your address conf\
idential for safety
reasons, do not enter the address, telephone, and fax information at the\
 bottom of this form. 
Instead, file  Petitioner’s Request for Confidential Filing of Address ,  O’  Florida Supreme Court
Approved Family Law Form 12.980(i). 
Remember, a person who is NOT an attorney is called a nonlawyer. If a no\
nlawyer helps you fill out these 
forms,  that person must give you a copy of a  Disclosure from Nonlawyer, O‘  Florida Family Law Rules
of Procedure Form 12.900(a), before he or she  helps you.  A nonlawyer helping you fill out these forms also
must  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.

Florida Supreme Court Approved Family Law Form 12.902(j),  Notice of S\
ocial Security Number (9/00)	
IN THE CIRCUIT COURT OF THE                                                      	 JUDICIAL CIRCUIT,
IN AND FOR                                                        	
  COUNTY, FLORIDA
Case No.: 	
Division:  	
                                                                      	 ,
Petitioner,
and
                                                                       
 ,
Respondent.
NOTICE OF SOCIAL SECURITY NUMBER
I,  {full legal name}  	
,
certify that my  social security number is 	
, as required in section
61.052(7),  sections 61.13(9) or (10), section 742.031(3), sections 742.032(\
1)–(3), and/or sections
742.10(1)–(2), Florida Statutes.  My date of birth is 	
.
[ /  one  only]	
1.This  notice is being filed in a dissolution of marriage case in which the pa\
rties have  no minor
children in common.
2. This  notice is being  filed  in a paternity or child support case, or in a dissolution of marriage i\
n
which  the parties have minor children in common.  The minor child(ren)'s na\
me(s), date(s) of
birth, and social security number(s) is/are:
Name Birth date      Social Security Number
                            	
      	
                            	      	
                            	      	
                            	      	
                            	      	
                            	      	
                            	      	
                            	      	
{Attach additional pages if necessary.} 
Disclosure  of social security numbers shall be limited  to the purpose of administration of the Title IV-D
program for child support enforcement.

Florida Supreme Court Approved Family Law Form 12.902(j),  Notice of S\
ocial Security Number (9/00)
I understand that I am swearing or affirming under oath to the truthfulness of the claims m\
ade in
this notice and that the punishment for knowingly making a false stateme\
nt includes fines  and/or
imprisonment. 
Dated:  	
Signature
Printed Name: 
Address:	  	
City, State, Zip:	  	
Telephone Number:	  	
Fax Number: 	
 STATE OF FLORIDA 
COUNTY OF ________ 
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 identification produced                                                	
 
IF  A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE
BLANKS BELOW:  [ N fill in  all blanks]
I,  {full legal name and trade name of nonlawyer}	
,
a nonlawyer, located at  {street} 	
, {city}  	,
{state}  	
, {phone}  	, helped {name} 	,
who is the [  / one  only]       	
 petitioner  or      	 respondent, fill out this form.