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Fill and Sign the Respondent Affidavit Form

Fill and Sign the Respondent Affidavit Form

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Select the sample of affidavit and open it.
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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 RESPONDENT’S and ) AFFIDAVIT RESPONDING TO MOTION TO MODIFY ________________________________, ) Respondent. ) STATE OF ________________________ ) ) County of _________________________ ) I, ____________________________________, being first duly sworn, say: I am the _ petitioner _ respondent in this case. I make this affidavit to respond to the motion to modify that has been filed. ____ I disagree with the following request(s) made by the other party: ______________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Petitioner’s / Respondent’s Affidavit Responding to Motion to Modify 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 ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ___ I disagree with these requests because: ____________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Information Required by the Uniform Child Custody Jurisdiction and Enforcement Act. (Please fill in the following blanks) a. The parties’ minor child/ren are: _______________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ b. The child/rens’ present address is: ______________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Petitioner’s / Respondent’s Affidavit Responding to Motion to Modify 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 ______________________________________________________________________________ c. The places where the minor child/ren of the parties have lived in the last five years and the names of the person with whom the child/ren 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 C continued.” d. The current addresses of the persons listed above with whom the minor child/ren have lived are: Name Address ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ___ I have not participated in any litigation concerning the custody, visitation, parenting time or placement of the children in this or any other state. Petitioner’s / Respondent’s Affidavit Responding to Motion to Modify 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 participated in the following litigation regarding the child/ren’s custody, visitation, parenting time or placement: Name of Court State Case No. Date Result ______________________________________________________________________________ ______________________________________________________________________________ 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) ______________________________________________________________________________ I do not know any person (other than the respondent) 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) ______________________________________________________________________________ Dated this _______ day of _________________, ________. ________________________________________ ___ Petitioner __ _ Respondent, Pro Se, Signature Petitioner’s / Respondent’s Affidavit Responding to Motion to Modify 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 certify that: ___ 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 __________________________________________ Print Name __________________________________________ Address __________________________________________ City, State, Zip Code ______________________________________ Telephone Petitioner’s / Respondent’s Affidavit Responding to Motion to Modify 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 I certify that this is a true copy: _______________________________________ Signature Petitioner’s / Respondent’s Affidavit Responding to Motion to Modify 6

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