Form 2 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN IN THE MATTER OF THE MARRIAGE OF SEPARATION OF CUSTODY OF ___________________________________, Petitioner, and ___________________________________, Respondent. STATE OF ______________________ County of _______________________ ) ) ss. ) ) ) ) ) ) ) ) ) ) ) )
Case No. ______________________ AFFIDAVIT IN SUPPORT OF MOTION FOR ORDER TO SHOW CAUSE RE: MODIFICATION OF JUDGMENT MODIFYING CUSTODY PARENTING TIME CHILD SUPPORT
I, Petitioner Respondent, being first duly sworn, say that the following is true: 1. The names, ages and birth dates of the child/ren involved in this case are: _____________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 2.
I want to change CUSTODY because of a change of circumstances since the last custody order. This change
is: _______________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ The current child support obligation should be terminated if the custody change is ordered.
Page 1 of 3, AFFIDAVIT IN SUPPORT OF MOTION FOR ORDER TO SHOW CAUSE RE: MODIFICATION OF JUDGMENT
LIN N CO U N TY FO RM M od ificat ion- 4A : Form 2 Affidavit in Support of Motion for Order to Show C ause Re M odification of Judgment (4-04)
3.
I want to change PARENTING TIME (visitation) because I believe the change is in my child/ren's best
interests. The specific reason(s) I want the change and believe the change would be best for my child/ren is/are:_____________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
4.
UCCJEA Information. 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/Contact Address of Parent/Caretaker Which Children
Additional page attached; see section labeled "paragraph 4 continued."
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
Page 2 of 3, AFFIDAVIT IN SUPPORT OF MOTION FOR ORDER TO SHOW CAUSE RE: MODIFICATION OF JUDGMENT
LIN N CO U N TY FO RM M od ificat ion- 4A : Form 2 Affidavit in Support of Motion for Order to Show C ause Re M odification of Judgment (4-04)
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 the kind of proceeding)
I do not know any person other than the other parent 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)
____________________________________________________________________________________ Petitioner Respondent, 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 3 of 3, AFFIDAVIT IN SUPPORT OF MOTION FOR ORDER TO SHOW CAUSE RE: MODIFICATION OF JUDGMENT
LIN N CO U N TY FO RM M od ificat ion- 4A : Form 2 Affidavit in Support of Motion for Order to Show C ause Re M odification of Judgment (4-04)