Fill and Sign the Oregon Dissolution Marriage Form

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF ___________________ In the Matter of the Marriage of: ) ___________________________, ) Case No. ______________________ Petitioner, ) PETITION FOR DISSOLUTION OF and ) MARRIAGE ___________________________, DOMESTIC RELATIONS CASE SUBJECT TO FEE UNDER ORS 21.111 Respondent ) I. Wife and husband were married on _____________________________, in (date) __________________ County, State of _______________________. II. Irreconcilable differences between the wife and husband have caused the irremediable breakdown of the marriage. III. ____ The wife is an Oregon resident and has been a resident of this state continuously for the past six months. Petition for Dissolution of Marriage 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ____ The husband is an Oregon resident and has been a resident of this state continuously for the past six months. IV. No other domestic relations suit or support proceeding involving this marriage, or the dependents of this marriage is pending in any other state ___ except for a child support proceeding initiated by the State of Oregon through the Department of Justice, Division of Child Support (Support Enforcement Division) or the District Attorney. V. The parties have _____ child/ren under 21 years of age born to or adopted by them prior to or during the marriage. The name(s), date(s) of birth, social security number(s) and address(es) of the child/ren of this marriage are: Name Date of Birth Soc. Sec. No. Address ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _____ Additional page attached; see section labeled “paragraph 5 continued.” ____ The wife is pregnant with the husband’s child. The expected date of the child’s birth is _________________________. ____ The wife is not pregnant at this time Petition for Dissolution of Marriage 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 VI. ____ Child/ren named _______________________________________________ were born to the wife on the following dates _______________________________________, during this marriage. The husband is not the father of the child/ren. The wife was not cohabiting with the husband when the child/ren were conceived. ____ The wife is pregnant at this time and the husband is not the father of this child. The wife was not cohabiting with the husband when this child was conceived. The expected date of the child’s birth is ________________________. VII. (Check all boxes that apply) ____ The child/ren have lived in Oregon continuously for the last six consecutive months. ____ The child/ren have lived in Oregon continuously for six consecutive months sometime during the last twelve months and the child/ren are not now in Oregon but one parent lives in this state. ____ The child/ren have lived in another state for six consecutive months but that state has declined to exercise jurisdiction on the ground that this state is the more appropriate forum, and ____ The child/ren and _________________________ have significant connections to (name of parent or caretaker) Petition for Dissolution of Marriage 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Oregon and substantial evidence about them is available here. ____ The child/ren are physically present in Oregon, and ____ The child/ren have been abandoned, or ____ An emergency exists because the child, or a sibling or parent of the child, is subject to or threatened with mistreatment or abuse. VIII. The places where the minor child/ren of the parties have lived in the last five years and the names of the persons with whom the children have resided are: Dates County/State With Whom Which Children From: _____To: _____ ____________ _______________ __________________ From: _____ To: _____ ____________ _______________ __________________ From: _____ To: _____ ____________ _______________ __________________ From: _____ To: _____ ____________ _______________ __________________ ____ Additional page attached; see section labeled “paragraph 8 continued.” The current addresses of the persons listed above with whom the minor child/ren have lived are: Petition for Dissolution of Marriage 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Name Address ______________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ IX. ____ I 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 regarding the child/ren’s custody, visitation, parenting time or placement: Name of Court State Case No . Date Result ______________________________________________________________________________ ______________________________________________________________________________ X. I do not know of any other domestic violence, custody, visitation, parenting time or placement proceeding involving the child/ren pending in this or any other state ____ except for: ________________________________________________________________________ (identify court, case number and the nature of the proceeding) ________________________________________________________________________ Petition for Dissolution of Marriage 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 XI. 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) _______________________________________________________________________. PARENTING PLAN (CUSTODY AND PARENTING TIME) XII. _____ _______________________________ is/are a fit and proper person(s) to be awarded custody of the parties’ minor children. Custody of the child/ren should be awarded as follows: ____ Wife should be awarded custody of the following child/ren: ________________________________________________________________________ ____ Husband should be awarded custody of the following child/ren: ________________________________________________________________________ ____ _______________________________________ should have parenting time with the child/ren in accordance with Marion County SLR 8.075. ____ Specific parenting time should be as follows: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Petition for Dissolution of Marriage 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ________________________________________________________________________ ____ Additional page(s) attached, labeled “Exhibit A .” ____ _________________________ should not be granted parenting time because this would endanger the health and safety of the child/ren. ____ Wife and Husband 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 distant from the other parent without advance notice because good cause exists. CHILD SUPPORT XIII. ____ There are no existing child support orders, administrative or judicial, currently in effect in the State of Oregon or any other state. ____ The following child support order(s) is/are currently in effect: _______________ (Name of court or agency) _______________________________________________________________________. (List case number, date of order and amount of arrearage(if any)). A certified copy of this order(s) is attached to this petition. XIV. ____ No child support should be ordered in this case because: ____ Child support in the amount of $ __________ monthly has already been ordered Petition for Dissolution of Marriage 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 and docketed with the _________________________ County Circuit Court. ____ Other reason: ______________________________________________________ _______________________________________________________________________ ________________________________________________________________________ ____ Child support should be paid by _______________________ to _______________________ beginning on the first day of the month following the date of the decree and continuing on the first (1st) day of each month thereafter. The total payment of child support per month should be $ __________________ for ________ children. The support amount was calculated pursuant to the support guidelines set out in Oregon’s Administrative Rules. The support amount: ____ does not deviate from the amount presumed correct under the guidelines ____ does deviate from the amount presumed correct under these guidelines because ________________________________________________________________________ ________________________________________________________________________ XV. Petition for Dissolution of Marriage 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 All payments of child support should be made to the Department of Justice, Child Support Accounting Unit, ________________________. Petitioner requests that collection, accounting, disbursement, and enforcement services be provided by the Department of Justice. In addition, support for a child attending school (between the ages of 18 and 21) as defined by Oregon law shall be distributed by the Department of Justice directly to the child subject to ORS 107.108. LIFE INSURANCE COVERAGE FOR CHILD/REN XVI. ____ ___________________________ should obtain and maintain life insurance for the benefit of the parties’ child/ren throughout the period of the support obligation. The coverage should be in an amount sufficient to provide continued support, in the event of the paying parent’s death, at least at the level of and for the duration of the support obligation. MEDICAL INSURANCE COVERAGE FOR CHILD/REN XVII. Throughout the period of the support obligation, __________________________________ should name the child/ren as beneficiaries of any health, accident, dental, orthodontic, and optical insurance plan, available through that parent’s employment, group, or union, at a cost not to exceed the amount of child support ordered in this case. If that parent fails to maintain insurance under these circumstances for the child/ren, that parent should be liable for any of those expenses incurred after the date of the court order requiring the coverage. If that parent maintains this insurance but the insurance does not provide complete coverage, that parent should pay ____ one-half ____ all of the uninsured costs. If the insurance coverage for the child/ren is provided through the parent’s employment, group, or union, and if this employment, or group of union membership is then terminated, this parent shall Petition for Dissolution of Marriage 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 notify the other parent of this fact prior to or immediately upon termination. If insurance is not available t o t his parent when the final judgment is entered, that parent should provide insurance in the future when it becomes available to him/her. Whenever _____________________________ does not have health, accident, dental, orthodontic, or optical insurance available through employment, group of union membership, that parent should pay ____ one-half ____ all uninsured costs incurred by the child/ren throughout that period, including costs for prescriptions. SPOUSAL SUPPORT, LIFE INSURANCE, AND MEDICAL COVERAGE XVIII. ____ No spousal support, spousal life insurance, or spousal medical coverage claims are made in this case. ____ Additional sheets inserted; see pages 8a and 8b labeled “Spousal Support, Life Insurance, and Medical Coverage - continued.” REAL PROPERTY PROVISIONS XIX. ____ Neither wife nor husband has any interest in any real property located in this or any other state. ____ ___________________________________has/have an interest in real property located at the address of __________________________________________________________________ _______________________________________________________________________. ____ This property should be distributed as follows: ________________________________________________________________________ ________________________________________________________________________ Petition for Dissolution of Marriage 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 _______________________________________________________________________. ____ The legal description of the real property is attached as Exhibit ____ and incorporated in this petition. ____ Distribution of this property is not within the jurisdiction of this court. PERSONAL PROPERTY DISTRIBUTION XX. ____ The wife and husband have divided between them all personal effects, household goods, and other personal property they own separately or together, and neither should claim those items now in possession of the other. ____ The wife should be awarded the following personal property: ________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Petition for Dissolution of Marriage 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ____ The wife should be awarded her retirement benefits, pension plan, profit-sharing plan, deferred-compensation plan, and /or stock option plan held by wife’s employer, free of any interest in the husband. ____ The husband should be awarded the following personal property: ____________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ____ The husband should be awarded his retirement benefits, pension plan, profit-sharing plan, deferred-compensation plan, and/or stock option plan held by husband’s employer, free of any interest in the wife. ____ Additional page attached; see section labeled “paragraph 20 continued.” DISTRIBUTION OF DEBTS XXI. ____ There are no outstanding debts of this marriage. ____ Husband should be required to pay the debts listed below: Petition for Dissolution of Marriage 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Name of Creditor What debt is for Amount ________________________________________________________________________ ________________________________________________________________________ ____ Wife should be granted a judgment against husband in the amount of $_________________, to be satisfied to the extent husband pays these debts. XXII. ____ Wife should be required to pay the debts listed below: Name of Creditor What debt is for Amount ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Petition for Dissolution of Marriage 13 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ____ Husband should be granted a judgment against wife in the amount of $________________, to be satisfied to the extent wife pays these debts. XXIII. Within 30 days of the date of judgment, each party should execute, acknowledge, and deliver whatever documents are necessary to accomplish the distribution of debts and property ordered by the court. FORMER NAME XXIV. ____ ____________________________’s former name of ______________________ should be restored. COURT COSTS AND FEES XXV. Deferred Costs: ____ Husband ____ Wife should be liable for all the court costs that were deferred. ____ Husband and Wife should each be liable for one-half the court costs and that were deferred. ____ The State of Oregon should have judgment against ____ Husband ____ Wife for ____ one-half ____ all the court costs. Petition for Dissolution of Marriage 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Court Costs and Fees Paid by the Parties . ____ Husband ____ Wife should be liable for ____ one-half ____ all the court costs and service fees that have been paid in this suit. ____ Husband ____ Wife should have a judgment against ____ Husband ____ Wife for _____ one-half ____ all of these costs. WHEREFORE, petitioner prays for a Judgment and Decree granting the relief petitioned for above, and other equitable relief that the Court deems just. STATE OF ______________________ ) ) County of ________________________ ) I, __________________________________ being duly sworn, say that I am the petitioner in this matter and that the foregoing Petition is true and correct to the best of my knowledge. ______________________________________________ Petitioner, Pro Se (signature) ______________________________________________ Print name ______________________________________________ Address ______________________________________________ City, State, Zip Code Petition for Dissolution of Marriage 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ______________________________________________ Telephone or Contact Telephone SUBSCRIBED AND SWORN to before me this ___________ day of ______________, ______, by _________________________________________________. ______________________________________________ Notary Public for ____________/Court Clerk My Commission Expires: _________________________ I certify that this is a true copy. _____________________________________ Petitioner (signature) Petition for Dissolution of Marriage 16