Fl. R. Juv. P. form 8.964

As amended through November 4, 2024

Form 8.964 - DEPENDENCY PETITION

PETITION FOR DEPENDENCY

COMES NOW, Petitioner, .....(name)....., by and through undersigned counsel, and petitions this court to adjudicate the above-named minor child(ren) to be dependent within the meaning and intent of chapter 39, Florida Statutes. As grounds, petitioner alleges the following:

1. This court has jurisdiction over the minor child(ren), .....(name(s))....., a .....(gender).....child, whose date(s) of birth is/are .........., and who, at the time the dependency arose, was/were in the custody of .....(name(s))......

2. The natural mother of the minor child(ren) is .....(name)....., a resident of .....(state)....., whose address is .....

3. The father of the minor child(ren), .....(name(s)).....is .....(name), whose address is ..... The father is is not married to the mother, and ..... is ..... is not listed on the child(ren)'s birth certificate(s). The mother filed a Sworn Statement About Identity or Location of Father with this court on .....(date)....., which named .... as the father.

4. The UCCJEA Affidavit .....is attached .....was filed with the Court on .....(date).....and is incorporated by reference.

5. The child(ren) is/are dependent within the meaning and intent of chapter 39, Florida Statutes, in that the mother/father/parents/legal custodian/caregiver(s) abused, abandoned, or neglected the minor child(ren) on or about .....(date)....., by: ....................and that these activities and environments cause the child(ren)'s physical, mental, or emotional health to be in danger of being significantly impaired.

OR

5. The above named child(ren) is/are presently under substantial risk or imminent threat of harm or abuse or neglect, within the meaning and intent of chapter 39, Florida Statutes, which is likely to cause the child(ren)'s physical health to be significantly impaired because .....................

6. The department is unable to ensure the protection of the minor child(ren) without judicial intervention.

7. The mother/father/parents has/have received the following services: .....................

8. A shelter hearing was held on .....(date)....., and the child(ren) was/were placed in the custody of .....................

9. An arraignment hearing

..... needs to be scheduled.

..... is scheduled for .....(date and time)......

10. A guardian ad litem

..... needs to be appointed.

..... was appointed at the shelter hearing to represent the child(ren).

11. .....(name of child(ren))..... has/have special needs as defined in Chapter 39, Florida Statutes. An attorney:

..... needs to be appointed.

..... has been appointed.

12. Under chapter 39, Florida Statutes, the clerk of the court is required to issue a summons to the following parents or custodians:

The natural mother, .....(name)....., whose address is

The natural father, .....(name)....., whose address is

.....(Additional fathers and their addresses)......

WHEREFORE, the petitioner asks that process may issue in due course to bring the above-named parties before the court to be dealt with according to the law, to adjudicate the named minor child(ren) named to be dependent.

___________________

..(Petitioner's name)..

.. (Attorney's name)...

... (address and telephone number)

Florida Bar Number:....

Verification

Certificate of service

NOTICE OF RIGHTS

PLEASE READ THIS PETITION BEFORE ENTERING THE COURTROOM.

YOU HAVE A RIGHT TO HAVE COUNSEL PRESENT AT THIS HEARING.

BY COPY OF THIS PETITION, THE PARENTS, CAREGIVERS, AND/OR LEGAL CUSTODIANS ARE NOTIFIED OF THEIR RIGHT

TO HAVE LEGAL COUNSEL PRESENT FOR ANY PROCEEDING RESULTING FROM THIS PETITION OR TO REQUEST THE COURT TO HAVE COUNSEL APPOINTED, IF INDIGENT.

Further, these persons are informed of the following:

An arraignment is set on this matter for .....(date)....., at .....a.m./p.m., at .....(location)......The purpose of the arraignment is to advise as to the allegations contained in the Petition For Dependency. When your case is called, the Judge will ask you to enter a plea to this petition. The plea entered may be one of the following:

1. Admit: This means you admit that the petition states the truth and you do not want a trial.

2. Consent: This means you neither admit nor deny the petition, but do not want a trial.

(If you enter either of the above two pleas, the court will set a disposition date for the matter. At disposition, the court will decide where the child will stay and under what conditions).

3. Deny: This means you deny the allegations of the petition and wish the state to attempt to prove them at a trial.

4. Continue: This means you wish time to confer with an attorney, before entering a plea. If you enter this plea, the court will schedule another hearing in approximately 2 weeks. At that time, another arraignment hearing will be held, and you (or your attorney) must enter one of the above three pleas.

COMMENT: The following paragraph must be in bold, 14 pt. Times New Roman or Courier font.

If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact .....(name, address, and telephone number)..... at least 7 days before your scheduled court appearance, or immediately upon receiving this notification if the time before the scheduled appearance is less than 7 days. If you are hearing or voice impaired, call 711.

Fl. R. Juv. P. form 8.964

Amended effective 7/1/2023; Amended by 258 So.3d 1254, effective 1/1/2019; amended by 115 So.3d 286, effective 7/1/2013; amended by 939 So.2d 74, effective 1/1/2007; amended by 783 So.2d 138, effective 1/1/2001; amended by 725 So.2d 296, effective 10/1/1998; amended by 684 So.2d 756, effective 1/1/1997; added by 589 So.2d 818, effective 7/1/1991.