REQUEST FOR CONFIDENTIAL FILING OF ADDRESS
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.980(h) REQUEST FOR CONFIDENTIAL FILING OF ADDRESS (03/15)
When should this form be used?

If you fear that disclosing your address would put you in danger because you are the victim of sexual battery, aggravated child abuse, stalking, aggravated stalking, harassment, aggravated battery, or domestic violence, you should complete this form and file it with the clerk of the circuit court..

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 keep a copy for your records.

IMPORTANT INFORMATION REGARDING E-FILING

The Florida Rules of 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 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.


Your full legal name:
I am the:

Address to be kept confidential:
Address:
City:
State:
Zip:
Phone (area code and number):


IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR  COUNTY, FLORIDA

,
,
,
Petitioner,

and

.
Respondent.


REQUEST FOR CONFIDENTIAL FILING OF ADDRESS


I, , request that the Court maintain and hold as confidential, the following address:
Address:
City, State Zip: , FL   
Phone:

This request is being made for the purpose of keeping the location of my residence unknown for safety reasons pursuant to section 119.071(2)(j)1, section 784.0485(3)(b)1, Florida Statutes, or other statutory provision providing for the separate confidential filing for safety reasons.



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