Free Form 12 General Judgment of Dissolution - Oregon


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State: Oregon
Category: Court Forms - Local
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URL

http://www.ojd.state.or.us/LIN/home.nsf/Files/p3f12.pdf/$File/p3f12.pdf

Download Form 12 General Judgment of Dissolution ( 64.0 kB)


Preview Form 12 General Judgment of Dissolution
Form 12
IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN

In the Matter of the Marriage of: ) ______________________________________, ) Petitioner, ) ) and ) ) ______________________________________, ) Respondent, ) ) Case No. ______________________



GENERAL JUDGMENT OF DISSOLUTION OF MARRIAGE



STIPULATED GENERAL JUDGMENT OF DISSOLUTION OF MARRIAGE [Both Parties Must Sign]

If this box is checked, both parties to this dissolution action have signed
this document and are filing as Co-Petitioners.
1. This matter came before the Court: On the motion and affidavit of Petitioner, the default of Respondent having been found. On the motion and affidavit of Petitioner, Respondent having filed a Waiver of Further Appearance. On the stipulations of the parties, as shown by the signatures below. On the affidavit of Co-Petitioners signatures. The court has waived the 90 day waiting period based on the following: the parties have entered into a stipulated (agreed to) judgment, or other:______________________________________________. At a hearing held ______________________, at which the following persons were present:
(Date)

Petitioner Petitioner's attorney ________________________________________ Respondent Respondent's attorney _____________________________________
2. Findings. The Court considered the: Affidavit Affidavit and stipulations Evidence presented and found that: A. B. Irreconcilable differences have caused the irremediable breakdown of this marriage.

Husband Wife has/have been a resident of and domiciled in the state of Oregon continuously for six
months immediately prior to the filing of the Petition for Dissolution of Marriage.

C.

There are no unemancipated children under the age of 18 of this marriage, OR no child of this marriage is age 18 to 21 and a "child attending school" as defined in ORS 107.108. Wife is not now pregnant.

D.

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NOW, THEREFORE, IT IS HEREBY ORDERED: The terms of this judgment are effective immediately. The marital status of the parties shall terminate on the date this judgment is signed by the judge. 1. Spousal Support, Life Insurance and Medical Coverage.

No spousal support, spousal life insurance, or spousal medical coverage is ordered in this case. The terms set out below shall be in effect.
Spousal Support. Support shall be paid by: Husband to Wife (or) Wife to Husband In the amount of: $________________ per month, or $____________ by __________(date). Period support payments shall last: __________________________, or the death of either party, whichever comes first. The support shall be called (check one or more): transitional compensatory spousal maintenance, based on consideration of the following factors: _________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ _______________________________________________________________________________________________________. Judgment is entered accordingly in the Money Award. Payments. Payments shall be made on the first day of each month beginning the month following the date the judgment is signed by a judge. All payments of spousal support shall be made: (check (a) or (b)) (a) To the Department of Justice, Child Support Accounting Unit, P.O. Box 14506, Salem, Oregon, 97309. Petitioner requests that collection, accounting, disbursement, and enforcement services be provided through the Department of Justice. (b) Directly into __________________________________'s checking, savings account, or the parties shall establish an electronic funds transfer arrangement to have the support payments paid directly from the payor's bank account into payee's bank account. A receipt of deposit shall be kept by the paying spouse as proof of payment. The spouse receiving support should provide the paying spouse with current deposit slips and/or bank name, account name, and account number. Life Insurance. Husband Wife shall buy and maintain life insurance for the benefit of Husband Wife throughout the period of the spousal support obligation in the amount of $___________________. Medical Coverage. Husband Wife shall buy and maintain health, accident, dental and optical insurance for the benefit of Husband Wife if insurance is available through his/her employment, group or union. The insurance payments shall be additional spousal support, and shall be treated as such for tax purposes. If coverage for a former spouse is available through the purchasing spouse's employment, group or union, and this membership is later terminated, the purchasing spouse shall notify the other spouse of this before or immediately upon termination. 2. Real Property Distribution. Neither wife nor husband has any interest in any real property located in this or in any other state. Husband Wife has/have an interest in real property located at the address of _____________________________ _________________________________________________________________________________________________ This property shall be distributed as follows : _________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ The legal description of the property is attached as "Exhibit ____" and incorporated into this Judgment. Husband Wife shall be responsible for the preparation, signing and recording of a deed, transferring the real property as required by this Judgment. Distribution of this property is not within the jurisdiction of this court. Page 2 of 6 - GENERAL JUDGMENT OF DISSOLUTION OF MARRIAGE
Linn Co unty Form D isso -1B : Form 12 General Judgment of Dissolution.wpd (2/06)

3.

Personal Property Distribution (including motor vehicles). The wife and husband have divided between them all personal effects, household goods and other personal property they own separately or together, and each shall be awarded those items now in their possession. The wife is awarded the following personal property: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ The wife is awarded her retirement benefits, pension plan, profit-sharing plan, deferred compensation plan, and/or stock option plan held by wife's current or past employer, free of any interest in the husband. The husband is awarded his retirement benefits, pension plan, profit-sharing plan, deferred compensation plan, and/or stock option plan held by husband's current or past employer, free of any interest in the wife. The husband is awarded the following personal property: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Additional page attached labeled "paragraph 3 continued". Distribution of Debts.

4.

There are no outstanding debts of this marriage. The debts shall be paid as follows:
Name of Creditor (who money is owed to) What debt is for Amount Who shall pay (Husband or Wife)

Additional page attached, labeled "paragraph 4 continued".
Each party shall be responsible for the payment of all debts incurred by him or her individually since the date of the separation; all debts which are distributed to him or her by the court; and all debts which are secured by property distributed to that party. Also, if any creditor asks the spouse not responsible for a debt to pay all or a portion of it, and he or she does so, the spouse responsible for that debt shall reimburse the other spouse for any monies he/she paid to the creditor after the date this Judgment was entered.

The date of separation (when you began living apart) was: _______________________.

5.

Transfer of Property and Debts. Within thirty (30) days of the date of this Judgment, each party shall execute, acknowledge and deliver whatever documents are necessary to accomplish the distribution of debts and property ordered by the court. The Judgment shall operate to convey title to the party awarded the property if the other party fails to comply with this requirement. 6. Former Name.

Husband's Wife's former name of ____________________________________ is restored. /// ///
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7.

Court Costs and Fees. A. Costs and Fees Paid by the Parties Each party shall be responsible for paying his or her own court costs and service fees for this case. Husband Wife shall reimburse the other spouse for his or her court costs and service fees for this case. Other: ________________________________________________________________________________. Judgment shall be entered according to the cost and fee allocation listed in the Money Award.

8.

Information Required by ORS 25.020 and ORS 107.085. Wife Full Name Former Legal Name(s) Age Address or Contact Address Telephone Number Social Security Number Drivers License Number Employer Name Employer Address Please provide your Social Security number on the UTCR 2.100 Form only Please provide your Social Security number on the UTCR 2.100 Form only Husband

Employer Telephone Based on a finding that the health, safety, or liberty of Husband Wife would unreasonably be put at risk by disclosure of the following information, Husband Wife has been allowed not to disclose this information. Additional page labeled "Paragraph 8 continued" attached. Both parties shall inform the Court and the Department of Justice (P.O. Box 14506, Salem, Oregon 97309) in writing of any change in the above information required by ORS 25.020 within ten (10) days of such change, unless a finding of unreasonable risk has been made in this case.

If the court has ordered that a party be allowed not to disclose information by means of this Judgment in the previous paragraph above, the Department of Justice or the District Attorney shall not disclose the information in the preceding section to the other parent.

Date of marriage: _____________ Place of marriage: _________________________________________________ /// ///

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Linn Co unty Form D isso -1B : Form 12 General Judgment of Dissolution.wpd (2/06)

9.

MONEY AWARD Money Award included not included. Wife Husband

Full Name Attorney's Name, Telephone Number and Address The following information is only required if spouse is listed as judgment debtor below. Date of Birth Social Security Number Driver's License Number and State of Issuance Please provide your Social Security number on the UTCR 2.100 Form only Please provide your Social Security number on the UTCR 2.100 Form only

The following person(s) or public bod(ies) are known by (either) judgment creditor to be entitled to a portion of a payment made out of the judgment (other than the judgment debtor's attorney): ____________________________________________________ ________________________________________________________________________________________________________

Type of Judgment Spousal Support Court Costs Service Fees Property Division Other: /// /// /// /// /// /// ///

Creditor (to receive payment from debtor)

Debtor (required to pay)

Amount of Judgment per month

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Linn Co unty Form D isso -1B : Form 12 General Judgment of Dissolution.wpd (2/06)

Interest accrues on all judgments at 9% per annum, simple interest from the date the judgment is entered. For purposes of spousal support, interest accrues on each unpaid installment as it becomes due on the first day of each month. Monthly payments begin the ______ day of the month following the date the judgment is signed. DATED this ________ day of ________________________________, 20______.

______________________________________________ Circuit Court Judge

_______________________________________________ Print Name

_________________________________ __________ Petitioner/Co-Petitioner, Signature Date

______________________________________ ________ Respondent/Co-Petitioner, Signature Date

If both parties have agreed (stipulated) to the terms of this judgment, they both are required to sign above.

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 and I completed it without paid assistance. I paid or will pay money to ________________________________ for assistance in preparing this form. Submitted by: ____________________________________________________________________________________________ Petitioner Respondent Signature Print Name Date ____________________________________________________________________________________________ Address or Contact Address City, State, Zip Telephone or Contact Telephone

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

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Linn Co unty Form D isso -1B : Form 12 General Judgment of Dissolution.wpd (2/06)