Free Defendant's Affidavit - Oregon

IN THE CIRCUIT COURT FOR THE STATE OF OREGON FOR THE THIRD JUDICIAL DISTRICT PO Box 12869 Salem, Oregon 97309-0869 State of Oregon Plaintiff v _______________________________ Defendant STATE OF OREGON County of Marion ) ) ) ) ) ) ) ) ) DEFENDANT'S AFFIDAVIT (Trial by Affidavit) Case #______________________

ss.

I, __________________________________, hereby waive my right to trial by personal appearance in Court and submit my evidence by this affidavit to the Court. I understand that I will be notified by mail of the findings. The testimony that I wish to submit for consideration by the Court is as follows, and I swear/affirm the following is true: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ DEFENDANT'S AFFIDAVIT - Page 1 of 2 FC (2/22/04)

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Signature:_____________________________________________________________________ Print Name: ___________________________________________________________________ Mailing Address:________________________________________________________________ City, State, Zip:_________________________________________________________________ Subscribed and sworn before me this______day of ____________________, 20_____ _____________________________________ Notary Public/Deputy Court Administrator My Commission Expires:_________________ DEFENDANT'S AFFIDAVIT - Page 2 of 2 FC (2/22/04)