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Affidavit In Support Of Ex Parte Motion For temporary custody And Parenting Time Under ORS 107.097(3)(a) (16A) - Oregon
| Affidavit In Support Of Ex Parte Motion For temporary custody And Parenting Time Under ORS 107.097(3)(a) (16A) Form. This is a Oregon form and can be used in Immediate Danger Temporary Custody Or Parenting Time 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. STATE OF ________________________ County of _________________________ 1. ) ) ) ) ) ) ) ) ) ) ) Case No. AFFIDAVIT IN SUPPORT OF EX PARTE MOTION FOR TEMPORARY CUSTODY AND PARENTING TIME UNDER ORS 107.097(3)(a) "IMMEDIATE DANGER" ss. I, (print your name) Petitioner Respondent in this proceeding. , being first duly sworn, say: I am the 2. The name(s) and birthdate(s) of my minor child/ren that should be protected by this order are: NAME BIRTHDATE 3. My child/ren are in "immediate danger" because of the following detailed facts (be specific): Additional page attached 4. 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/Contact Address of Parent/Caretaker Which Children Additional page attached /// /// AFFIDAVIT IN SUPPORT OF EX PARTE MOTION FOR TEMPORARY ORDER FOR CUSTODY AND PARENTING TIME UNDER ORS 107.097(3)(a) "IMMEDIATE DANGER" - Page 1 of 2 PreJudgTempCustPT 16A: Affidavit-16AVer01.doc (3/08) American LegalNet, Inc. www.FormsWorkFlow.com 5. 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 6. 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) 7. I do not know any person other than the other parent 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) 8. There are are not any other custody, parenting time, visitation or restraining orders affecting the child/ren. I have attached copies of any existing orders to this affidavit. day of , 20 . Dated: Petitioner Respondent, Signature SIGNED AND SWORN to before me this ___________ day of by: , 20 Notary Public for ____________/Court Clerk My Commission Expires: 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. Petitioner Respondent, Signature Print Name City, State, Zip Telephone or Contact Telephone Address or Contact Address I certify that this is a true copy: ____________________________________ Petitioner Respondent, Signature AFFIDAVIT IN SUPPORT OF EX PARTE MOTION FOR TEMPORARY ORDER FOR CUSTODY AND PARENTING TIME UNDER ORS 107.097(3)(a) "IMMEDIATE DANGER" - Page 2 of 2 PreJudgTempCustPT 16A: Affidavit-16AVer01.doc (3/08) American LegalNet, Inc. www.FormsWorkFlow.com
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