7a7463a2d1
Financial affidavits (FL-12.902(b)/(c)), child support worksheet (FL-12.902(e)), motion to modify (FL 61.14), notice of deposition (FL 1.310), motion to compel (FL 1.380), income withholding order (FL 61.1301/FL SDU), fee waiver application (FL 57.082), SSN notice (FL-12.930(a) — filed under seal), mandatory disclosure certificate (FL-12.932), default motion packet (FL 12.922 — 3-part), and parenting plan (FL-12.995(a)). All 12 reports registered in __manifest__.py. Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
247 lines
17 KiB
XML
247 lines
17 KiB
XML
<?xml version="1.0" encoding="utf-8"?>
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<!-- FL 57.082 — Application for Civil Indigent Status
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Auto-populated from fl.fee.waiver record.
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Used to waive court filing fees and mediator fees for qualifying parties.
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Eligibility: income <= 200% Federal Poverty Level (FPL) per FL 57.082.
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Mediator waiver: separate threshold per FL 44.108.
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-->
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<odoo>
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<data>
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<record id="action_report_fee_waiver" model="ir.actions.report">
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<field name="name">Application for Civil Indigent Status (FL 57.082)</field>
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<field name="model">fl.fee.waiver</field>
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<field name="report_type">qweb-pdf</field>
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<field name="report_name">activeblue_familylaw.report_fee_waiver</field>
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<field name="report_file">activeblue_familylaw/report/report_fee_waiver</field>
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<field name="print_report_name">'Fee Waiver Application - ' + object.case_id.name</field>
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<field name="binding_model_id" ref="model_fl_fee_waiver"/>
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<field name="binding_type">report</field>
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</record>
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<template id="report_fee_waiver">
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<t t-call="web.html_container">
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<t t-foreach="docs" t-as="o">
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<t t-call="web.external_layout">
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<div class="page" style="font-family: Times New Roman, serif; font-size: 11pt; line-height: 1.7;">
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<!-- Court Header -->
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<div style="text-align: center; margin-bottom: 16px;">
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IN THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL CIRCUIT<br/>
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IN AND FOR MIAMI-DADE COUNTY, FLORIDA<br/>
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FAMILY DIVISION
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</div>
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<!-- Title -->
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<div style="text-align: center; font-size: 14pt; font-weight: bold; margin-bottom: 4px; text-decoration: underline;">
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APPLICATION FOR CIVIL INDIGENT STATUS
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</div>
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<div style="text-align: center; font-size: 10pt; margin-bottom: 16px; color: #333;">
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Section 57.082, Florida Statutes
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</div>
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<!-- Caption -->
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<table style="width: 100%; margin-bottom: 16px; border-collapse: collapse;">
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<tr>
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<td style="width: 55%; vertical-align: top; padding-right: 20px;">
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<t t-esc="o.case_id.petitioner_id.name if o.case_id.petitioner_id else '__________________'"/>, Petitioner,<br/>
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vs.<br/>
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<t t-esc="o.case_id.respondent_id.name if o.case_id.respondent_id else '__________________'"/>, Respondent.
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</td>
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<td style="width: 45%; border-left: 1px solid #000; padding-left: 20px; vertical-align: top;">
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Case No.: <t t-esc="o.case_id.court_case_number or '____________________'"/><br/>
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Division: <t t-esc="o.case_id.division or '___'"/>
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</td>
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</tr>
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</table>
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<!-- Eligibility Result Banner -->
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<t t-if="o.is_eligible">
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<div style="border: 2px solid #28a745; padding: 10px; margin-bottom: 16px; background: #d4edda; text-align: center; font-size: 11pt; font-weight: bold;">
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✓ PRELIMINARY ELIGIBILITY: APPLICANT APPEARS TO QUALIFY FOR FEE WAIVER<br/>
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<span style="font-size: 9pt; font-weight: normal;">
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Annual Income: $<t t-esc="'%,.2f' % (o.annual_income or 0.0)"/> |
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FPL Threshold (200%): $<t t-esc="'%,.2f' % (o.fpl_threshold_200 or 0.0)"/>
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</span>
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</div>
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</t>
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<t t-else="">
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<div style="border: 2px solid #dc3545; padding: 10px; margin-bottom: 16px; background: #f8d7da; text-align: center; font-size: 11pt; font-weight: bold;">
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✗ PRELIMINARY REVIEW: INCOME MAY EXCEED ELIGIBILITY THRESHOLD<br/>
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<span style="font-size: 9pt; font-weight: normal;">
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Annual Income: $<t t-esc="'%,.2f' % (o.annual_income or 0.0)"/> |
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FPL Threshold (200%): $<t t-esc="'%,.2f' % (o.fpl_threshold_200 or 0.0)"/>
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— The clerk will make the final determination.
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</span>
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</div>
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</t>
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<!-- PART I: APPLICANT INFO -->
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<div style="font-weight: bold; background: #e9ecef; padding: 5px; margin-bottom: 8px; font-size: 10pt; border-left: 4px solid #003366;">
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PART I — APPLICANT INFORMATION
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</div>
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<table style="width: 100%; font-size: 10pt; border-collapse: collapse; margin-bottom: 12px;">
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<tr>
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<td style="padding: 4px; width: 30%; font-weight: bold;">Full Legal Name:</td>
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<td style="padding: 4px;"><t t-esc="o.party_id.name if o.party_id else '_______________________________'"/></td>
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<td style="padding: 4px; width: 20%; font-weight: bold;">Date of Birth:</td>
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<td style="padding: 4px;"><t t-esc="str(o.party_id.date_of_birth) if o.party_id and o.party_id.date_of_birth else '________________'"/></td>
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</tr>
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<tr>
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<td style="padding: 4px; font-weight: bold;">Address:</td>
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<td colspan="3" style="padding: 4px;">
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<t t-if="o.party_id and o.party_id.street">
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<t t-esc="o.party_id.street"/>, <t t-esc="o.party_id.city"/>, FL <t t-esc="o.party_id.zip"/>
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</t>
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<t t-else="">_____________________________________________</t>
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</td>
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</tr>
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<tr>
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<td style="padding: 4px; font-weight: bold;">Phone:</td>
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<td style="padding: 4px;"><t t-esc="o.party_id.phone if o.party_id else '___________________'"/></td>
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<td style="padding: 4px; font-weight: bold;">Email:</td>
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<td style="padding: 4px;"><t t-esc="o.party_id.email if o.party_id else '___________________'"/></td>
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</tr>
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<tr>
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<td style="padding: 4px; font-weight: bold;">Role in Case:</td>
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<td colspan="3" style="padding: 4px;">[ ] Petitioner [ ] Respondent</td>
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</tr>
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</table>
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<!-- PART II: INCOME -->
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<div style="font-weight: bold; background: #e9ecef; padding: 5px; margin-bottom: 8px; font-size: 10pt; border-left: 4px solid #003366;">
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PART II — INCOME INFORMATION
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</div>
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<table style="width: 100%; font-size: 10pt; border-collapse: collapse; margin-bottom: 12px;">
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<tr>
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<td style="padding: 4px; width: 55%; font-weight: bold;">Number of persons in household:</td>
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<td style="padding: 4px;"><t t-esc="o.household_size or '____'"/></td>
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</tr>
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<tr>
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<td style="padding: 4px; font-weight: bold;">Monthly Gross Income (all sources):</td>
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<td style="padding: 4px;">$<t t-esc="'%,.2f' % (o.monthly_income or 0.0)"/></td>
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</tr>
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<tr>
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<td style="padding: 4px; font-weight: bold;">Annual Gross Income (× 12):</td>
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<td style="padding: 4px;"><strong>$<t t-esc="'%,.2f' % (o.annual_income or 0.0)"/></strong></td>
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</tr>
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<tr style="background: #f8f9fa;">
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<td style="padding: 4px; font-weight: bold;">Federal Poverty Level (200%) for household of <t t-esc="o.household_size or '___'"/>:</td>
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<td style="padding: 4px;">$<t t-esc="'%,.2f' % (o.fpl_threshold_200 or 0.0)"/>/year</td>
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</tr>
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</table>
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<!-- PART III: INCOME SOURCES -->
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<div style="font-weight: bold; background: #e9ecef; padding: 5px; margin-bottom: 8px; font-size: 10pt; border-left: 4px solid #003366;">
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PART III — SOURCES OF INCOME (Check all that apply)
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</div>
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<div style="font-size: 10pt; margin-bottom: 12px; line-height: 2.0;">
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[ ] Employment wages/salary: $________ /month<br/>
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[ ] Self-employment / business income: $________ /month<br/>
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[ ] Social Security / SSI: $________ /month<br/>
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[ ] Unemployment compensation: $________ /month<br/>
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[ ] Workers' Compensation: $________ /month<br/>
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[ ] Child support received: $________ /month<br/>
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[ ] Alimony received: $________ /month<br/>
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[ ] Pension / retirement / IRA distributions: $________ /month<br/>
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[ ] Rental income: $________ /month<br/>
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[ ] Public assistance (food stamps, welfare, Medicaid): $________ /month<br/>
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[ ] Other: ________________________ $________ /month
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</div>
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<!-- PART IV: ASSETS -->
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<div style="font-weight: bold; background: #e9ecef; padding: 5px; margin-bottom: 8px; font-size: 10pt; border-left: 4px solid #003366;">
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PART IV — ASSETS
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</div>
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<div style="font-size: 10pt; margin-bottom: 12px; line-height: 2.0;">
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Cash on hand / bank accounts: $________<br/>
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Real property (value): $________ Mortgage/lien: $________<br/>
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Vehicles (value): $________ Loan balance: $________<br/>
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Other assets: $________
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</div>
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<!-- PART V: PUBLIC BENEFITS -->
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<div style="font-weight: bold; background: #e9ecef; padding: 5px; margin-bottom: 8px; font-size: 10pt; border-left: 4px solid #003366;">
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PART V — PUBLIC BENEFITS (Auto-Qualify under FL 57.082(1)(b))
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</div>
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<div style="font-size: 10pt; margin-bottom: 12px; line-height: 2.0;">
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Are you currently receiving any of the following benefits?<br/>
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[ ] Temporary Assistance for Needy Families (TANF)<br/>
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[ ] Supplemental Security Income (SSI)<br/>
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[ ] Medicaid (income-based)<br/>
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[ ] Food Stamps (SNAP)<br/>
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If YES to any of the above, you automatically qualify under FL 57.082(1)(b).
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</div>
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<!-- PART VI: MEDIATOR WAIVER -->
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<div style="font-weight: bold; background: #e9ecef; padding: 5px; margin-bottom: 8px; font-size: 10pt; border-left: 4px solid #003366;">
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PART VI — MEDIATOR FEE WAIVER REQUEST (FL 44.108)
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</div>
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<div style="font-size: 10pt; margin-bottom: 12px;">
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<t t-if="o.mediator_waiver_eligible">
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<div style="color: #28a745; font-weight: bold;">
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✓ Applicant also appears to qualify for reduced/waived mediator fees under FL 44.108.
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</div>
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</t>
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<t t-else="">
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[ ] I also request a waiver of mediator fees pursuant to Section 44.108, Florida Statutes.
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</t>
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<div style="margin-top: 6px;">
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<strong>Basis for mediator fee waiver:</strong><br/>
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[ ] Income-based (same threshold as above)<br/>
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[ ] Receiving public assistance (TANF, SSI, Medicaid, SNAP)
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</div>
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</div>
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<!-- Oath -->
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<div style="border: 1px solid #000; padding: 10px; margin-top: 12px; font-size: 10pt;">
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<strong>OATH:</strong><br/>
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I, <t t-esc="o.party_id.name if o.party_id else '__________________________'"/>, hereby swear or affirm
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under penalty of perjury that the information provided in this Application is true and
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correct to the best of my knowledge. I understand that the clerk will make the final
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determination of indigent status and that the court may review this determination.
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I further understand that if I am found to have provided false information, I may
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be required to pay all fees, costs, and potentially face criminal penalties.
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</div>
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<!-- Signature -->
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<div style="margin-top: 20px;">
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<table style="width: 100%;">
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<tr>
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<td style="width: 55%;">
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<div style="border-top: 1px solid #000; margin-top: 50px; padding-top: 4px;">
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Signature of Applicant
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</div>
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</td>
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<td style="padding-left: 20px;">
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<div style="margin-top: 20px;">Date: ______________________</div>
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</td>
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</tr>
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</table>
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</div>
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<!-- Clerk Use Only -->
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<div style="border: 2px solid #000; padding: 10px; margin-top: 16px; font-size: 10pt;">
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<strong>FOR CLERK USE ONLY:</strong><br/><br/>
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[ ] APPROVED — Civil indigent status granted. Filing fees waived.<br/>
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[ ] DENIED — Income exceeds threshold. Filing fee required: $________<br/>
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[ ] DEFERRED — Additional documentation required.<br/><br/>
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Clerk Signature: _________________________ Date: _________________<br/>
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Determination No.: _________________________
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</div>
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<!-- Disclaimer -->
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<div style="margin-top: 10px; font-size: 8pt; color: #666; border-top: 1px solid #ccc; padding-top: 6px;">
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Generated by ActiveBlue Family Law. FPL figures effective January 2025.
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Verify current FPL at HHS.gov before filing. Case: <t t-esc="o.case_id.name"/> | Generated: <t t-esc="context_today()"/>
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</div>
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</div>
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</t>
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</t>
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</t>
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</template>
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</data>
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</odoo>
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