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

Case No.:

Division:

Petitioner ====>

Respondent ==>

PLEASE ENTER THE DESIRED FORM#s or FORM TYPE HERE:

(example: form 54 or Answer to Petition for Dissolution of Marriage)

Full Name:  

Phone#:  Email:  

Address:

A Lorins Consulting Consultant told me that s/he is a non-lawyer and may not give me legal advice, and 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(b) 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 and who performs specifically delegated substantive legal work for which a member of The Florida Bar is responsible.

Only persons who meet the definition may call themselves paralegals. The Lorins Consuting Consultant, informed me that he/she is not a paralegal and cannot call himself/herself a paralegal. The Lorins Consuting Consultant, told me that he/she may only type the factual information provided by me in writing into the blanks on the form. The Lorins Consuting Consultant may not help me fill in the form and may not complete the form for me. If using a form approved by the Supreme Court of Florida, The Lorins Consuting Consultant may ask me factual questions to fill in the blanks on the form and may also tell me how to file the form.

[Check one only] I can read English.

[Check one only] I cannot read English, but this disclosure was read to me by in {language} , which I understand.

Dated:

Signature of Party:

Signature of NONLAWYER: Lorins Consulting, Inc.

Printed Name: Lorins Consulting, Inc.

Name of Business: Lorins Consulting, Inc.

Address: 2431 Aloma Ave, Suite 139, Orlando, Florida 32792

Telephone Number: (407) 272-0873

Florida Family Law Rules of Procedure Form 12.900(a), Disclosure From Nonlawyer (02/06)

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