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INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.910(b), PROCESS SERVICE MEMORANDUM
When should this form be used?

You should use this form to give the sheriff's department (or private process server) instructions for serving the other party in your case with the Summons: Personal Service on an Individual, O' Florida Family Law Rules of Procedure Form 12.910(a), and other papers to be served. On this form, you can tell the sheriff's department the best times to find the person at work and/or at home. You can also include a map to the other person's home or work place to help the sheriff find the person and deliver the summons. Do not forget to attach to the summons a copy of your initial petition and any other papers you want personally served on the other party. 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 petition was filed and attach a copy to the Summons: Personal Service on an Individual, O' Florida Family Law Rules of Procedure Form 12.910(a). You should also keep a copy for your records. 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. You should read the instructions for Summons: Personal Service on an Individual, O' Florida Family Law Rules of Procedure Form 12.910(a), for additional information. Special notes... If this is a domestic violence case and you want to keep your address confidential for safety reasons, do not enter your address, telephone, and fax information at the bottom of this form. Instead, write "confidential" in the spaces provided for that information and 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 nonlawyer helps you fill out these forms, that person must give you a copy of 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.

Instructions for Florida Supreme Court Approved Family Law Form 12.910(b), Process Service Memorandum (9/00)

IN THE CIRCUIT COURT OF THE IN AND FOR

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

Petitioner, and , Respondent. PROCESS SERVICE MEMORANDUM TO: ( ) Sheriff of ( ) Private process server: Please serve the {name of document(s)} in the above-styled cause upon: Party: {full legal name} Address or location for service: Work Address: County, Florida; Division

If the party to be served owns, has, and/or is known to have guns or other weapons, describe what type of weapon(s): SPECIAL INSTRUCTIONS:

Dated: Signature of Party *Printed Name:
*Address: *City, State, Zip: *Telephone Number: *Fax Number: * If this is a domestic violence case, do not enter this information if your address or telephone number need to be kept confidential for safety reasons; instead write "confidential" in the spaces provided and file O' Florida Supreme Court Approved Family Law Form 12.980(i), Petitioner's Request for Confidential Filing of Address.
Florida Supreme Court Approved Family Law Form 12.910(b), Process Service Memorandum (9/00)

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} , , {city} , a nonlawyer, located at {street} , {phone} , helped {name} , {state} who is the petitioner, fill out this form.

Florida Supreme Court Approved Family Law Form 12.910(b), Process Service Memorandum (9/00)