This form was completed with the assistance of:
......(Name of Individual)......
......(Name of Business)......
......(Address)......
......(Telephone Number)......
......(Name)...... told me that he/she is a nonlawyer and may not give legal advice, cannot tell me what my rights or remedies are, cannot tell me how to testify in court, and cannot represent me in court.
Rule 10-2.1(h) of the Rules Regulating The Florida Bar defines a paralegal as a person who works under the supervision of a member of The Florida Bar, an out-of-state lawyer engaged in the authorized practice of law in Florida, or a foreign lawyer engaged in the authorized practice of law in Florida and who performs specifically delegated substantive legal work for which the supervising lawyer is responsible. Only persons who meet the definition may call themselves paralegals. ......(Name)...... informed me that he/she is not a paralegal as defined by the rule and cannot call himself/herself a paralegal.
......(Name)...... told me that he/she may only type the factual information provided by me in writing into the blanks on the form. Except for typing, ......(Name)...... may not tell me what to put in the form and may not complete the form for me. However, if using a form approved by the Supreme Court of Florida, ......(Name)...... may ask me factual questions to fill in the blanks on the form and may also tell me how to file the form.
...... I can read English
...... I cannot read English but this notice was read to me by ......(Name)...... in ......(Language)...... which I understand.
R. Regul. Fl. Bar 10-2.2