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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.943, MOTION TO DEVIATE FROM CHILD SUPPORT GUIDELINES (03/09)
When should this form be used?
Child support in Florida is determined by the child support guidelines found in section 61.30, Florida Statutes. The court, at its discretion, may raise or lower the child support guidelines amount by up to 5%. In addition, the court may raise or lower the guidelines support amount by more than 5%, if written reasons are given for the adjustment. The court may make these additional adjustments based on certain considerations, which are reflected in this form. You should review this form to determine if any of the reasons for adjusting the child support guidelines amount apply to your situation and you should complete this form only if you want the court to order more child support or less child support than the amount required by the child support guidelines. This form should be typed or printed in black ink. After completing this form, you should file the original with the clerk of the circuit court in the county where your case is filed and keep a copy for your records.

What should I do next?
A copy of this form must be mailed or hand delivered to the other party in your case.

Where can I look for more information?
Before proceeding, you should read General Information for Self-Represented Litigants found at the beginning of these forms. For further information, see section 61.30, Florida Statutes.

Special notes...
More information on the child support guidelines as well as a chart for converting income and expenses to monthly amounts if paid or incurred on other than a monthly basis is contained in the instructions to Florida Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c), and the Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e). With this form you must also file the following, if not already filed: Florida Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c). Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e). (If you do not know the other party's income, you should file this worksheet as soon as you receive a copy of his or her financial affidavit.)

Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out
Instructions for Florida Supreme Court Approved Family Law Form 12.943, Motion to Deviate from Child Support Guidelines (03/09)

these forms, that person must give you a copy of 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 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.

Instructions for Florida Supreme Court Approved Family Law Form 12.943, Motion to Deviate from Child Support Guidelines (03/09)

IN THE CIRCUIT COURT OF THE IN AND FOR

JUDICIAL CIRCUIT, COUNTY, FLORIDA Case No.: Division:

, Petitioner, and , Respondent.

MOTION TO DEVIATE FROM CHILD SUPPORT GUIDELINES
( ) Petitioner ( ) Respondent requests that the Court enter an order granting the following: SECTION I [one only] a. ___MORE child support than the amount required by the child support guidelines. The Court should order MORE child support than the amount required by the child support guidelines because of: [ all that apply to your situation] 1. ___Extraordinary medical, psychological, educational, or dental expenses; 2. ___Seasonal variations in one or both parent's income or expenses ; 3. ___Age(s) of the child(ren), taking into consideration the greater needs of older child(ren); 4. ___Special needs, such as costs that may be associated with the disability of a child or child(ren), that have traditionally been met within the family budget even though the fulfilling of those needs will cause support to exceed the presumptive amount established by the guidelines; 5. ___Total available assets of obligee, obligor, and the child(ren); 6. ___Impact of IRS dependency exemption and waiver of that exemption; 7. ___The Parenting Plan, such as where the child or children spend a significant amount of time, but less than 40 percent of the overnights, with one parent, thereby reducing the financial expenditures incurred by the other parent, or the refusal of a parent to become involved in the activities of the child(ren); 8. ___Any other adjustment that is needed to achieve an equitable result, which may include reasonable and necessary expenses or debts jointly incurred during the marriage. Explain any items marked above: ____________________________________________ . b. ___LESS child support than the amount required by the child support guidelines. The Court
Florida Supreme Court Approved Family Law Form 12.943, Motion to Deviate from Child Support Guidelines (03/09)

should order LESS child support than the amount required by the child support guidelines because of: [all that apply to your situation] 1. ___ Extraordinary medical, psychological, educational, or dental expenses; 2. ___Independent income of child(ren), excluding the child(ren)'s SSI (supplemental security income) 3. ___Payment of both child support and spousal support to a parent that regularly has been paid and for which there is a demonstrated need; 4. ___Seasonal variations in one or both parent's income or expenses; 5. ___Age of the child(ren), taking into consideration the greater needs of older child(ren); 6. ___ Total available assets of obligee, obligor, and child(ren); 7. ___ Impact of IRS dependency exemption and waiver of that exemption; 8. ___ Application of the child support guidelines which requires the obligor to pay more than 55% of gross income for a single support order; 9. ___ Residency of subsequently born or adopted child(ren) with the obligor, include consideration of the subsequent spouse's income; 10. ___ The Parenting Plan, where the child(ren) spend a significant amount of time, but less than 40 percent of the overnights, with one parent, thereby reducing the financial expenditures incurred by the other parent; or the refusal of a parent to become involved in the activities of the child(ren); 11. ___Any other adjustment that is needed to achieve an equitable result, which may include reasonable and necessary expenses or debts jointly incurred during the marriage. Explain any items marked above:___________________________ _________________ . SECTION II. INCOME AND ASSETS OF CHILD(REN) COMMON TO BOTH PARTIES List the total of any independent income or assets of the child(ren) common to both parties (income from Social Security, gifts, stocks/bonds, employment, trust fund(s), investment(s), etc.). Attach an explanation. TOTAL VALUE OF ASSETS OF CHILD(REN) TOTAL MONTHLY INCOME OF CHILD(REN) SECTION III. EXPENSES FOR CHILD(REN) COMMON TO BOTH PARTIES All amounts must be MONTHLY. See the instructions with this form to figure out money amounts for anything that is NOT paid monthly. Attach more paper, if needed. Items included under other should be listed separately with separate dollar amounts. 1. Monthly nursery, babysitting, or other child care 2. Monthly after-school care 3. Monthly school tuition 1. $ 2. $ 3. $ $ $

Florida Supreme Court Approved Family Law Form 12.943, Motion to Deviate from Child Support Guidelines (03/09)

4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22.

Monthly school supplies, books, and fees Monthly after-school activities Monthly lunch money Monthly private lessons/tutoring Monthly allowance Monthly clothing Monthly uniforms Monthly entertainment (movies, birthday parties, etc.) Monthly health and dental insurance premiums Monthly medical, dental, prescription charges (unreimbursed) Monthly psychiatric/psychological/counselor (unreimbursed) Monthly orthodontic (unreimbursed) Monthly grooming Monthly non-prescription medications/cosmetics/toiletries/sundries Monthly gifts from children to others (other children, relatives, teachers, etc.) Monthly camp or other summer activities Monthly clubs (Boy/Girl Scouts, etc.) or recreational fees Monthly visitation expenses (for nonresidential parent) Explain: ______________________________________________ Monthly insurance (life, etc.) {explain}: ______________________

4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18.

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $

19. $ 20. $ 21. $ 22. $

Other {explain}: 23. ____________________________________________________ 24. _____________________________________________________ 25. _____________________________________________________ 26. TOTAL EXPENSES FOR CHILD(REN) COMMON TO BOTH PARTIES (add lines 1 through 25)

23. $ 24. $ 25. $ 26. $ _______

I have filed, will file, or am filing with this form the following additional documents: 1. Florida Family Law Family Law Financial Affidavit, Florida Family Law Rules of Procedure Form 12.902(b) or (c). 2. Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e). I certify that a copy of this document was [one only] ( ) mailed ( ) faxed and mailed ( ) hand delivered to the person(s) listed below on {date} ____________________. Other party or his/her attorney: Name: Address: City, State, Zip: Fax Number:

Florida Supreme Court Approved Family Law Form 12.943, Motion to Deviate from Child Support Guidelines (03/09)

I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this motion and that the punishment for knowingly making a false statement 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: [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. , , ,

Florida Supreme Court Approved Family Law Form 12.943, Motion to Deviate from Child Support Guidelines (03/09)