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Affidavit In Support Of Ex Parte Motion For Order Prohibiting Disclosure Of Personal Identification Information - Oregon
| Affidavit In Support Of Ex Parte Motion For Order Prohibiting Disclosure Of Personal Identification Information Form. This is a Oregon form and can be used in Non Disclosure Of Personal Identifying Information 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 ________________________ County of _________________________ ) ) ss. ) ) ) ) ) ) ) ) ) ) ) Case No.: Petitioner's Respondent's AFFIDAVIT IN SUPPORT OF EX PARTE MOTION FOR ORDER PROHIBITING DISCLOSURE OF PERSONAL IDENTIFICATION INFORMATION ORS 25.020(8)(d)(A) ORS 110.375 ORS 109.767(5) I, Petitioner Respondent, being first duly sworn, say that the following is true: 1. Petitioner Respondent should not be given: my fax number my social security number my driver license number the name, address, and telephone number of my employer emergency notice about the child/ren my residential address my mailing address my email address my telephone number my contact telephone/cell phone number other personal information as set forth below: 2. This information should not be disclosed for the following reasons: A. An existing order (a copy of which is attached and labeled "Exhibit 1") requires nondisclosure: Case No. Name of Court Date of Order B. Because the health, safety, or liberty of myself or of my child/ren would be jeopardized by disclosure of this information due to the following circumstance(s): AFFIDAVIT IN SUPPORT OF EX PARTE MOTION FOR ORDER PROHIBITING DISCLOSURE OF PERSONAL IDENTIFICATION INFORMATION - Page 1 of 2 American LegalNet, Inc. NonDisclose - 8: NDAffidavit-8Ver02.doc (3/08) www.FormsWorkFlow.com 3. To keep my identification information confidential, I request that the court waive the requirement that the other party have me personally served with court documents, hearing notices, and other paperwork while this case is pending (being decided.) While this case is pending, I request that process shall be served on me by mailing a certified, true copy of paperwork and hearing notices to the following contact address: I understand that if I wish to select a different method of service during the pendency of the proceedings, I must file an amended waiver of personal service form changing the waiver, setting out a substitute method of service, or selecting a substitute address for service. 4. In order that I may receive notices from the court about future court proceedings after the current matter has been decided, I select the following contact address for post-judgment notification: I understand that if I wish to change my selected post-judgment notification address, I must inform the court in writing of my preferred contact address. 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. Dated day of , 20 . Petitioner/Respondent, Signature Service Address as set out on page 2, question 3. SIGNED AND SWORN to before me by day of , 20 this . Notary Public for My Commission Expires: / Court Clerk AFFIDAVIT IN SUPPORT OF EX PARTE MOTION FOR ORDER PROHIBITING DISCLOSURE OF PERSONAL IDENTIFICATION INFORMATION - Page 2 of 2 American LegalNet, Inc. NonDisclose 8: NDAffidavit-8Ver02.doc (3/08) www.FormsWorkFlow.com
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