This form contains 23 fields organized into 9 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Case Info
CASE NO Text
Enter the case number assigned by the court for this proceeding.
Certification
Filer’s Signature Signature
Provide your signature to certify the filing.
Confidentiality
( ) Precise location of confidential information in document Text
Provide the precise location in the document where the confidential information appears.
Check if Applicable RadioButton
Select this option if the document is to be treated as fully confidential.
Check if Applicable RadioButton
Select this option if the document is to be treated as partially confidential.
Check if Applicable RadioButton
Select this option as an alternate way to indicate full confidentiality of the document.
Contact Info
Address Text
Enter the address related to the service or contact information for the filing.
Name Text
Enter the name of the person responsible for service or contact.
Phone Text
Enter the phone number for the person or entity responsible for service.
Florida Bar Number. (if applicable) Text
Enter the Florida Bar Number, if applicable.
E-mail address Text
Enter the email address for communications related to the filing.
Document Details
(a) The title/type of document is Text
Enter the title or type of document as it appears in the filing.
(a) Title/type of document Text
Enter the title or type of document for filing purposes.
Filing Info
(b) Date of filing (if known) Date
Enter the filing date of the document, if known.
(c) Date of document Date
Enter the date on which the document was created.
(d) Docket entry number Text
Enter the docket entry number assigned to this filing.
Filing Options
Check if Applicable RadioButton
Check if this filing is an amended filing.
Check if Applicable RadioButton
Check if this document has been previously filed.
Party Info
Plaintiff/Petitioner Text
Enter the name of the plaintiff or petitioner involved in the case.
Defendant/Respondent Text
Enter the name of the defendant or respondent in the case.
Service Info
year Text
Enter the year when service of the document occurred.
service Text
Enter details or the method used for serving the document.
on Date
Enter the day (date) on which the document was served.