Free Request for default judgment / money award - Oregon

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR LINN COUNTY
_____________________________________________ Plain tiff(s), vs. _____________________________________________ ) ) ) ) ) ) _____________________________________________ ) Defend ant(s). ) CASE NO : _____________________________ REQUEST FOR D EFAULT JUDGMEN T, NON-MILITARY, NON-MINOR A FFIDAVIT, AND MONEY AWARD ____ Gen eral ____ Limited ____ Supp lemental

I, the above na me d Plaintiff, hereby request a Judgm ent be en tered against the Defend ant(s) ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ __, a nd bein g first du ly sw orn, state: 1. T hat D efen dan t(s) was duly and regularly served w ith a copy of th e claim and notic e of claim and failed to pa y the claim or demand a hearing or trial within 14 days from date of service; that the Defendant(s) is not now in the military service of the United States as defined by the "Servicememb er Civil Relief Act", and is not a minor or an incapacitated person as defin ed in OR S 125,005; 2. That Judgm ent should b e entered for $_ _____ _____ ____, pre -judgm ent interest of $_____ _____ _ plus ___ ___ p ercent post judgm ent in terest, cou rt costs and service expenses of ** $_____________, and prevailing party fee of $85.00; _____________________________________________________
Plaintiff/Plaintiff's Agent signature

_____________________________________________________
Address

_____________________________________________________
City OR Zip Phone #

Subscribed and sworn to before me on __________________________________, 20____. __________________________________________________________ Clerk of the Court/Notary Public for Oregon My Commission expires: ______________
** If your service expenses exceed the statutory rate, submit an affidavit of additional service expense or a copy of your receipts for service.
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

DEFAULT JUDGMENT
Default Judgment is entered in favor of the plaintiff and against the defendant as set out in the Money Award below.

MONEY AWARD
JUDGMENT CREDITOR(S): JUDGMENT DEBTOR(S): DEBTOR 1 - Address: (If known) _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________________ SSN or TAX ID: _______________________ DR LIC #/STATE: _______________________

DOB: _______________

DEBTOR 2 - Address: (If known)

_________________________________________________________________________________________________ SSN or TAX ID: _______________________ DR LIC #/STATE: _______________________ $__________________ $__________________ $______85.00_______ PRE-JUDGMENT INTEREST: $__________________ ________%

DOB: _______________

JUDGMENT AMOUNT: COURT COSTS/SERVICE EXPENSES: PREVAILING PARTY FEE:

POST JUDGMENT INTEREST RATE: TOTAL JUDGMENT:

$__________________

DATED: ________________________
Rev 9/07

BY:

____________________________________________________ Circuit Court Judge/Court Operations Specialist