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Petitioners Affidavit Supporting Judgment 3A - Oregon
| Petitioners Affidavit Supporting Judgment Form. This is a Oregon form and can be used in Custody Parenting Time And Child Support Family Law Circuit Court Statewide . |
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IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF _________________ In the Matter of: ________________________________, Petitioner, and ________________________________, Respondent. STATE OF OREGON County of _________________________ ) ) ) ) ) ) ) ) ) ) ss. ) Case No. ______________________ PETITIONER'S AFFIDAVIT SUPPORTING JUDGMENT I, ____________________________________, being first duly sworn, say: I am the petitioner in this proceeding. Respondent and I are the parents of the following minor child/ren: ____________________________ ____________________________________________________________________________________________ (name(s) and date(s) of birth) ____________________________________________________________________________________________ ` Respondent has not appeared in this matter and an Order of Default has been entered. ` Respondent filed a response and later ` signed and filed a Waiver of Further Appearance and Consent to Entry of Judgment, (or) ` has waived further hearing by stipulating to the terms of the Judgment. This case is now ready for a hearing on the merits. I make this affidavit in support of a Judgment without a hearing. The allegations in my Petition are true and it is just and reasonable the relief requested in the proposed judgment be granted. ` Child custody or child support is involved in this case and at the time of filing: ` The child/ren had continuously resided in Oregon for six months before this case was filed. ` List any other basis for child custody jurisdiction: ___________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Page 1 of 3, PETITIONER'S AFFIDAVIT SUPPORTING JUDGMENT UnmarriedParents-3A: AffJudgment-3A-Ver02.wpd (3/03) American LegalNet, Inc. www.USCourtForms.com The current residence of the minor child/ren is: Name of Child Resides With (Name, Address or Contact Address) For How Long ` Additional page attached, labeled "Information About Children, Continued". ` Parenting time should not be ordered because my child/ren's health or safety would be endangered because: _____________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________. ` I have good reason for the court to allow me to move more than 60 miles further distant from the other parent without giving written advance notice to the other parent. My good cause is: _________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ` Child support is involved: Mother's average gross monthly income is $____________. Father's average gross monthly income is approximately $ _________. Work or school related daycare is $________/month and is paid by ` Mother ` Father. Health insurance for our child/ren costs $___________/month out of pocket and is paid by ` Mother ` Father. The child support amount I have requested ` does not deviate from the amount presumed correct under Oregon Administrative Rules, or ` does deviate from the presumed amount of $ ________ per month because:_____________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ` Child Support is involved and respondent does not live in Oregon. (If you checked the box above, check any of the following boxes that are true) ` Respondent was personally served with the petition in Oregon. ` Respondent lived in Oregon with the child. ` Respondent lived in Oregon and paid expenses for the birth or support of the child. Page 2 of 3, PETITIONER'S AFFIDAVIT SUPPORTING JUDGMENT UnmarriedParents-3A: AffJudgment-3A-Ver02.wpd (3/03) American LegalNet, Inc. www.USCourtForms.com ` The child was possibly conceived in Oregon. ` The child lives in Oregon because of the wishes of Respondent. ` Other basis for jurisdiction: ________________________________________. ` A child support order currently exists and I requested that this court issue a new order because the existing order was issued by an Oregon court or agency, one of the parents or the child/ren receiving support under the order still resides in Oregon, and circumstances have changed since the first order was entered. The changed circumstances are (explain what has changed since the last order):_______________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ` I request that personal information, such as telephone number, address and employment information, not be disclosed in the court's judgment as otherwise required by ORS 25.020 and ORS 107.085 because my health, safety or liberty, or that of my child __________________________ would unreasonably be put at risk by such disclosure. State supporting facts: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Certificate of Document Preparation. You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks that apply: ` I selected this document form myself, and I completed it without paid assistance. ` I paid or will pay money to ___________________________ for assistance in preparing this form. Dated: ________________________, 20_____. __________________________________________
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