Free Form 3 Request To Initiate or Waive Mediation - Oregon


File Size: 36.7 kB
Pages: 3
Date: April 15, 2005
File Format: PDF
State: Oregon
Category: Court Forms - Local
Word Count: 536 Words, 5,034 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.ojd.state.or.us/LIN/home.nsf/Files/Mediation.pdf/$File/Mediation.pdf

Download Form 3 Request To Initiate or Waive Mediation ( 36.7 kB)


Preview Form 3 Request To Initiate or Waive Mediation
IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN IN THE MATTER OF THE MARRIAGE OF SEPARATION OF CUSTODY PROCEEDING OTHER _______________________________________ PETITIONER, AND _______________________________________ RESPONDENT, ) ) ) ) ) ) ) ) ) ) )
Motion

Case No.________________________

MOTION AND AFFIDAVIT FOR ORDER TO INITIATE MEDIATION WAIVE MEDIATION WAIVE CO-PARENTING CLASS

I, ______________________________, request that the court issue an Order to Initiate Mediation, Order to Waive Mediation, Order to Waive Co-Parenting Class.
Affidavit in Support of Motion STATE OF OREGON ) County of Linn ) ss. I, Petitioner Respondent, being first duly sworn, say that the following is true: Custody and Parenting time issues are are not in dispute. Other

Dated: ________________________, 20____. _________________________________________ _______________________________________________ Petitioner, Signature Print Name _________________________________________________________________________________________ Address or Contact Address City, State, Zip Telephone or Contact Telephone

SIGNED AND SWORN to before me this _________ day of ______________, 20_____, by _________________________________________________. ____________________________________ Notary Public for ____________/Court Clerk My Commission Expires: ______________
Page 1 of 2, MOTION/AFFIDAVIT/ORDER FOR MEDIATION
LINN COUNTY FOR M Motion Mediation.wpd (4/05)

ORDER REFERRING CASE TO MEDIATION COME NOW THE COURT, upon consideration of Local Trial Court, Chapter 8, and finds that the above matter has been filed in Linn County Circuit Court, and that the matter involves a potential controversy over custody or parenting time of minor children and is therefore subject to mediation. Based upon the Motion and Affidavit of the Petitioner Respondent on file herein, the request for and an Order to Initiate Mediation, Order to Waive Mediation, Order to Waive Co-Parenting Class is hereby:

Allowed Denied

DATED this ____ day of ______________, 20______. __________________________________ Circuit Court Judge __________________________________ Print Name

You are required to truthfully complete this certificate regarding the documents you are filing with the court. Check all boxes and complete all blanks that apply: I selected these documents for myself, and I completed them without paid assistance. I paid or will pay money to ____________________________ for assistance in preparing this document. Dated: ___________________, 20______. Submitted by: ______________________________________________ ________________________________________________ Signature Print Name _______________________________________________________________________________________________ Address or Contact Address City, State, Zip Telephone or Contact Telephone

I certify that this is a true copy: _______________________________________ Petitioner, Signature

Page 2 of 2, MOTION/AFFIDAVIT/ORDER FOR MEDIATION
LINN COUNTY FOR M Motion Mediation.wpd (4/05)

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN

IN THE MATTER OF THE MARRIAGE OF SEPARATION OF CUSTODY PROCEEDING OTHER

____________________________________ PETITIONER, AND ____________________________________ RESPONDENT.

) ) ) ) ) ) ) ) ) ) ) )

Case No. _________________________

CERTIFICATE OF MAILING

I certify that on _____________________________, 20_______, I mailed a true copy of: _________________ _____________________________________________________________ previously filed in this case:
(List documents)

to the other party directly, at the following address, because s/he has no attorney:
_________________________________________________________________________________________ to the other party's attorney ___________________________________ at the following
(Name of other party's attorney)

address: ________________________________________________________________________________________ _______________________________________________________________________________________________. Mailing was done by first class mail and by certified or registered mail, return receipt requested, or express mail. 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 form myself, and I completed it without paid assistance. I paid or will pay money to _______________________ for assistance in preparing this form. Dated: _______________________, 20______. _______________________________________________ _______________________________________________ Petitioner, Signature Print Name _______________________________________________________________________________________________ Address or Contact Address City, State, Zip Telephone or Contact Telephone

Page 1 of 1, CERTIFICATE OF MAILING
LINN COUNTY FOR M 6A -Certificate of Mailing.wpd 4/20/01)