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Request For Default Judgment Defendant Status Affidavit - Oregon
| Request For Default Judgment Defendant Status Affidavit Form. This is a Oregon form and can be used in Circuit Court Jackson Local County . |
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IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR JACKSON COUNTY SMALL CLAIMS DEPARTMENT (Please type or print legibly) Plaintiff(s): 1.) 2.) Defendant(s): 1.) 2.) _ CASE NUMBER: ________________ REQUEST FOR DEFAULT JUDGMENT; DEFENDANT STATUS AFFIDAVIT NOTE: Complete this and attach a completed judgment you propose. I, _________________________________________ request default judgment against ___________________________________________ defendant(s), for the following: A total judgment award of: $__________ which total includes: 1. Money awarded in the amount of: $__________, 2. Prejudgment interest of: $__________, 3. Accrued arrearages of: $__________,if any, 4. Costs and service expenses of: $__________, $ 93.00 , 5. A prevailing party fee under ORS 20.190 of: 6. The amount paid since filing the claim is $__________. I request the judgment include post judgment interest at a rate of ______% per _________ based on: _________________________________________________________________ (Note statutory interest is 9% per annum unless a contract/agreement differs.) And, I request the following terms in addition to or in lieu of a money award NONE, or _______________________________________________________ In furtherance of this request, I state that: 1. The above-named defendant(s) was duly and regularly served with a copy of the claim and failed to pay the claim or demand a hearing or trial within 14 days: 2. The person against whom I seek a judgment by this request: a. is not one of the following defined by ORS 125.005 and protected by ORCP 69B; a minor, incapacitated, a protected person or respondent; b. is is not I am unable t o det erm ine whet her t his person is a person protected by the Service members Civil Relief Act (50 U.S.C. App 501 to 596). The facts that support this statement are: _____________________________________________________________________ _____________________________________________________________________ I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and is subject to penalty for perjury. DATED: __________________________________ Plaintiff's Name (print) __________________________________ Authorized Signature Public SmClaim Request Default Judgment Page 1 of 1 11/17/11 OJIN code: RQJD American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR JACKSON COUNTY SMALL CLAIMS DEPARTMENT (Please type or print legibly) Plaintiff(s): 1.) 2.) Defendant(s): 1.) 2.) _ CASE NUMBER: ________________ LIMITED JUDGMENT GENERAL JUDGMENT I hereby give judgment in this case for the Judgment Creditor named in the money judgment/money award below and against the judgment debtor(s) named therin. In addition or in lieu of the money award below, this judgment established the following requirements: NONE, or _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ______________ Based upon ___________________________________________________________________'s failure to appear for the scheduled Mediation Hearing (check box if applicable). MONEY JUDGMENT AWARD Judgment Creditor(s): Creditor's Address: Judgment Debtor(s): Debtor's Address: Judgment Amount: Prejudgment Interest: Costs and Service Fees: Prevailing Party Fee: Post Judgment Interest: $ __________ $ __________ $ __________ $93.00 _____% per annum Dated:_________________________ _____________________________________ Circuit Court Judge/Clerk Public SmClaim Default Judgment Page 1 of 1 11/17/11 OJIN code: JGLM/JGGL American LegalNet, Inc. www.FormsWorkFlow.com
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