Oregon > Statewide > Circuit Court > Family Law > Custody Parenting Time And Child Support
Response (Child Custody-Parenting Time) 3B - Oregon
| Response (Child Custody-Parenting Time) 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 ) ) ) ) ) ) ) ) ) ) Case No. ____________________ RESPONSE (CHILD CUSTODY/PARENTING TIME) ` and COUNTERCLAIM DOMESTIC RELATIONS CASE SUBJECT TO FEE UNDER ORS 21.111 ________________________________, Respondent. 1. Respondent appears and agrees with the petition filed in this case, except paragraph(s): ______________________________________. 2. ` Respondent makes the following counterclaim(s): (a) ___________________________________________________________________________________ (b) ___________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ` Additional page attached labeled "Counterclaims, continued." 3. Child Support: ` Social Security or apportioned Veterans' benefits are paid to or on behalf of the child[ren] in the amounts listed below as a result of my disability or retirement, and I request that child support be reduced dollar for dollar. Amount of Benefit received by child: $ Child's Name: Child's Name: Amount of Benefit received by child: $ Amount of Benefit received by child: $ Child's Name: ` Survivors' and Dependents' Educational Assistance under 38 USC chapter 35 is paid to or on behalf of the child[ren] in the amounts listed below as a result of my disability or retirement, and child support must be reduced dollar for dollar. Amount of monthly assistance received: $ Child's Name: Child's Name: Amount of monthly assistance received: $ Child's Name: Amount of monthly assistance received: $ Page 1 of 3, RESPONSE (CHILD CUSTODY/PARENTING TIME) ` and COUNTERCLAIM UnmarriedParents-3B: Response3BVer03.wpd (6/02) American LegalNet, Inc. www.USCourtForms.com 4. (Optional) Exception to Income Withholding of Child Support: Respondent requests an exception to the income withholding requirement of ORS 25.378 as follows: ` Allowing payment to be made by electronic funds transfer (EFT) to the Department of Justice (this option is the only one permitted if support enforcement services are being provided to either party). ` Allowing payment to be made directly to ` Husband's ` Wife's checking or savings account (this option is allowed only if support enforcement services are not being provided to either party). A receipt of deposit should be kept by the parent paying support as proof of payment. The parent receiving support should provide the paying parent with current deposit slips and/or bank name, account name, and account number. State facts in support of your request for an exception to income withholding: 5. Information Required by the Uniform Child Custody Jurisdiction and Enforcement Act. List the places where the minor child/ren of the parties have lived in the last five years and the names of the people they lived with at that time. Dates County, State Parent(s)/Caretaker Current Address or Contact Address of Parent/Caretaker Which Children ` Additional page attached; see section labeled "UCCJEA Information Continued". I ` have ` have not participated in any litigation concerning the custody, visitation, parenting time or placement of the child/ren in this or any other state. I have participated in the following litigation: Name of Court State Case No. Date Result I do not know of any other domestic violence, custody, visitation, parenting time or placement proceeding involving the child/ren, or of any other court case which could affect this case, pending in this or any other state ` except for:__________________________________________________________________________________ ____________________________________________________________________________________________ (identify court, case number and kind of proceeding) I do not know any person other than petitioner who has physical custody of the child/ren or who claims to have custody, visitation or parenting time rights ` except for: __________________________________________ ____________________________________________________________________________________________ (list name and address) Page 2 of 3, RESPONSE (CHILD CUSTODY/PARENTING TIME) ` and COUNTERCLAIM UnmarriedParents-3B: Response3BVer03.wpd (6/02) American LegalNet, Inc. www.USCourtForms.com 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 for myself and I completed it without paid assistance. ` I paid or will pay money to ________________________________for assistance in preparing this form. STATE OF __________________________ County of ___________________________ ) ) ss. ) I, _______________________________, being duly sworn, say that I am the respondent in this matter, and that the statements in this Response are true and correct to the best of my knowledge. __________________________________________________________________________________________ Signature Print Name __________________________________________________________________________________________ Address or Contact Address City, State, Zip Telephone or Contact Telephone SIGNED AND SWORN to before me this _________ day of ______________, 20_____, by _________________________________________________. ___________________________________ Notary Public for ____________/Court Clerk My Commission Expires: ______________ I certify that this is a true copy. ________________________________ Respondent, Signature Page 3 of 3, RESPONSE (CHILD CUSTODY/PARENTING TIME) ` and COUNTERCLAIM UnmarriedParents-3B: Response3BVer03.wpd (6/02) American LegalNet, Inc. www.USCourtForms.com
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