Oregon > Local County > Lincoln > Circuit Court > Divorce
Affidavit In Support Of Motion For Waiver Or Deferral Of Fees And Costs (Notary Public) - Oregon
| Affidavit In Support Of Motion For Waiver Or Deferral Of Fees And Costs (Notary Public) Form. This is a Oregon form and can be used in Divorce Circuit Court Lincoln Local County . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR LINCOLN COUNTY In the Matter of the Marriage of ) ) _____________________________________ ) 9 Co-Pe titioner 9 Petitioner ) and ) ) ______________________________________ ) 9 Co-Petitioner 9 Respondent ) STATE OF OREGON County of Lin coln ) ) Case No. ____________________ AFFIDAVIT IN SUPPORT OF MOTION FOR WAIVER OR DEFERRAL OF FEES AND COSTS ss. I, __ ____________________________________ being first duly sworn, depose and say: I am a party in this case. I have insufficient income and resources to pay the filing fees, service fees and cou rt cos ts neces sary to proc eed in this su it. My m onthly household income which supports _______ persons is as follows: W ages . . . . . . . . . . . . $_____________ W elfare Grant . . . . . . . $_____________ Unem ployment . . . . . . $_____________ Social Se curity . . . . . . $_____________ Child Support / Alimony . . . . . . . $____________ Veteran s Be nefits . . . . . . . . . . . $____________ Other . . . . . . . . . . . . . . . . . . . . $____________ Other . . . . . . . . . . . . . . . . . . . . . $____________ TO TAL . . . . . . . . . . . $____________ My monthly expenses are as follows: Rent/Mortgage . . . . . . $_____________ Utilities . . . . . . . . . . . . $_____________ Food . . . . . . . . . . . . . . $_____________ Other . . . . . . . . . . . . . $_____________ Transportation . . . . . . . . . . . . . . $____________ Clothing . . . . . . . . . . . . . . . . . . . $____________ De bt Pa ym ents . . . . . . . . . . . . . $____________ Other . . . . . . . . . . . . . . . . . . . . . $____________ TO TAL . . . . . . . . . . . $____________ My asse ts, other than househo ld goods and furnishings consist of: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ My present debts are as follows: ________________________________ $_______ ________________________________ $_______ ________________________________ $_______ ________________________________ $_______ ________________________________ $_______ ________________________________ $_______ ________________________________ $_______ TOT AL DEBTS $_______ American LegalNet, Inc. www.USCourtForms.com Other facts relevant to this affidavit: ________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ I understand that the cou rt rules allow a sum m ons and certa in othe r doc um ents to be served (d elivered to the other party) b y any com petent person, other than m yself, who is 18 years of age or older and who is also a res ident of the state where service is m ade. I understa nd that an Oregon sheriff will norm ally charge a fee for doing this for me. I am requesting that the court waive the normal service fee of any Oregon sheriff. The reason I need the Sheriff to serve the docum ents inste ad of h aving them serve d by a friend, acquaintance or other third person is: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ I understan d that th e fe es and costs w hich have not been waived which rem ain unpaid at the tim e jud gm ent is ente red shall becom e a jud gm ent in favor of the Sta te of O regon, and that failure or d efault in paym ent of said judgm ent by a date certa in given by the court o r on the ha ppe ning of on e or m ore e vents sub jects m e to being cha rged with be ing in conte m pt of c ourt. Dated ________________________________ _______________________________________ Signature SUBSCR IBED AND SW ORN to before me this ____ day of __________________, 20 _____. ______________________________________ Notary Public / Court Clerk Page 2 - AFFID AVIT American LegalNet, Inc. www.USCourtForms.com
|
|||||||
