Free Form 2a Affidavit - Oregon

Form 2a 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. _____________________

AFFIDAVIT ____________________________ ________________________________________

________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________

Additional page attached, labeled "Affidavit, continued."
___________________________________________________________________________________________ Petitioner Respondent, Signature Print Name ___________________________________________________________________________________________ Address or Contact Address City, State, Zip Telephone or Contact Telephone

SIGNED AND SWORN to before me this ___________ day of _______________, 20 _____. ____________________________________ Notary Public for ____________/Court Clerk My Commission Expires: _______________

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

Page 1 of 1, AFFIDAVIT
Linn County Form Affidavit Blank.wpd (3/01)