Fill and Sign the Petitioners Affidavit Supporting Judgment Oregon 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, ) PETITIONER’S AFFIDAVIT and ) SUPPORTING JUDGMENT OF DISSOLUTION ________________________________, ) Respondent. ) STATE OF ________________________ ) ) County of _________________________ ) I, ____________________________________, being first duly sworn, say: I am the petitioner in this proceeding. Respondent and I were married on the ______ day of ____________________, _________, in the County of __________________________, State of___________________________. Irreconcilable differences between us have caused the irremediable breakdown of our marriage. ____ Petitioner ____ Respondent was an Oregon resident continuously for more than six months immediately prior to commencement of this suit. Petitioner’s Affidavit Supporting Judgment of Dissolution 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 ____ No domestic relations suits involving this marriage of Petitioner and Husband are pending in any other court. ____There are ________ child/ren of the marriage. ____ The wife is pregnant with husband’s child. The wife was cohabiting with the husband when the child was conceived. The expected date of the child’s birth is ________________________. ____The wife is not now pregnant. ____ Child(ren) named _______________________________ were born to 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 _____________________________. Respondent has not appeared in this matter and an Order of Default has been entered. This case is now ready for a hearing on the merits. I make this affidavit in support of a Judgment and Decree of Dissolution of Marriage without a hearing. The allegations in my Petition are true and it is just and reasonable that I be granted the relief I request. ____ Child custody or child support is involved in this case and at the time of filing: ____ The child/ren had continuously resided in Oregon for six months. ____ The child/ren had lived in Oregon continuously for six months sometime during the twelve months prior to filing, and the child/ren are not now in Oregon but one parent lives in this state. Petitioner’s Affidavit Supporting Judgment of Dissolution 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 ____ The child/ren had lived in another state continuously for six months prior to filing, but a court in that state had 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) Oregon and substantial evidence about them is available here. ____ The child/ren were physically present in Oregon at the time of filing 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. That emergency is: ________________________________________________________________________ ________________________________________________________________________ The current residence of the minor child/ren is: Name of Child Resides With For How Long ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ____ Parenting time should not be ordered because my child/ren’s health or safety would be endangered because: _______________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Petitioner’s Affidavit Supporting Judgment of Dissolution 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 ____ I have good reason for the court to allow me to move more than 60 miles distant from the other parent without giving written advance notice to the other parent. My good cause is: _____________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ____ Child support or spousal support is involved: I believe that respondent’s gross monthly income is approximately $____________. My gross monthly income is approximately $ _________. The child support amount I have requested _____ does not deviate from the amount presumed correct under Oregon Administrative Rules, or ____does deviate from the presumed amount of $ ___________ because: ______________________________________________________________________________ ______________________________________________________________________________ ____ There is an existing child support order, a certified copy of which is on file in this case. As of today’s date, the back child support owed is _________________. The (Total amount not paid to date) next payment of ______________ is due on _____________________. (Monthly payment) (Date due) __________________________________________ Petitioner, Pro Se (Signature) __________________________________________ Print Name __________________________________________ Address __________________________________________ City, State, Zip Code __________________________________________ Telephone Petitioner’s Affidavit Supporting Judgment of Dissolution 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 SUBSCRIBED AND SWORN to before me this ___________ day of ______________, ______, by _______________________________________________. __________________________________________ 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. ____ I was provided this document by an attorney. ____ I completed this document without paid assistance. ____ I paid or will pay money to _____________________________ for assistance in preparing this document. __________________________________________ Signature Petitioner’s Affidavit Supporting Judgment of Dissolution 5