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NOTICE OF SOCIAL SECURITY NUMBER-MODIFICATION-3 MINORS

NOTICE OF SOCIAL SECURITY NUMBER

(Petition for Modification in which the parties have three (3) minor children)


IN THE CIRCUIT COURT OF THE 17TH JUDICIAL CIRCUIT IN AND FOR BROWARD COUNTY, FLORIDA

 

In Re: The Former Marriage of                                          Case Number:

 

JAMIE CROWN,

Petitioner/Former Wife,

and

 

JACK KING,

Respondent/Former Husband.

_____________________________________/

NOTICE OF SOCIAL SECURITY NUMBER

I, JAMIE CROWN, certify that my social security ending numbers are XXXas required in section 61.052(7), sections 61.13(9) or (10), section 742.031(3), sections 742.032(1)-(3), and/or sections 742.10(1)-(2), Florida Statutes.  My date of birth xx-xx-1984.

 

     X               1.         This notice is being filed in a Petition for Modification in which the parties have three (3) minor children.

 

  1.          This notice is being filed in a paternity or child support case, or in a dissolution of marriage in which the parties have minor children in common.  The minor children’s names, dates of birth, and social security numbers are:

 

XX, born on xx/xx/20__

XX, born on xx/xx/20__

XX, born on xx/xx/20__

                        

Disclosure of my social security number(s) shall be limited to the purpose of administration of the Title IV-D program for child support enforcement.

I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this notice and that the punishment for knowingly making a false statement includes fines and/or imprisonment.

 

 

Dated:_________________________

____________________
JAMIE CROWN
Petitioner/ Former Wife

 

 

STATE OF FLORIDA         )

)§:

COUNTY OF BROWARD  )

 

BEFORE ME, the undersigned authority, personally appeared, JAMIE CROWN known to me or who produced  __________________ as identification, under penalties of perjury and having been sworn under oath, verifies that the above contents and information is true and correct to the best of her personal knowledge and that she executed this document.

WITNESS my hand and seal in the State and County aforesaid this ______ day of XXXXX 20__.

 

______________________________
NOTARY PUBLIC

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing was provided to: Jack King, Former Husband, by personal service.

 

LARRY D. SCHOTT

Attorney for Former Wife

 

By:____________________________
LARRY D. SCHOTT

 

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This document is a sample pleading related to a specific set of facts and circumstances and should not be used or relied upon for any family law matter. This document is being provided for illustrative purposes only. We recommend and urge you to consult with an experienced divorce lawyer for professional advice as each case is unique.

To Learn About Larry Schott’s Qualifications as a Divorce Lawyer and Family Law Advocate, See His About Me Page.