Free Form 1 Response to Petition - Oregon

Form 1

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN In the Matter of: ________________________________, Petitioner, and ) ) ) ) ) ) ) ) ) )

Case No. ____________________ RESPONSE TO PETITION (CHILD CUSTODY/PARENTING TIME) and COUNTERCLAIM

________________________________, Respondent.

1.

Respondent appears and agrees with the petition filed in this case, except paragraph(s): _________________________________________________________________________________________ ________________________________________________________________________________________.

2.

Respondent makes the following counterclaim(s):
(a) ______________________________________________________________________________________ _________________________________________________________________________________________ (b) ______________________________________________________________________________________ _________________________________________________________________________________________

Additional page attached labeled "Counterclaims, continued."
3. Information Required by the Uniform Child Custody Jurisdiction and Enforcement Act. List the places where the minor child/ren of the parties have lived in the last five years and the names of the people they lived with at that time. Dates County, State Parent(s)/Caretaker Current Address or Contact Address of Parent/Caretaker Which Children

Additional page attached; see section labeled "UCCJEA Information Continued".

Page 1 of 2, RESPONSE (CHILD CUSTODY/PARENTING TIME)
Linn Co unty Fo rm U nma rried Pa ren ts-3 B: Form 1 Response to Petition.wpd (4/04)

I have have not participated in any litigation concerning the custody, visitation, parenting time or placement of the child/ren in this or any other state. I have participated in the following litigation: 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, or of any other court case which could affect this case, pending in this or any other state except for:____________________________________________________________________________________ _______________________________________________________________________________________________
(identify court, case number and kind of proceeding)

I do not know any person other than petitioner who has physical custody of the child/ren or who claims to have custody, visitation or parenting time rights except for: _________________________________________________ _______________________________________________________________________________________________
(list name and ad dress)

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. ________________________________________

Respondent, Signature
STATE OF __________________________ County of ___________________________ ) ) ss. )

Date

I, _______________________________, being duly sworn, say that I am the respondent in this matter, and that the statements in this Response are true and correct to the best of my knowledge.
________________________________________________

__________________________________________ 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. ________________________________ Respondent, Signature Page 2 of 2, RESPONSE (CHILD CUSTODY/PARENTING TIME)
Linn Co unty Fo rm U nma rried Pa ren ts-3 B: Form 1 Response to Petition.wpd (4/04)