Free Form 9 Affidavit in Support of Motion for Order of Default - Oregon

Form 9
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. ______________________

PETITIONER'S RESPONDENT'S
AFFIDAVIT IN SUPPORT OF MOTION FOR ORDER OF DEFAULT

I, _______________________________, being first duly sworn, say: I am the Petitioner Respondent in this proceeding.

To my best knowledge and belief, the Petitioner Respondent is not now, and was not at the time of the service of
the Motion, Affidavit, and Order re: Modification of Judgment, in the active military service of the United States, a minor, "incapacitated," a "financially incapable" person, a "protected person," nor a "respondent" in a fiduciary protective proceeding, as defined by Oregon law.

The Petitioner Respondent is now, or was at the time of the service of the Motion, Affidavit, and Order re:
Modification of Judgment, in the active military service of the United States, but the Petitioner Respondent has waived his or her rights under the Soldiers and Sailors Civil Relief Act, as shown by the attached affidavit, labeled as Exhibit _____. 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 document. DATED this _______ day of ____________________, 20_____.

____________________________________________________________________________________ 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_____, by _________________________________________________. ________________________________ Notary Public for ____________/Court Clerk My Commission Expires: ______________

Page 1 of 1 - PETITION ER'S/RESPONDENT 'S AFFIDAVIT IN SUP PORT OF MO TION FOR ORDER O F DEFAULT
LIN N CO U N TY FO RM M od ificat ion- 4A : Form 9 Affidavit in Support of motion for Order of Default.wpd (12/17/03)