Oregon > Statewide > Circuit Court > Family Law > Legal Separation
Petition For Separation (With Children) (2A) - Oregon
| Petition For Separation (With Children) (2A) Form. This is a Oregon form and can be used in Legal Separation 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 the Marriage of: ) ) ) ) Petitioner, ) ) and ) ) ) Respondent. ) ) and ) ) ) , ) Child who is at least 18 and under 21 years ) of age, unmarried and unemancipated. ) (ORS 107.108) ) 1. Date of marriage/domestic partnership: . (County, State) Case No. PETITION FOR SEPARATION DOMESTIC RELATIONS CASE SUBJECT TO FEE UNDER ORS 21.111 CLAIM SUBJECT NOT SUBJECT TO MANDATORY ARBITRATION . Place of marriage/domestic partnership: 2. of (Check the box/es that apply) Irreconcilable differences between the Petitioner and Respondent have caused a temporary or unlimited breakdown of the marriage/domestic partnership. The parties have entered into an agreement that will be filed with the court suspending for a period not less than one year our obligation to live together as husband and wife/domestic partners and Respondent. Irreconcilable differences exist between the parties and the continuation of the marriage/domestic partnership preserves or protects their legal, financial, social or religious interests. Certificate of Residency. Marriage Only: I certify that one or both of the parties to this case currently live in the county in which this petition is being filed. Domestic Partnership Only: I certify that one or both of the parties to this case currently live in the county in which this petition is being filed, or neither party currently resides in Oregon but I certify that this petition is filed in the county where Petitioner or Respondent last resided. The Petitioner Respondent is an Oregon resident. 3. 4. PETITION FOR SEPARATION DOMESTIC RELATIONS CASE SUBJECT TO FEE UNDER ORS 21.111 American LegalNet, Inc. PAGE 1 OF 9 Separation-2A: Petition2AVer07.doc (1/08) www.FormsWorkflow.com 5. By filing this petition, I acknowledge that I am bound by the terms of the statutory restraining order prohibiting either party from disposing of marital/parnership assets, a copy of which I have received and read, and understand that this restraining order is effective immediately upon service of this petition and the summons upon the Respondent. Children Born to Both Parties. Name Date of Birth Social Security No. Do not list. Provide by UTCR 2.100 Affidavit Do not list. Provide by UTCR 2.100 Affidavit Do not list. Provide by UTCR 2.100 Affidavit 6. Address Additional page attached; see section labeled "Paragraph 6 continued." Petitioner Respondent is pregnant. Petitioner Respondent is is not the parent of this child. The expected date of the child's birth is . Neither party is now pregnant. Child/ren Born During Marriage/Domestic Partnership. List any child/ren born during the marriage/domestic partnership that spouse/domestic partners is not the parent of, and that were not conceived when husband and wife/domestic partners were living together: (name/s and date/s of birth) UCCJEA Information. The child/ren listed above has/have continuously resided in Oregon for the six months preceding the filing of this case. 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 From/To County, State Parent(s)/Caretaker Current Address/ Contact Address of Parent/Caretaker Which Children 8. 7. Additional page attached; see section labeled "Paragraph 8 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 PETITION FOR SEPARATION DOMESTIC RELATIONS CASE SUBJECT TO FEE UNDER ORS 21.111 American LegalNet, Inc. PAGE 2 OF 9 Separation-2A: Petition2AVer07.doc (1/08) www.FormsWorkflow.com 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 the kind of proceeding) I do not know any person other than my spouse 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) 9. Parenting Plan (Custody and Parenting Time). Custody of the child/ren should be awarded as follows: Respondent should be awarded sole custody of the following child/ren (list names): Petitioner should be awarded sole custody of the following child/ren (list names): The parties have agreed to joint custody of the following child/ren (list names): Petitioner Respondent should have parenting time with the child/ren as set forth in the attached Parenting Plan, labeled Exhibit , or Other: Petitioner Respondent should not be granted parenting time because this would endanger the health and safety of the child/ren. State supporting facts: Parenting time should be supervised by Any cost of the supervision shall be paid by Petitioner Respondent Other: Petitioner and Respondent should each provide contact addresses and contact telephone numbers to the other and notify each other of any emergency circumstances or substantial changes in the child/ren's health. Petitioner should be allowed to move more than 60 miles further distant from the other parent without advance notice because good cause exists. 10. Child Support, including Health Care Coverage and Cash Medical Support. A. Other Pending Child Support Cases. (Check one.) No other agency or court child support proceeding is currently pending (include any child support matter being heard as part of a dissolution, separation, annulment, paternity, support or modification case). There is/are other child support proceeding(s) currently pending in either an agency or court case as set forth in the CERTIFICATE RE: PENDING CHILD SUPPORT PROCEEDING and/or EXISTING CHILD SUPPORT ORDER attached to this petition. /// /// PETITION FOR SEPARATION DOMESTIC RELATIONS CASE SUBJECT TO FEE UNDER ORS 21.111 American LegalNet, Inc. PAGE 3 OF 9 Separation-2A: Petition2AVer07.doc (1/08) www.FormsWorkflow.com B. Other Child Support Orders. (Check one.) No other child support orders, from an agency or court, are currently in effect in the State of Oregon or any other state. There is/are other child support orders from an agency or court as set forth in the CERTIFICATE RE: PENDING CHILD SUPPORT PROCEEDING and/or EXISTING CHILD SUPPORT ORDERS/JUDGMENTS attached
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