Free Emancipation Information (PDF) - Oregon

IN THE CIRCUIT COURT OF THE STATE OF OREGON THIRD JUDICIAL DISTRICT Juvenile Division

In the Matter of the Emancipation of: ______________________________________ Applicant The Applicant states as follows: 1) 2)

) ) ) ) )

No. APPLICATION FOR JUDGMENT OF EMANCIPATION

I was born on the ______ day of ______________, 19___ and I am now _____ years of age. I currently reside at __________________________________________, in the city of ________________, County of Marion, Oregon, and I intend that Marion County be my place of residence for the indefinite future. My custodial parent(s) or guardian(s) ___do ___do not consent to my emancipation. I am substantially able to be self-sufficient and self-supporting without parental guidance and supervision. I am sufficiently mature and knowledgeable to manage my own affairs without parental assistance. WHEREFORE, I request that the Court enter a Judgment as follows: 1) Declaring me to be an emancipated minor; 2) Advising me of my civil and criminal rights and liabilities; and 3) Instructing me to obtain from the Oregon Motor Division an Oregon driver's license or identification card with a notation thereon of my emancipated status.

3) 4)

5)

Parent's Name

Applicant

Street Address

Street Address

City, State, Zip Code

City, State, Zip Code

Phone

Phone

SUBSCRIBED and SWORN to before me this day of , 20 .

Applicant Signature

Notary Public for the State of Oregon My Commission Expires:
JUV-PROBATION-010.app REV: 3-21-04