FILING FOR CUSTODY, PARENTING TIME, & CHILD SUPPORT

Instructions – Unmarried Parents OJD Official

Page 1 of 24

(Jul 2023)

FILING FOR CUSTODY, PARENTING TIME, &

CHILD SUPPORT FOR UNMARRIED PARENTS

TABLE OF FORMS

1. Starting your Case (See the last box of this table for additional forms you may need)

___ Petition for Custody and Parenting Time, and Child Support

___ Summons

___ Notice of Statutory Restraining Order Preventing Dissipation of Assets

___ Confidential Information Form (CIF) (one for each party, including adult children)

___ Notice of CIF Filing

Optional:

___ Fee Deferral or Waiver Application and Declaration

2. Notifying the Other Party (Respondent)

___ Acceptance of Service (if possible)

___ Certificate of Service

___ Certificate of Mailing to DCS (if you or the respondent is receiving public assistance)

3. Temporary Orders

4. Resolving Your Case

By Agreement

___ Declaration in Support of Judgment

___ General Judgment of Custody and Parenting Time, and Child Support

By Default

__ Ex Parte Motion for Order of Default and Declaration in Support

___ Order on Motion for Default

___ Declaration in Support of Judgment

___ General Judgment of Custody and Parenting Time, and Child Support

By Hearing

___ General Judgment of Custody and Parenting Time, and Child Support

Instructions – Unmarried Parents OJD Official

Page 2 of 24

(Jul 2023)

Additional forms you may need: (More information is in the Instructions below)

___ Parenting Plan

___ Fee Deferral or Waiver Application and Declaration (optional)

___ Child Support Worksheets

___ Uniform Support Declaration

___ Parenting Class Certificate of Completion (if required for your court)

___ Waiver of Personal Service

___ Waiver of Further Appearance and Consent to Entry of Judgment (for adult children)

___ End-of-case Fee Waiver Application

What these forms do

This set of forms will help you get a court order for custody, parenting time, and child support

if you are not married to the other parent and have children under 18, and support for a child

who is 18, 19, or 20 years old and attending school.

Symbols used

in this form:

Important Note

STOP! You may not be able to use this form

Caution! You may need a lawyer

Timing requirement

Important Contact Information

Oregon Judicial Department – www.courts.oregon.gov

Oregon State Bar Lawyer Referral Service - www.oregonstatebar.org

Phone: 503.684.3763 or toll-free in Oregon at 800.452.7636

If you are deployed or about to be deployed, contact the Oregon State Bar Military Assistance

Panel (www.osbar.org/_docs/ris/militaryflier.pdf

) for information about special rights and

rules that may apply to you.

Instructions – Unmarried Parents OJD Official

Page 3 of 24

(Jul 2023)

Table of Contents

General Information ............................................................................................... 5

TEP 1: STARTING YOUR CASE ............................................................................. 6

UCCJEA………………………………………………………………………………………………………7

Custody and Parenting Time (Visitation) ................................................................. 8

Safety ………………………………………………………………………………………………………. 8

Child Support ........................................................................................................... 9

TEP 2: FILING AND SERVICE .............................................................................. 11

ERVICE ……………………………………………………………………………………………………..12

Formal Service ........................................................................................................ 12

TEP 3: TEMPORARY ORDERS ............................................................................. 14

Domestic Violence ................................................................................................... 14

TEP 4: RESOLVING YOUR CASE ......................................................................... 15

HE JUDGMENT .................................................................................................... 19

Appendix A – Custody and Parenting Plans .......................................................... 21

Appendix B – Uniform Support Declaration ........................................................ 23

Appendix C – Support for a Child Attending School ............................................ 24

Appendix D – Statutory Restraining Order .......................................................... 25

Instructions – Unmarried Parents OJD Official

Page 4 of 24

(Jul 2023)

Parentage Parentage (who the parents of the minor children are) must be legally

established before you can use these forms if you want the court to order custody,

parenting time, or child support for minor children.

 Parentage is established if both biological parents sign and file a birth

certificate or Voluntary Acknowledgment of Paternity (a statement that says

who the parents are) with the State Registrar of Vital Statistics. This is

usually signed in the hospital when the child is born.

 Parentage can also be established through the Oregon Child Support

Program or through the courts before you file these forms. Contact the

Oregon Child Support Program (www.oregonchildsupport.gov

) or a lawyer.

 Parentage is presumed if you and the other parent were married at the time

of the child’s birth or if the child was born within 300 days after the

marriage ended. This presumption can be rebutted (challenged).

Notice about these instructions and forms

These instructions are not a complete statement of the law. They cover basic

procedures for simple cases involving custody, parenting time, and child support. If

you have complicated issues or questions about the law, talk to a lawyer.

All of the necessary forms should be online. If you cannot find a form, ask your local

court.

Each court has local rules, programs, and procedures that may not be explained in

these instructions. Refer to the Supplementary Local Rules for your county. These

rules are available online or at your local court or law library. Forms and information

about your local court are on the Oregon Judicial Department website.

WHO IS A “CHILD”?

 A child must be born before you can file these forms

o If you are pregnant with another child when you file this Petition and the child is

also the child of the Respondent, you will need to file an amended Petition after

the child is born. Talk to a lawyer if you need to do this.

 Children who have been emancipated are not “children” for purposes of these forms. A

child is considered emancipated (independent) if the child:

o Has been declared emancipated by a court order or

o Is legally and validly married

 Adult Children: If you have a child age 18, 19, or 20 years old, that child is a

“necessary party” to any family law case until his or her 21

birthday. The child

must be included in your filings and properly served with all documents. The child

may later waive the right to be part of the case, but this must be done formally after

you file. If you fail to properly serve an adult child, your case may be delayed until

you do.

Instructions – Unmarried Parents OJD Official

Page 5 of 24

(Jul 2023)

o Child Attending School, ORS 107.108: If you have an adult child, child

support may be ordered for that child as long as the child is attending school.

More information is included below.

 NOTE FOR PREVIOUSLY MARRIED COUPLES

If you and the respondent were married before and already divorced, you may be able

to use these forms.

o If the child was born more than 300 days after your dissolution judgment was

signed, then you can use these forms.

o If the child was born less than 300 days after your dissolution judgment was

signed, talk to a lawyer. You may need to amend your prior filings and modify

your existing dissolution judgment.

CO-PARENTING EDUCATION

Many courts require that parents of minor children go to a court-approved co-

parenting class. Some courts will not allow you to finalize your case until you have

completed the class and filed a certificate of completion with the court. Contact the

court to see if you have to sign up or if the court will send you information after you

file.

General Information

 This type of case starts with a “petition,” which tells the court what you want. That’s

why you are called the “petitioner.” The other parent is the “respondent.” The

case ends with a “judgment,” which is the court’s final decision. The judgment is the

document that finalizes your case and contains your rights and responsibilities.

 Keep the court and all other parties informed of your current address. You don’t

have to use your home address. You may use any contact address where you

regularly check in, as long as it is in the same state as your home. The court will

assume that you receive all notices and documents sent to that address. It is YOUR

responsibility to let the court and other parties know if you move or

want to get mail at a different address.

Instructions – Unmarried Parents OJD Official

Page 6 of 24

(Jul 2023)

STEP 1: STARTING YOUR CASE

General Questions

 Where to File - You can file in the circuit court of the county where any

child lives, or in a county where either parent lives.

 Statutory Restraining Order – By filing your Petition, you agree to follow

the terms of an automatic restraining order. The order is effective once the

papers have been served on the respondent (see below for service

information). If you don’t follow the order, you can be held in contempt of

court and subject to penalties.

o You must attach a copy of the restraining order (called “Notice of

Statutory Restraining Order Preventing the Dissipation of

Assets in Domestic Relations Actions Between Unmarried

Parents”) to the Summons and serve it on the respondent. The form

is included as Appendix D

o The statutory restraining order prevents either party from making

changes to insurance policies without the agreement of the other party

if those policies are for the benefit of the children.

Filling Out The Forms

 MAKE SURE YOU COMPLETE THE COUNTY NAME AT THE TOP OF THE

FIRST PAGE OF EACH FORM

If Both Parties Agree on All Issues

Filing separately

You can file as Petitioner and the respondent can accept service of the Petition. Complete

the appropriate General Judgment form and have both parties sign it. If you file

separately, each party is required to pay a fee.

 The respondent can choose not to file a Response. If no response is filed,

judgment will be entered based on what is in the Petition after you file a

Motion for Order of Default (see “By Default” section below).

Filing together

You can choose to file as Co-parties using the Co-party Petition for Entry of Stipulated

Judgment form. You do not have to complete or serve the regular Petition if you choose to

file a co-party petition. Complete the appropriate General Judgment form and file it with

your Co-party Petition. All of the information you need to complete the forms is in these

instructions.

 If you file as co-parties, one of you will be labeled ‘petitioner’ and the other will

be ‘respondent.’ There is no legal or procedural difference between the

“petitioner” and “respondent” in co-party filings.

 If you file as co-parties, only one filing fee is required at the time of filing. Note

that if you file as co-parties and later need to file a modification of judgment,

you will have to pay both the filing fee for modification of judgment and the

second initial filing fee.

Instructions – Unmarried Parents OJD Official

Page 7 of 24

(Jul 2023)

 You are the “Petitioner” on ALL forms throughout this case,

and the other parent is the “Respondent.”

o Use full names (first, middle or middle initial, last) and print

names the same way on all forms – first, middle, last.

 Do not put Social Security numbers on your Petition. Social

Security numbers must be given to the court but kept confidential from

the public and the other party. Use the “Confidential Information Form”

(CIF) to protect your identifying information.

o Fill out one CIF for each party, including adult children.

o The Notice of Filing of Confidential Information Form must be

served on the respondent with your other documents. See below

for information about service.

 If the other parent does not respond, you may be able to get a

judgment by default (see “Resolving Your Case,” below, for more

information). As you fill out your Petition, you must include enough

information that the respondent knows what you are asking for. If you do

not include specific requests, the court will not be able to enter a

judgment by default until after you serve amended (changed) paperwork

on the respondent.

o NOTE: this often happens with parenting plans. See below for

more information.

Fill out the following forms

• Petition for Custody and Parenting Time, and Child Support

• Summons

• Confidential Information Form (CIF) (one for each party)

• Notice of Filing of Confidential Information Form

• Certificate of Mailing or Delivery to Division of Child Support (ONLY if

you or Respondent receives certain types of public assistance – see “Make

Copies” below)

You may need additional paperwork before the court can enter a judgment. See

the Appendices for more information about when you need each form.

◊ Parenting Plan - See Appendix A

◊ Uniform Support Declaration – See Appendix B

UCCJEA

The Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) is a law

that controls which state can decide issues of custody and parenting time. In

most cases, if all of the children you are asking the court to address have lived in

Oregon for the six months before you filed the Petition, Oregon courts can make a

decision. You must provide certain information before an Oregon court can

decide custody or parenting time.

Click here

to read the UCCJEA (ORS 109.701-.834).

Instructions – Unmarried Parents OJD Official

Page 8 of 24

(Jul 2023)

If you have any other orders or judgments about custody or parenting time from

other states, or if any of your children have not lived in Oregon for six months

before you file, you should see a lawyer.

Custody and Parenting Time (Visitation)

Read ORS 107.137

to see what a court will consider when awarding custody. The

most important factor is always the best interest and welfare of the child.

Custody and Parenting Time

Joint and Sole Custody are legal terms that generally refer to the right to make

certain decisions about the child. The parenting plan controls how much time

each parent has with the child. See Appendix A

for important information about

custody and parenting plans. The court can only award joint custody if both

parents agree to all of the terms. In most cases, both parents will have equal

rights to information about the child regardless of the type of custody ordered.

Both parents will have time with the child unless the court orders otherwise.

Parenting Plans

To avoid delay in your case, your Petition should include a parenting plan. A

parenting plan sets out the schedule and may include rules for each parent’s time

with the child. Your plan must include the minimum amount of parenting time

(formerly called “visitation”) you want the non-custodial parent to have. You can

be as detailed as you like. You can describe the parenting plan in the Petition or

you can attach a separate page.

At the end of your case, the Judgment must contain a parenting plan. The

parenting plan can be a part of the judgment form, or it can be in an attached

document. See Appendix A

for more information about parenting plans.

Moving – The Judgment will prohibit either parent from moving

more than 60 miles farther away from the other parent without giving written

notice to the court and the other parent.

You can ask the judge to waive this rule by checking the appropriate box on the

Petition and explaining why you should not have to give notice of a move.

Safety

If you have safety concerns, you can ask the judge to suspend certain rights that

the non-custodial parent automatically has. Check the appropriate box on the

Petition. These rights include your duty to provide contact information and to tell

the other parent if there is a major health concern for the children. ORS 107.154

and 107.164 list the rights of a non-custodial parent. You MUST have a good

reason for suspending these rights. Talk to a lawyer about these issues.

Instructions – Unmarried Parents OJD Official

Page 9 of 24

(Jul 2023)

CHILD SUPPORT

Calculating Child Support

In most cases, the court will order child support if no child support order already

exists. Go to www.oregonchildsupport.gov/calculator

for worksheets and an

interactive program to use when calculating support.

Click on this link:

Worksheets must be submitted to the court before a judgment can be entered.

You can submit them with your Petition. At the latest, you can submit them with

your Judgment.

NOTE: If you request a child support amount that is different from what the

calculator or worksheet says, you must explain why and how you reached that

amount. If not, your case may be delayed until you explain the difference.

You will need to complete a Uniform Support Declaration (USD) if you and

Respondent do not agree on an amount for child support. See Appendix B

for

information about the USD.

Payment of Child Support

Support is usually withheld from the payor’s (the person who has to pay support)

paycheck. The court may allow an exception to the income withholding

requirement if you qualify under ORS 25.396

and if you request an exception in

the Petition. If the court grants an exception to income withholding, payment can

be deposited into the receiver’s bank account. If you are paying child support

directly to the other parent, you should keep proof of every payment, including a

receipt if you pay cash.

See Appendix C

for information about how payments are made to adult children

attending school.

Child support is NOT taxable as income or deductible to either party.

Life Insurance

The court can order a party to carry life insurance if that party is ordered to pay

child support. Life insurance in connection with a support obligation is for the

benefit of the children receiving support.

Health Insurance

Your judgment must address health insurance for any minor child involved in

your case. Health insurance coverage may be provided through an employer or

Instructions – Unmarried Parents OJD Official

Page 10 of 24

(Jul 2023)

directly from an insurance carrier, or from a public option such as the Oregon

Health Plan, which you have to apply to the state for.

Cash Medical Support

In addition to child support, the court may order “Cash Medical Support.” Cash

Medical Support is to help pay for health insurance and out-of-pocket medical

expenses.

If health insurance is not available, the court must order Cash Medical Support

unless the judge finds reasons not to. The judge cannot order Cash Medical

Support in some situations.

Go to http://oregonlawhelp.org/resource/insurance-for-children

for additional

information about insurance

* * *

Adult Children (under 21)

If you have any child 18, 19, or 20 years old who is not married or emancipated,

that child is a necessary party to this case. He or she must be added as a party in

the case caption and has the right to participate. Adult children who are attending

school at least half-time may seek child support from either or both parents. See

Appendix C

for more information about a Child Attending School.

You must properly serve each adult child with all the same papers as Respondent

(see section below about serving the other party). After being served, a child may

sign a Waiver of Further Appearance and Consent to Entry of

Judgment form if the child chooses not to participate in the case.

Have your documents reviewed

You may have your documents reviewed by a lawyer or a court facilitator before you

file. Call your court or go to www.courts.oregon.gov

to see if your court has a

facilitator available. Court facilitators are free. For information about how to find a

lawyer, call the Oregon State Bar at the number on

Page 2. If you are low-income, you

may get your documents reviewed for a smaller fee through the Oregon State Bar’s

Modest Means program, or call your local Legal Aid office.

Make copies

Make one copy of all of the completed forms for your records. See Step 2 for

additional copies you will need.

Instructions – Unmarried Parents OJD Official

Page 11 of 24

(Jul 2023)

STEP 2: FILING AND SERVICE

File your forms

File all of the original forms except the Summons and Notice of Statutory

Restraining Order with the court clerk. The clerk will give you a case number

when you file. Put the case number on all copies and originals. See below for a list

of the forms you will need to copy to serve on the respondent.

You have to pay the filing fees when you file your papers. Go to

www.courts.oregon.gov

for the filing fee.

• If you are low income, you may ask the court to defer (postpone) or waive

your filing fee. You must complete an Application and

Declaration for Deferral or Waiver of Fees and an Order

Regarding Deferral or Waiver of Fees and file them with your

papers. If the fee is deferred, you will have to pay the fee later. If the fee is

waived, you don’t have to pay it now. However, the judge may reconsider

waived and deferred fees at the end of the case.

The clerk may give you some papers. A copy of these papers must be

included with the Petition that you serve on Respondent (see below regarding

service).

Make a copy of the following forms to serve on the respondent:

• Petition

• Summons

• Notice of Filing of Confidential Information Form

• Notice of Statutory Restraining Order Preventing the Dissipation of

Assets in Domestic Relations Actions Between Unmarried Parents

• Parenting Plan and Uniform Support Declaration (if you are filing these

documents with your Petition) (see Appendices A & B

for information)

• Any other forms your local court requires you to serve on Respondent

If either you or Respondent receives Temporary Assistance to Needy Families

(TANF) or the Oregon Health Plan (OHP), or if your children are in foster care or

in custody of the Oregon Youth Authority, then you must also send a copy of the

filed Petition to the Department of Justice Division of Child Support (DCS).

Your county branch office’s address can be found at

www.oregonchildsupport.gov/offices

. After you mail the Petition, fill out the

Certificate of Mailing or Delivery to Division of Child Support and file

it with the court.

TANF

OHP

OYA

Foster

Instructions – Unmarried Parents OJD Official

Page 12 of 24

(Jul 2023)

SERVICE

You must officially notify Respondent that you have filed a case. This is called

“service.” Follow the same steps to serve any 18, 19, or 20 year old children.

Acceptance of Service – If it is safe for you to give the respondent the papers

yourself, you can use an Acceptance of Service form. If the respondent signs

an Acceptance of Service, no other kind of service is required. Signing the

Acceptance of Service does not mean the respondent agrees with anything in

your Petition, only that he or she received the papers. You must file the

papers with the court before you give the copies to the respondent.

Formal Service

If the respondent does not want to sign the Acceptance of Service, you must

use another method. There are four ways you can serve. Service must be done

after your Petition is filed.

**3 CRITICAL POINTS**

1. If you serve before you file, you will have to serve the papers again

2. You CANNOT serve the papers yourself

3. If Respondent has a lawyer, you should also send a courtesy copy of the papers to the lawyer

1. Personal Service:

a. By Process Server: Take a copy of your papers to the sheriff’s office in

the county where Respondent is located and have a sheriff’s officer

serve the papers. The sheriff’s office charges a fee for service. You can

also hire a private process server of your choice.

b. By a Non-Party: Have a competent* person 18 years or older who is a

resident of Oregon and who is not a party to the case (Petitioner or

Respondent), nor the lawyer of a party, serve the papers. The server

cannot be an employee of any party. If the respondent is outside of

Oregon, the server can be a resident of the state where the respondent

is. If you have safety concerns, have the sheriff perform service.

*competent means a person who can understand, remember, and tell

others about an event.

A Certificate of Service must be filed with the court by whoever serves

the respondent. The certificate must include the date of service and the

name of the person served.

2. Substituted Service: The process server may leave the papers at the

respondent’s residence (where he or she normally lives) with someone 14

years or older who lives there. The process server must also mail a copy of

the papers (with a statement of the date, time, and place that the papers

were served) to the respondent by first class mail. Make sure the process

Instructions – Unmarried Parents OJD Official

Page 13 of 24

(Jul 2023)

server completes a Certificate of Service. The date of service is the day

the first class mailing is put in the mail.

3. Office Service: The process server may leave the papers with someone in

charge of the respondent’s office or normal workplace. The process server

must also mail a copy of the papers (with a statement of the date, time, and

place that the papers were served) to the respondent by first class mail.

Make sure the process server completes a Certificate of Service. The

date of service is the day the first class mailing is put in the mail.

4. By Mail: First, the process server must send the papers to the

respondent’s home or business address by first class mail. Second, the

server must send a copy by certified mail, return receipt requested. The

process server must file proof of service with the court, including the

signed green card, date of receipt, and item number along with a

Certificate of Service. If the green card is not returned or if someone

other than the respondent signed for it, then service by mail was not

effective and you must try another type of service. The date of service is the

day the respondent signs the returned green card.

If you are not able to have Respondent served by any of the methods listed above,

you may ask a judge to allow you to use another service method. The judge might

allow you to publish or post the documents. Forms to make this request are

available online at www.courts.oregon.gov/forms

Proof of Service

The Certificates are your proof of service. An original Certificate of Service or

Acceptance of Service must be filed with the court for your case to proceed,

regardless of the method of service.

If proof of service is not received within 63 days of filing your Petition,

the court may send you a notice of dismissal. Your case may be dismissed if

you do not provide proof of service within 28 days of the notice.

Instructions – Unmarried Parents OJD Official

Page 14 of 24

(Jul 2023)

STEP 3: TEMPORARY ORDERS

You can ask the court to make temporary orders after you file the Petition.

Temporary orders are effective as soon as a judge signs the order. They last until

a judge changes the terms, signs the General Judgment, or dismisses the case.

For example, either party may request an order for child support or an order

about temporary use of property. To make any of these requests, you must file a

“motion” (request) asking the court to do what you want. You may need a lawyer

to file these requests.

 NOTE: The General Judgment may affect earlier temporary orders

done by Limited Judgment. Talk to a lawyer if you have questions.

One type of temporary order is called a Status Quo Order. This order prevents

either parent from changing the children’s normal schedules, interfering with

parenting time by the other parent, or changing where the children live. This does

not decide custody or who can make major decisions for the children. “Normal

schedule” means the children’s schedule for the three months before you file a

request for a Status Quo Order.

Go to www.www.courts.oregon.gov

for the forms to request temporary orders.

The forms may not cover all temporary orders you need. Talk to a lawyer for

more information.

Domestic Violence

All courts have restraining order forms for cases involving domestic violence. A

judge will usually hear your request within a day or two of filing. Check with your

local court for filing times and procedures.

Refer to http://courts.oregon.gov/fapa for Family Abuse Prevention Act (FAPA)

forms and information.

Forms for other types of protective order are available at www.courts.oregon.gov/forms

Instructions – Unmarried Parents OJD Official

Page 15 of 24

(Jul 2023)

STEP 4: RESOLVING YOUR CASE

There are three ways your case can be resolved: by agreement between the

parties, by default if the respondent doesn’t respond, or by a judge in a hearing.

Even if you submitted Child Support Worksheets with your Petition,

you MUST attach worksheets to your Judgment, regardless of how

you resolve your case.

By Agreement

It is always better to resolve issues yourselves, since you know what’s important

to you. Once the case goes to a judge, it is out of your control. If you can’t resolve

the issues on your own, or if it is not safe for you to talk to Respondent, the court

may provide options to help you, including mediation and arbitration. For

information about arbitration, see “By Trial” section below.

Mediation: A mediator is a person trained to help people resolve

disagreements. Mediation is confidential. You may ask to meet with the mediator

alone if you are uncomfortable meeting with the other party for any reason.

Check with your local court clerk to see if there is a fee for this service. Mediators

are not judges – they cannot impose their decisions on you. Their job is to help

you reach an agreement. This may be your last chance to retain control over the

outcome of the case. Agreements incorporated into a Judgment are fully

enforceable (see below).

Some courts may require that you mediate before you have a hearing.

Check your court’s Supplemental Local Rules for more information.

If mediation has not yet been ordered in your case and you would like to

request it, you may file a Request for Mediation form. If your court requires

mediation, you may request that the court waive mediation if you have a good

reason by filing a Motion and Declaration for Waiver of Mediation. Talk

to your court if you have safety concerns.

If you and Respondent have agreed to all of the issues, fill out and file:

• Declaration in Support of Judgment

• General Judgment of Custody, Parenting Time, and Child

Support

Note: The Judgment must be signed by both parties and all adult children

before being submitted to the court

By Default

Respondent has 30 days to respond to your Petition. The time starts running

from the day after the date of service. The response must be in writing and must

be filed with the court and mailed to you. If the respondent does not file a

response within 30 days, you may request an Order of Default.

Instructions – Unmarried Parents OJD Official

Page 16 of 24

(Jul 2023)

Default means that you are asking the judge to award you what you asked for in

your Petition because the respondent did not file a response. Look at

Oregon

Rules of Civil Procedure (ORCP) rule 69 for more detailed information.

 NOTE: If the respondent has given you written notice that he or she intends

to appear, you have to give written notice that you intend to apply for a

default order at least 10 days before you file your motion. See

Uniform Trial

Court Rule 2.010 for the form your notice must be in. File your notice with

the court and mail it to the respondent.

The judge may not grant a default if the respondent is incapacitated, a minor, a

financially incapable person, a protected person, or a respondent in a fiduciary

protective proceeding, as defined by ORS 125.005

You must also show that the respondent is not in active military service

before the court can enter an order of default. This is part of the Ex Parte

Motion for Order of Default & Declaration in Support. If the respondent

is in active military service, you cannot get an order of default unless the

servicemember waives protection under the Servicemembers Civil Relief Act

(SCRA). This federal law starts at 50 U.S.C. 3901. Your local law librarian can

help you find it, or go to www.law.cornell.edu

(under Get the Law click

U.S.Code, then click Title 50 and go to Chapter 50). This law has strict rules

about what “active military service” means. This protection does not apply to all

servicemembers at all times.

If the respondent is in the military, you should see a lawyer before trying to get an

order of default. If a default is not done properly, the respondent can re-open the

case after returning from service. Be aware that if you knowingly make false

statements about the respondent’s status, you may face both federal and state

penalties.

If you know the respondent is not in the military, you must state facts that

explain how you know.

If you have the respondent’s Social Security Number or date of birth, go to the

Department of Defense website (https://scra.dmdc.osd.mil/

) to find out if the

respondent is in active service. This site can give you a free statement of service

status that you can print out (called a “certificate of service” on the website).

Attach this statement, or a printout of the screen, to your motion. You can also

call 571.372.1100 for military verification. Put the date and the name of the

person you spoke with on your motion. If you don’t have the Social Security

Number or date of birth, commercial sites may be able to provide information.

If you don’t know whether the respondent is in the military and have checked the

website, or don’t have the necessary information, mark “I am unable to

determine whether this person is in military service” and add any facts that you

do know. The judge will decide whether to grant the default.

This is an outside site maintained by Cornell University. The Oregon Judicial Department is not

responsible for any information on this site. Links may have moved.

Instructions – Unmarried Parents OJD Official

Page 17 of 24

(Jul 2023)

 If Respondent is in the military

If Respondent is in active military service of the United States and has not

responded to the Petition, the court won’t go ahead with your case until one of

the following things happens:

(1) Respondent is no longer in active military service,

(2) Respondent waives, in writing, the right to avoid default, or

(3) the judge holds a special hearing in your case

Talk to a lawyer if Respondent will not sign the waiver and you do not want to

wait for military service to end. The SCRA rules are technical and complex.

Contact the Oregon State Bar for help (contact information is on Page 2

* * * * *

Requesting a Default - fill out the following forms:

• Ex Parte Motion for Order of Default and Declaration in Support

• Order on Motion for Default

• Declaration in Support of Judgment

• General Judgment of Custody and Parenting Time and Child

Support

The Declaration in Support of Judgment allows you to note any

information that has changed since you filed the Petition. Read each section of

the Petition you filed CAREFULLY and note any changes in the spaces provided

in the Declaration in Support of Judgment. You must complete the rest of the

Declaration in all cases.

After you make yourself a copy of the completed forms, file the originals with the

court any time after 30 days from the date of service. You must file the Motion

for Order of Default by the 91

day after you filed the Petition (NOT the proof of

service!). If not, your case may be dismissed.

The court will send you notice when your judgment has been entered.

By Trial

If Respondent has filed a response and the parties are unable to agree on the

terms of a judgment, your case may go to trial

Informal Domestic Relations Trials (IDRTs) are available in all courts if both

parties agree. See UTCR 8.120

for more information. Each court handles IDRTs

differently. Contact your court for more information.

Conferences with the Judge

Many courts will schedule a “status,” “pretrial,” or “settlement” conference before

a case goes to trial. These meetings usually take place with a judge with both

parties present, along with their lawyers (if any). You must attend any

conferences that are scheduled unless you have received permission from the

judge not to attend. At the conference, the judge may talk to you about how your

case is going to be handled, consider requests for temporary orders, or set future

court dates.

Instructions – Unmarried Parents OJD Official

Page 18 of 24

(Jul 2023)

Some courts may refer certain cases to arbitration. You will receive information

from the court if that happens.

 Many courts require that you mediate before you can get a trial. See the BY

AGREEMENT section above.

NOTE: You must give the other party an opportunity to review the judgment

before you submit it to the court. See UTCR 5.100

for information.

You can represent yourself at trial. Some courts provide information about

representing yourself on their websites. Go to www.courts.oregon.gov

to find

your court’s website.

The State Family Law Advisory Committee has written a guide that may help you

prepare for trial. This guide is NOT a substitute for legal advice! The rules of

court can be technical and complex. You may damage your case if you are not

properly informed. If your case goes to trial, you are strongly advised to talk to a

lawyer. To read the guide, go to:

http://www.courts.oregon.gov/help/Documents/famlawtrialbrochure.pdf

Page 19 of 24 (Mar 2019)

THE JUDGMENT

Regardless of how you resolve your case, a General Judgment of Custody and Parenting

Time and Child Support must be signed by a judge. One of you may be ordered to fill out the

judgment form and give it to the court to be signed. NOTE: you must include Child Support

Worksheets with your Judgment if child support is awarded.

The judgment finalizes your case and contains all of the issues decided in the mediation, trial, or

by agreement.

 NOTE: The General Judgment may affect earlier temporary orders done by Limited

Judgment. Talk to a lawyer if you have questions.

If the respondent DID NOT file a response, the information you fill out in the judgment should

be exactly the same as what you requested in the Petition.

If the respondent DID file a response, the information should be the exactly the same as what

was decided in mediation, arbitration, hearing, trial, or through your agreement. All parties

must review the Judgment before you submit it to the court. You must send the Judgment

document along with the Notice of Proposed Judgment or Order to the respondent and any

adult children who have not filed a Waiver of Further Appearance in the case.

Other parties can object to the Judgment. If that happens, you have to discuss the objections

and attempt to resolve them before you submit the Judgment to the court. If you are not able to

resolve the objections, the objecting parties can either send you a written statement explaining

their objections, or they can submit their objections directly to the court. You must complete the

Certificate of Readiness section of the Judgment to tell the judge whether there are outstanding

objections. See UTCR 5.100(1) for more information about notice and objections.

If the respondent is responsible for preparing the judgment, the respondent must send the

proposed judgment to you before submitting it to the court. Then you can review it and object to

it within 7 days of the date it was sent to you. If you and the respondent are not able to resolve

your objections after reasonable efforts, you can either send a written explanation of your

objections to the respondent or directly to the court. You must notify the respondent of your

intentions so that they can advise the judge that there are outstanding issues. The judge may

make a decision after reviewing the documents, or the court may contact you with further

information.

If you are responsible for preparing the final judgment, make a copy for yourself and one for

Respondent (unless you got an Order of Default). File the original with the court.

http://courts.oregon.gov/utcr

Page 20 of 24 (Mar 2019)

Your case is finished and effective the date the Judgment is signed by the judge. NOTE: the

terms of your judgment are not enforceable until the court enters the judgment. You will receive

a Notice of Entry of Judgment.

NOTE: Every document you file must have a mailing address where you will

receive documents related to this case. You do NOT need to use your home

address. You can use any contact address in the same state as your home. You are

responsible for checking your contact address. Notify the court and the other party

in writing if your contact address changes.

Page 21 of 24 (Mar 2019)

Appendix A– Custody and Parenting Plans

Joint Custody and Sole Custody

A parenting plan is where you provide a plan for when each parent will actually be with the

child (parenting time). Parenting plans can also include specific times for contact. For example,

“Mother can call on Fridays between 7pm and 10pm.” Parenting time is separate from custody.

For example, you can have joint custody with one parent having the child 75% of the time, and

you can have sole custody with 50-50 parenting time. See below for more information.

Child support is separate from custody. Either parent can be ordered to pay child support

regardless of who has custody or what kind of custody is ordered.

Sole Custody

If sole custody is ordered, the other parent will almost always have some parenting time with the

child. The non-custodial parent has equal rights to the child’s school records and medical

records, and to authorize emergency medical, dental, psychological, or other health care if the

other parent is not available, unless the court orders otherwise.

Joint Custody

Joint custody does not mean that every day-to-day activity has to be agreed to, but major

decisions must be discussed by the parties.

A joint custody order can also specify certain decisions that can be made by one parent or the

other. For example, Mother may be allowed to make decisions about religious training, or

Father can made decisions about medical care.

A joint custody order might specify that one parent’s home is the child’s primary residence, but

it’s not required.

What does “Custody” mean?

 Custody refers to decision-making about a child. Decisions may include the child’s

residence, health care, education, religion, and other big issues.

 Joint custody means that the parents have agreed to decide major decisions in the

child’s life together. Joint custody can also occur when parents agree about how to split

up major decisions about a child. The court can order joint custody only if both parents

agree to all of the terms, including the parenting plan.

 Sole custody means that one parent can make decisions alone. These are legal terms

and don’t impact how much time each parent has with the child.

Regardless of the custody order, both parents will usually have time with the child (parenting

time) and the right to certain information. Both parents have the right to review school records

and medical records, and to authorize emergency medical, dental, psychological, or other

health care if the other parent is not available, unless the court orders otherwise.

Read ORS 107.137

to see what a court will consider when awarding custody. The most

important factor is always the best interest and welfare of the child.

Page 22 of 24 (Mar 2019)

Parenting Time & Parenting Plans

Parenting time is what some people call ‘visitation’ – it is the time a child spends with each

parent. Parenting time is detailed in a “parenting plan,” which is usually focused on the parent

who does not have sole or primary residential custody.

Once the court enters a judgment with parenting time included, that time is enforceable like any

other court order. Parents can file for an expedited (faster) hearing if the other is not following

the parenting time in the judgment.

A parenting plan is required for all cases involving a minor child. The plan sets out

the schedule and rules for each parent’s time with each child. A parenting plan should be written

in the space provided in your Petition or attached to it as a separate form.

A parenting plan can be as general or as specific as you need it to be. The judge will expect to see

some information about the days and times when children will be picked up and dropped off,

and some plan for weekends, holidays, and school breaks. Consider whether you have children

with different needs. Children at different ages may need different parenting plans. If you have a

child with a medical issue, you may want to consider how the plan will impact care.

BE AWARE that if you do not include enough information in your plan and the other parent

does not respond, you may have to serve the other parent with corrected paperwork before you

can get a Judgment.

The parenting plan may include safety provisions for the child if problems like domestic

violence, drug or alcohol abuse, or child abuse are involved in your case.

Oregon has a Basic Parenting Plan Guide for Parents. This guide has information about

how to develop a plan, information about alternative schedules, and stages of your children’s

growth that should be considered when creating a plan. A sample parenting plan is included in

the guide. The guide can be downloaded at www.courts.oregon.gov/familylaw

. There is also a

Safety Focused Parenting Plan Guide on this website. This can help you develop a parenting

plan if you have safety concerns for your children. Many local courts also have standard plans in

their Supplemental Local Rules. Check your local court’s website. You can use these plans whole

or as a guide to develop your own.

A mediator can help you create a parenting plan. Your local court may also have a mediation

program for parents. A mediator is a neutral person trained to help you come to your own

agreement and cannot make decisions for you. Information about mediation and parenting

plans may be available through your court’s parent education program, the court facilitator, or

your local law library. Some courts require you to try mediation before your hearing.

Custody/Parenting Time Evaluation - If parents can’t agree on a parenting plan, the court

may order the parents to hire a custody or parenting time evaluator. Either or both parents may

be ordered to pay for the evaluator.

If you and Respondent don’t agree on a parenting plan before trial, the judge will order one.

Page 23 of 24 (Mar 2019)

Appendix B – Uniform Support Declaration

You may need to complete a Uniform Support Declaration (USD) if you and Respondent

do not agree on an amount for child support.

You can file your USD with the Petition. If you don’t file it with your Petition and Respondent

opposes your claim for support, you must provide it to the court and serve a copy on Respondent

within 30 days after you receive the Response.

If you are NOT requesting child support, do not file the USD.

Tips for filling out the USD:

 If you are requesting child support for the amount that the Child Support Guidelines

recommend, fill out only the Declaration and attach the documents it asks for.

o If you are requesting a different amount of child support than the Guidelines

recommend, fill out both the Declaration and Schedule 1. Attach all of the documents

that the Declaration and Schedule ask for.

 Use your actual, present expenses. Estimates are fine as long as they are realistic and you

have no way of confirming the amount.

o Some items may not apply to you – mark those spaces “N/A” (Not Applicable), but

complete every item that does apply.

o If your amounts are unusual or likely to change soon, include a brief explanation of

why (if you are temporarily living with a relative, or if one party moved out and is no

longer contributing to shared expenses). Include an estimate of what you believe

your expenses will be after the situation changes.

 If you have an expense that is not listed, add it, along with a brief explanation.

 If you anticipate any major changes (a child entering or leaving school, a layoff, a car

payment or mortgage being paid off), note these as well. Do NOT include fears or

possibilities – only things you know or reasonably expect will happen.

 If one of your children has a serious medical problem, note it and include a reasonably

accurate estimate of the treatment cost.

 Household items are things like paper towels, cleaning supplies, light bulbs, storage

containers.

 If you are attending school, include your tuition payments, supplies and books, and any

other necessary school-related costs.

The Uniform Support Declaration is Form 8.010.5 and can be found here:

www.courts.oregon.gov/forms

in the Family Law



Miscellaneous category.

Certificate of Mailing – the Uniform Support Declaration includes a Certificate of Mailing at

the bottom of the form. Once the USD is completed, copy the entire form and all attachments

and mail them to the respondent. THEN fill out the Certificate of Mailing and file the original

with the court. Keep a copy of all documents for your own records.

Page 24 of 24 (Mar 2019)

Appendix C – Support for a Child Attending School

If an adult child is attending school at least half-time according to the school’s standards, that

child is considered a “Child Attending School.” A Child Attending School may be entitled to child

support until he or she turns 21. “Child Attending School” is defined at ORS 107.108 and does

not include children who are married.

IMPORTANT! After an order is made for support of a child attending

school, the child must remain enrolled at least half-time AND make

sufficient academic progress according to the school to qualify as a child

attending school and continue to receive support.

NOTE: you can ask the court to extend child support for minor children to cover them when

they qualify as Children Attending School. If a child does not immediately enter higher

education after high school or drops out of high school, child support will end.

If you have an order that says support continues if the child becomes a Child Attending School,

the child must notify the payor before the child turns 18 that he or she will be attending school,

which school, and when the child expects to graduate or stop taking classes. Support generally

continues during summers if the child has properly notified the other parent that the child

intends to return to school.

The child must also provide consent to the school to release certain information to any parent

paying child support. The requirements are at ORS107.108.

Paying Support for a Child Attending School

Support for an adult child is normally paid directly to the child, whether by the payor directly or

by DCS. If you have good cause why the child should not receive payment, you must explain that

in your Petition.

There is NO parenting plan or parenting time credit for a Child Attending School who has

graduated from high school.

For more information, go to:

http://oregonchildsupport.gov/services/pages/child_attending_school.aspx

Page 1 of 1 (Mar 2019)

Appendix D – Statutory Restraining Order

[Attach to Summons per ORS 109.103(5)]

NOTICE OF STATUTORY RESTRAINING ORDER

PREVENTING THE DISSIPATION OF ASSETS

IN DOMESTIC RELATIONS ACTIONS BETWEEN UNMARRIED PARENTS

TO THE PETITIONER AND RESPONDENT:

Under ORS 109.103(5) and UTCR 8.080, neither Petitioner nor Respondent may:

Insurance Policies

(1) Cancel, modify, terminate, or allow to lapse for nonpayment of premiums, any policy of

health insurance that one party maintains to provide coverage for the other party or a minor

child of the parties, or any life insurance policy that names either of the parties or a minor child

of the parties as a beneficiary.

Insurance Beneficiaries

(2) Change beneficiaries or covered parties under any policy of health insurance that one party

maintains to provide coverage for a minor child of the parties, or any life insurance policy.

EFFECTIVE DATE:

The above provisions are in effect immediately upon service of the Petition and Summons on the

respondent. They remain in effect until a final judgment is issued, until the petition is dismissed,

or until further order of the court.

RIGHT TO REQUEST A HEARING

Either Petitioner or Respondent may request a hearing to modify or revoke one or more terms of

this restraining order by filing with the court the Request for Hearing re: Statutory Restraining

Order form specified in Form 8.080.3 in the UTCR Appendix of Forms.

REVIEW THIS NOTICE CAREFULLY.

BOTH PARTIES MUST OBEY EACH PROVISION OF THIS ORDER

TO AVOID VIOLATING THE LAW.

SEE INFORMATION ON YOUR RIGHT TO A HEARING BELOW

Petition – Custody/Parenting Time/Support OJD Official

Page 1 of 9

(Feb 2023)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: ____________________

Petitioner

PETITION FOR CUSTODY

and

AND PARENTING TIME

AND CHILD SUPPORT

Filing Fees at ORS 21.155

Respondent

Claim is not subject to mandatory

arbitration

Unmarried children 18, 19, or 20 years old (per ORS 107.108) (full names)

 I need an interpreter: Spanish Russian other: _____________________

I, Petitioner, ask the court to grant custody, parenting time, and child support as specified

below. I am not married to the respondent in this case.

1. Residency (check all that apply)

At least one parent currently lives in the county where this petition is being filed

All of the minor children named in Section 2 live or can be found in the county where this

petition is being filed

2. Minor children of Petitioner and Respondent

(list only children born to BOTH parties, not children that one party has with someone else)

Name

Age

Additional children listed on page attached titled “Section 2”

3. Parentage (complete all that apply)

Parentage (who the legal parents are) has been established for both parties by:

 petitioner respondent giving birth to (names):

 filing a Birth Certificate or Voluntary Acknowledgment of Paternity

form listing

petitioner respondent as the parent of children (names):

 judicial order or administrative/agency order

(court/agency name): case number

located in (county/state)

Petition – Custody/Parenting Time/Support OJD Official

Page 2 of 9

(Feb 2023)

re: petitioner respondent for children (list names):

 other method (explain):

re: petitioner respondent for children (list names):

4. By filing this petition, I acknowledge that I am bound by the terms of the Statutory

Restraining Order (SRO) prohibiting either party from making certain changes to

insurance policies that affect our minor children. I understand that this restraining order is

effective as soon as this Petition and the Summons are served on Respondent.

5. Other Case Information

A No-Contact Order (criminal or other) prohibits Respondent from exercising parenting

time

Case # County/State:

5A. Pending Cases

Has any other case been started but not yet finished in any state regarding any of the

parties’ minor children? (including child support, dissolution (divorce), annulment,

separation, custody, paternity, juvenile court, or modification cases)

No Yes – as follows

Name of Court or

Agency

Case No.

Involves:

(check all that apply)

Child Support

Custody/Parenting Time

Restraining Order

Juvenile Dependency/Delinquency

5B. Existing Orders or Judgments

Is there an order or judgment in this or any other state between the parties? (including

child support (whether or not it is currently effective), dissolution (divorce), annulment,

separation, custody, paternity, juvenile court, modification, or restraining/protective

orders)

No Yes – as follows (attach a copy of the signed order or judgment)

Name of Court or

Agency

Case No.

Date

Signed

Involves:

(check all that apply)

Child Support

Custody/Parenting Time*

Restraining Order

Juvenile Dependency/Delinquency

*Result (if custody/parenting time):

Additional information attached

Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA)

You must advise the court if any of this information changes

Petition – Custody/Parenting Time/Support OJD Official

Page 3 of 9

(Feb 2023)

6A. Other than any cases listed above, have you participated in any case about the CUSTODY or

PARENTING TIME (visitation) of the minor children named in this case? (include cases that

were filed but dismissed or denied by the court, and any cases filed by or against someone

other than the Petitioner and Respondent in this case.)

No Yes – as follows:

Name of Court

State

Case No.

Date of final

decision

Result

(include names of

affected children)

6B. Do you know of any OTHER legal proceeding that may affect the outcome of this case?

(including enforcement of domestic violence or protective orders, adoption, termination

of parental rights, or guardianship involving any of the children pending in any state)

No Yes – as follows:

Name of Court

State

Case No.

Type of Case

Affected Children

6C. List the places where the minor children have lived in the last five years, the names of the

people they lived with at that time, and current contact addresses for those people

Current:

Child’s Name

Current Address

Lives with:

Petitioner Respondent

Other: _________________________

Petitioner Respondent

Other: _________________________

Residences:

Dates

From/To

County, State

Name of

Parent/Caretaker

Contact Address of

Parent/Caretaker

Which

Children

□ Additional page attached titled “Section 6C-UCCJEA”

Petition – Custody/Parenting Time/Support OJD Official

Page 4 of 9

(Feb 2023)

Additional Caregivers:

Dates

From/To

Name of

Parent/Caretaker

Where did they live

with this caretaker?

Contact Address of

Parent/Caretaker

Which

Children

6D. The children listed in Section 2 have continuously lived in Oregon for the six months

before the filing of this Petition, except for the children named below

The following children have not live in Oregon continuously for six months:

(names)

There is another basis for Oregon to address these children. Explain:

6E. I do not know any person other than the other parent who has physical custody of the

children or who claims to have custody, visitation, or parenting time rights

□ except for (list name and address):

7. Custody and Parenting Time

Custody of the children should be awarded as follows:

Parties should have joint custody of the following children (list names):

I should be awarded sole custody of the following children (list names):

Respondent should be awarded sole custody of the following children (list names):

Parenting time should be awarded as set forth in the attached Parenting Plan, labeled

Exhibit or

as follows

Parenting time should be supervised by

Any cost of the supervision should be paid by □Petitioner □Respondent □Other:

□ Respondent should not be granted parenting time because this would endanger the

health or safety of the children. State supporting facts:

Petition – Custody/Parenting Time/Support OJD Official

Page 5 of 9

(Feb 2023)

Relocation

I should be allowed to move more than 60 miles further distant from the respondent

without advance written notice because good cause exists (explain):

Contact Information

I should not be required to provide contact information to Respondent or to contact

Respondent in case of emergency circumstances or substantial change in the health of

the children because:

Parental Authority under ORS 107.154

Respondent should not have authority under ORS 107.154 (explain):

8. Support

A. Child Support

There IS an existing child support order in the monthly amount of $

from (county, state)

The court case # is and the Child

Support Program (CSP)# is

I do not want to change this amount (skip to section 8D, below)

I do want to change this amount because circumstances have changed

significantly since the order was issued. Explain the change

(fill in the sections below with the new amount you are requesting)

(or)

There IS NOT an existing child support order from any other court or agency

I am not requesting child support because

(skip to section 8E, below)

I am requesting child support (fill in the sections below)

i. Support (including Cash Medical Support, see instructions) is presumed to

be unavailable because the parent who would pay (check all that apply):

receives cash payments from a public assistance program including

TANF or SSI

is (or is expected to be) incarcerated (in jail or prison for at least 6

months)

Petition – Custody/Parenting Time/Support OJD Official

Page 6 of 9

(Feb 2023)

Support should be ordered despite the presumption (explain why and

complete section ii, below):

ii. Support should be ordered payable:

by Petitioner Respondent

to Petitioner Respondent Adult Child Attending School (name):

on the first day of each month

beginning the month following entry of this judgment or the date of service

of this Petition

The total monthly amount should be:

Determined under the Oregon child support guidelines prior to judgment (or)

$ , which is (check one)

the amount presumed correct as reflected on the child support guideline

worksheets attached to this petition (or)

different from the amount presumed correct by the child support guidelines

because the guideline amount would be unjust or inappropriate (explain)

B. Medical Support

Medical support has already been ordered in another case as noted in Section 4 above

The existing order should not be changed (skip to Section ii. below)

The existing order should be changed (fill out the sections below). I have also

requested a change of child support above.

If medical support has not been ordered in another case, complete sections below

i. Health Insurance Coverage:

Petitioner Respondent both parents should be ordered to provide health

insurance coverage throughout the period of the child support obligation

Cash Medical Support

(If health insurance is not available, then the parent who is ordered to pay child

support will also be ordered to pay cash medical support according to the Child

Support Guidelines unless the court finds reason not to)

Cash Medical Support should not be ordered because:

Support is presumed to be unavailable for the reason marked in

Section 8.A.i, above (Note: if you asked that support be awarded

anyway, do not mark this box)

the parent paying child support has income at or below Oregon’s

minimum wage for full-time employment, so cash medical support

should not be ordered

The children’s medical needs will be met by the Uninsured Medical

Expenses provision below

Other (explain):

Petition – Custody/Parenting Time/Support OJD Official

Page 7 of 9

(Feb 2023)

ii. Uninsured Medical Expenses

Uninsured medical expenses should not be awarded

Petitioner should pay % and Respondent should pay % of the

unreimbursed costs of the children’s reasonable medical, dental, and vision

care. This does not include ordinary expenses like nonprescription medication,

bandages, vitamins, and copays for regular checkups, which the parents are

presumed to provide for the children in proportion to their parenting time. This

obligation is in addition to any child support and will be offset by any cash medical

support ordered above.

This obligation should be in addition to any child support and cash

medical support ordered above

C. Payment

How should payments be made?

I understand that payments will be made by income withholding unless an exception

applies

I request an exception to the income withholding requirement of ORS 25.378 so that

payment can be made another way because good cause exists

Petitioner and Respondent have agreed in writing to the following alternative

payment method (explain)

Other exception under ORS 25.396 (explain)

Where should payments go?

All support payments should be made to the Department of Justice, Child Support

Accounting Unit, P.O. Box 14506, Salem, Oregon, 97309

An exception to income withholding applies as noted above. All support payments

should be made to the recipient’s checking or savings account. Deposit receipts should be

kept by the paying parent as proof of payment. The receiving parent should be ordered to

provide the paying parent with current deposit slips or bank name, account name, and

account number.

Other (explain)

(only available if you request an exception to income withholding, above)

Adult Child Attending School

The Division of Child Support (DCS) should pay support for an adult child attending

school directly to the child unless good cause exists for payment to be made another way

GOOD CAUSE exists for DCS not to pay support directly to a child attending

school (explain):

Petition – Custody/Parenting Time/Support OJD Official

Page 8 of 9

(Feb 2023)

D. Length of child support

Support should end when the last child (check one):

reaches age 18, or if the child qualifies as a child attending school under ORS

107.108, age 21

reaches age 18

or becomes self-supporting, emancipated, or married

E. Tax Dependents

(Note that the judgment is not binding on the IRS and will not provide a defense if the parties

fail to comply with IRS regulations in any given tax year. Speak to a lawyer or tax

professional.)

Petitioner Respondent should be permitted to claim the following children as

dependents for tax purposes beginning with the tax year this judgment is entered.

The other parent must complete any IRS waivers or forms necessary to accomplish

this order in each tax year and must not file contradictory tax returns.

List names:

Other (specify):

F. Life Insurance Coverage for Children

The party paying support should carry life insurance for the benefit of the parties’

children throughout the period of the support obligation. The coverage should be in

the amount of $

9. Additional Provisions

Additional page attached titled “Section 9-Additional Provisions”

10. A Confidential Information Form (CIF) has been completed and filed with the court clerk

containing all information required by ORS 107.085 that is identified as confidential by UTCR

2.130 for:

Petitioner Respondent each adult child

11. Court Costs and Fees for this case (whether paid or deferred)

Each party should be responsible for paying his or her own costs and fees

Costs and fees should be paid by both parties equally

Respondent should reimburse Petitioner for court costs and service fees paid

Other:

I request a judgment granting the relief asked for above, and other equitable relief

that the court finds just.

Certificate of pending/existing child support proceedings

 There is is not a PENDING child support proceeding

 There is is not an EXISTING child support order or judgment

Information about any pending or existing child support proceedings is included above

Petition – Custody/Parenting Time/Support OJD Official

Page 9 of 9

(Feb 2023)

I hereby declare that the above statements are true and complete to the best of my

knowledge and belief. I understand they are made for use in court and I am subject

to penalty for perjury.

Date Signature

Print Name

Contact Address City, State, Zip Contact Phone

Summons – Family Law

Page 1 of 1

(Dec 2017)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: ______________________

Petitioner

SUMMONS FOR FAMILY LAW

and

CASE

Marriage

Registered Domestic

Partnership (RDP)

Respondent

Unmarried & Unregistered

To (name):

Home Address: Work Address:

Your spouse, partner, or child’s parent has filed a Petition asking for:

Separation of your marriage or Registered Domestic Partnership (RDP)

Divorce or dissolution of your marriage or Registered Domestic Partnership (RDP)

Child Support, custody, or parenting time

You must “appear” in this case or the other side will win automatically. To “appear,”

you must file a legal paper called a “Response” or a motion. Response forms are available

through the court above or online at www.courts.oregon.gov

. Talk to a lawyer for information

about appearing by motion.

Your Response must be filed with the court clerk at the court named above within 30 days of

the day you received this Summons, along with the required filing fee (go to

www.courts.oregon.gov

for fee information). It must be in proper form and you must show that

the Petitioner’s lawyer (or the Petitioner if he or she does not have a lawyer) was formally served

with a copy of the Response according to the service rules. Service rules are included in

Instructions for Respondents, available at

www.courts.oregon.gov.

If you have questions, see a lawyer immediately. If you need help finding a lawyer, you can call

the Oregon State Bar’s Lawyer Referral Service at 503.684.3763 or toll free in Oregon at

800.452.7636, or go to www.oregonstatebar.org.

Date Petitioner Signature

Name (printed)

Contact Address City, State, ZIP Contact Phone

NOTICE TO RESPONDENT: READ THESE PAPERS CAREFULLY!

Confidential Information Form

Page 1 of 1 (Apr 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: ______________________

Petitioner

and

CONFIDENTIAL

INFORMATION FORM

Amended CIF

Respondent

UTCR 2.130

Unmarried children age 18, 19, or 20 years old (per ORS 107.108)

Submitted by: Petitioner Respondent other:

Information about (name):

(first, middle, last) Petitioner Respondent other:

Date of Birth:

Social Security Number:

Driver License (Number and State):

Former Legal Names:

Employer’s Name, Address, and Phone:

Minor children of the parties:

Name:

Date of Birth:

Social Security Number:

Additional page attached

The names of parties and children, and children’s ages are not confidential. This form can only be viewed by the

party who files it unless the court orders otherwise.

Confidential Information Form

Page 1 of 1 (Apr 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: ______________________

Petitioner

and

CONFIDENTIAL

INFORMATION FORM

Amended CIF

Respondent

UTCR 2.130

Unmarried children age 18, 19, or 20 years old (per ORS 107.108)

Submitted by: Petitioner Respondent other:

Information about (name):

(first, middle, last) Petitioner Respondent other:

Date of Birth:

Social Security Number:

Driver License (Number and State):

Former Legal Names:

Employer’s Name, Address, and Phone:

Minor children of the parties:

Name:

Date of Birth:

Social Security Number:

Additional page attached

The names of parties and children, and children’s ages are not confidential. This form can only be viewed by the

party who files it unless the court orders otherwise.

Notice of CIF Filing

Page 1 of 1

(Apr 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: ______________________

Petitioner

and

NOTICE OF FILING OF

CONFIDENTIAL

INFORMATION

FORM (CIF)

Respondent

and

Amended CIF

Unmarried children 18, 19, or 20 years old (per ORS 107.108) (full names)

I filed Confidential Information Forms with the court about the following parties to this case as

required by Uniform Trial Court Rule (UTCR) 2.130 (Use first, middle, last names below):

1) My Name:

Petitioner Respondent Other:__________________

Containing (check all that apply):

Social Security Number (SSN) Date of Birth (DOB) children’s SSN children’s DOB

employer’s name, address, and phone number driver license number

former legal names

2) Name:

Petitioner Respondent Other:__________________

Containing (check all that apply):

SSN DOB children’s SSN children’s DOB employer’s name, address, and phone

number

driver license number former legal names

3) Name:

Petitioner Respondent Other:__________________

Containing (check all that apply):

SSN DOB children’s SSN children’s DOB employer’s name, address, and phone

number

driver license number former legal names

4) Name:

Petitioner Respondent Other:__________________

Containing (check all that apply):

SSN DOB children’s SSN children’s DOB employer’s name, address, and phone

number

driver license number former legal names

Date Signature

Name (printed)

Contact Address City, State, ZIP Contact Phone

Acceptance of Service

Page 1 of 1

(Aug 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: _________________

Plaintiff/Petitioner

ACCEPTANCE OF

SERVICE

Defendant/Respondent

I am the Plaintiff/Petitioner Defendant/Respondent in this matter.

On (date) I received a true copy of (check all that apply):

Petition Summons

Claim Information on mediation

Complaint Other:

And for Domestic Relations cases:

Notice of Statutory Restraining Order Preventing Dissipation of Assets

Notice of CIF (Confidential Information Form) Filing

Information on continuation of insurance coverage (COBRA)

Order to Show Cause re: Modification with Motion and Declaration

Statement of Assets and Liabilities

Uniform Support Declaration

Other forms:

I hereby declare that the above statements are true to the best of my knowledge

and belief. I understand they are made for use in court and I am subject to penalty

for perjury.

Date Signature

Name (printed)

Address City/State/Zip Telephone

Certificate of Mailing to DCS

Page 1 of 1

(Aug 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No. ___________________

Petitioner

and

CERTIFICATE OF MAILING OR

DELIVERY TO DIVISION OF

CHILD SUPPORT

Respondent

I certify that on (date) , I hand-delivered or mailed by

first-class mail a true copy of the Petition in the above domestic relations case to the

local branch office of the Department of Justice, Division of Child Support at

(list address):

I hereby declare that the above statements are true to the best of my knowledge

and belief. I understand they are made for use as evidence in court and I am

subject to penalty for perjury.

Date Signature { Petitioner Respondent}

Name (printed)

Contact Address City / State / ZIP Contact Phone

Certificate of Service (Family Case)

Page 1 of 2

(Aug 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No:

____________________

CERTIFICATE OF SERVICE

Petitioner

(ORCP 7D(2))

and

□

(a) Personal Service

□

(b) Substitute Service

□

Respondent

□

(d) Service by Mail

I, (name) , declare that I am a resident of the state of

. I am a competent person 18 years of age or older. I am not a

party to or lawyer in this case, and not the employee of a party. I certify that the person served is

the person named below. I served true copies of the original (check all that apply):

Petition and Summons

Information about mediation

Notice of Confidential Information Form (CIF) Filing

Notice of Statutory Restraining Order Preventing Dissipation of Assets

Order to Show Cause re: Modification with Motion and Declaration

Information about continuing insurance coverage (COBRA)

Uniform Support Declaration

Other information provided by the court clerk (name all forms or documents served)

Other (name all forms or documents served)

by (check a, b, c, or d and complete all information):

(a) □ Personal Service on (date) , at a.m./p.m., to

{□ Petitioner □ Respondent} (name) in person at the

following address in the

County of , State of .

(b) □ Substitute Service on (date) , at a.m./p.m., by

delivering them to the following address

in the County of , State of . Delivered to (name)

, who is a person age 14 or older and who lives there.

(Complete the section below only if the server also did the follow-up mailing required by ORCP

7D(2)(b). If a person other than the server did the follow-up mailing, that person must

complete a separate Certificate of Service Mailing.)

□ On (date) , I personally deposited a true copy of the same

documents served with the U.S. Postal Service, via first class mail, in a sealed envelope, postage

paid, addressed to the party to be served: □ Petitioner □ Respondent (name)

Certificate of Service (Family Case)

Page 2 of 2

(Aug 2019)

, at the party’s home address listed above, together with a statement of the date,

time and place that the documents were hand-delivered to the party’s dwelling (residence).

delivering them to the office of the party to be served, located at: (address)

, during normal working hours for that

office, where I left the documents with (name) , who

is a person apparently in charge, to give the documents to the party to be served.

(Complete the section below only if the server also did the follow-up mailing required by ORCP

7D(2)(c). If a person other than the server did the follow-up mailing, that person must

complete a separate Certificate of Service Mailing.)

□ On (date) , I personally deposited a true copy of the same

documents served with the U.S. Postal Service, via first class mail, in a sealed envelope, postage

paid, addressed to the party to be served: □ Petitioner □ Respondent (name)

, at the party’s: □ home address at:

, OR business address above, together with a statement

of the date, time and place that the documents were hand-delivered to the party’s office.

(d) □ Service by Mail, Return Receipt Requested on (date) ,

I personally deposited two true copies with the U.S. Postal Service. One by first class mail, and

the other by certified or registered mail, Return Receipt Requested, or by express mail, postage

paid, addressed to the party to be served: □ Petitioner □ Respondent

(name), at the party’s home address located at:

(address). (NOTE: If mailed Return Receipt

Requested, the return receipt must be attached to this Certificate of Service.)

I hereby declare that the above statements are true to the best of my knowledge

and belief, and that I understand they are made for use as evidence in court and I

am subject to penalty for perjury.

Date Signature of Server

Print Name

If person serving is NOT a sheriff or sheriff’s deputy, address and phone number of server:

Declaration in Support of Judgment – Custody/Parenting Time/Support

Page 1 of 2

(Aug 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: ______________________

Petitioner

and

DECLARATION

SUPPORTING

GENERAL JUDGMENT OF

CUSTODY, PARENTING

TIME,

Respondent

AND CHILD SUPPORT

and

Unmarried children 18, 19, or 20 years old (full names)

The Petition was filed in the county where Petitioner Respondent Child resided at the

time of filing

The statements made in the Petition remain true and accurate except:

Section Number Explain

Additional page attached

Minor Children

List all minor children of both parties (under age 18) (do not list children that one party has with

another person)

Name of Child

Age

Currently lives with

(Name, Address or Contact Address)

For how

long

Additional children listed on page attached titled “Additional Children”

Child support has been requested. The information included in that worksheet is true and

accurate to the best of my knowledge. (Attach the worksheets to the General Judgment)

The parent who should pay child support (“payor”) does not live in Oregon but (check all

that apply)

Was personally served with the Petition in Oregon

Filed a response in this case

Lived in Oregon with at least one of the children

Declaration in Support of Judgment – Custody/Parenting Time/Support

Page 2 of 2

(Aug 2019)

Lived in Oregon and paid for prenatal or other costs for at least one of the children

At least one child lives in Oregon as a result of an act or instruction by the payor

At least one child may have been conceived in Oregon

Claimed parenthood on a Voluntary Acknowledgment of Paternity

Both parties lived in Oregon for at least 6 months and the non-resident party moved

out of Oregon less than one year before the Petition was filed in this case

There is another basis for jurisdiction (explain):

I ask the court to enter judgment without a hearing under ORS 107.095(4) because:

Respondent has not appeared and an Order of Default has been entered

Respondent has stipulated (agreed) to the terms of the Judgment

Respondent signed a Waiver of Appearance and Consent to Entry of Judgment

I hereby declare that the above statements are true and complete to the best of my

knowledge and belief. I understand they are made for use as evidence in court I am

subject to penalty for perjury.

Submitted by Petitioner Respondent

Date Signature

Print Name

Contact Address City, State, Zip Contact Phone

Judgment – Custody/Parenting Time/Support OJD Official

Page 1 of 11

(Feb 2023)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: ____________________

Petitioner

and

GENERAL JUDGMENT OF

CUSTODY AND PARENTING

TIME

Respondent

AND CHILD SUPPORT

and

Unmarried Children 18, 19, or 20 years old (full names)

This document was presented to the court:

□ On the motion and declaration of Petitioner, the default of Respondent having been found

□ and Respondent being represented by a guardian ad litem or other person described in

Oregon Rules of Civil Procedure, Rule 27

□ On the stipulation of the parties, as shown by the signatures at the end of this Judgment

□ After a hearing held (date), at which the following persons were present:

□ Petitioner □ Petitioner’s attorney

□ Respondent □ Respondent’s attorney

□ Other

Children 18, 19, or 20 Years of Age

□ Waived further appearance in these proceedings: (names)

□ Fully participated in the proceedings and are bound by the terms of this judgment:

(names)

□ Signed and stipulated to the terms of this judgment as shown by the signature below

FINDINGS:

The court considered the: □ Declaration □ Stipulations □ Evidence presented and finds that:

A. The parties were not married to each other at the time the Petition was filed

B. Children of the Parties (list only children legally recognized as children of both parties

together; do not list children either party has with another person)

Name Year of Birth Age

Additional page attached titled “Findings B – Children of the Parties”

C. Child Custody Jurisdiction

Oregon has jurisdiction under the Uniform Child Custody Jurisdiction and Enforcement Act

(UCCJEA) to decide custody and parenting time matters because:

Judgment – Custody/Parenting Time/Support OJD Official

Page 2 of 11

(Feb 2023)

□ Oregon is the children’s home state (all of the children have lived here continuously for

the six month period immediately before this case was filed)

□ Other:

□ Oregon does not have jurisdiction under the UCCJEA because:

D. Paternity has been established for the children listed in Section B

The court grants judgment as follows:

The terms of this judgment are effective upon entry in the court register

NOTICE ABOUT PARENTING TIME AND CHILD SUPPORT

The terms of child support and parenting time (visitation) are designed for the child’s benefit

and not the parents’ benefit. You must pay support even if you are not receiving parenting time.

You must comply with parenting time and visitation orders even if you are not receiving child

support.

Violation of child support orders and visitation or parenting time orders may result in fines,

imprisonment, or other penalties.

Help may be available to establish, enforce, and modify child support orders. Paternity

establishment services are also available. Contact your local district attorney, the domestic

relations court clerk, or the Department of Justice at 1.800.850.0228 or 503.378.5567 for

information.

Help may be available to establish, enforce, and modify parenting time or visitation orders.

Forms are available to enforce parenting time or visitation orders. Contact your local court for

information.

1. Custody and Parenting Time

Custody of the children is awarded as follows:

□ Petitioner and Respondent have joint custody of the following children:

□ Petitioner is awarded sole custody of the following children (names):

□ Respondent is awarded sole custody of the following children (names):

Parenting time is awarded

as described in the attached Parenting Plan, labeled Exhibit or

to Petitioner Respondent as follows

Judgment – Custody/Parenting Time/Support OJD Official

Page 3 of 11

(Feb 2023)

□ Parenting time will be supervised by

□ Any cost of supervision must be paid by □ Petitioner □ Respondent

□ Other:

□ Petitioner □ Respondent must not have parenting time because this would

endanger the health and safety of the children

2. Relocation

□ Neither parent may move more than 60 miles further distant from the other parent

without giving the other parent reasonable notice of the change of residence and providing a

copy of such notice to the court

□ The requirement of ORS 107.159 regarding notice of relocation is suspended for good

cause

3. Contact Information

Parents must both provide contact addresses and contact telephone numbers to each other

and notify each other of any emergencies or substantial changes in the children’s health

Good cause exists to suspend the obligation of the parties to provide contact information

to each other

4. Parental Authority under ORS 107.154

The non-custodial parent’s authority under ORS 107.154 is suspended for good cause

5. Child and Medical Support and Life Insurance for Children

A. Child Support

Existing Child Support Obligation

(list court/agency, case number, and date of prior child support orders and judgments:

_______________________________________________________

No action is taken by this judgment regarding any prior child support order or judgment

This judgment does not replace any existing child support order or judgment. Payment

amount and schedule remain as ordered on (date of order or judgment):_______________

any arrears accumulated under the continued order or judgment remain due

This judgment replaces the existing child support obligation because the existing orders

and judgments were issued by an Oregon court or agency, one of the parents or children

receiving support still resides in Oregon, and circumstances have changed since the orders were

entered. Support is due as detailed in the “Support Order” section below.

any arrears accumulated under the continued order or judgment remain due

Other:

Judgment – Custody/Parenting Time/Support OJD Official

Page 4 of 11

(Feb 2023)

Presumed Inability To Pay Under ORS 25.245

The parent who would pay support is presumed to be unable to pay because that parent:

receives cash payments from a public assistance program including TANF or SSI

is (or is expected to be) incarcerated (in jail or prison for at least 6 months)

The presumption has not been rebutted and no child support (including cash medical

support) is ordered

The presumption has been rebutted, and support is ordered as detailed in the “Support

Order” section below for the following reasons:

_______ ______________________________

Support Order

No support is ordered for reasons other than the presumption of inability to pay or continuation

of an existing order or judgment

(explain):__________________________________________

Support must be paid:

Petitioner Respondent

Adult Child Attending School (name): ________________________

On the first day of each month

Starting

the month following entry of this judgment or

the date of service of this Petition

The total monthly amount due is: $ ___ ___ (Child Support Worksheets are attached

and incorporated, labeled Exhibit )

This amount is:

the amount presumed to be appropriate under the support guidelines

different from the presumed appropriate amount of $ because the presumed

amount is unjust or inappropriate (explain):

B. Medical Support

Medical support has already been ordered in another case as listed in Section 5A,

above or from county. The court case # is

and the Child Support Program CSP# is

The existing order is not changed

The existing order is terminated. Medical support is ordered as follows.

i. Health Insurance Coverage

Petitioner Respondent is ordered to keep insurance throughout the period

of the child support obligation

Judgment – Custody/Parenting Time/Support OJD Official

Page 5 of 11

(Feb 2023)

ii. Cash Medical Support

Cash Medical Support is ordered in the amount of $ per month

because health insurance coverage is not available. Cash Medical Support is

payable by the parent ordered to pay child support on the same schedule.

The paying parent is ordered to provide Cash Medical Support only when

not providing private health insurance

for the children

Cash Medical Support is not ordered because:

Support is presumed to be unavailable for the reason marked above and the

presumption has not been sufficiently rebutted

The parent paying child support has income at or below Oregon’s minimum

wage for full-time employment, so cash medical support should not be ordered

The children’s medical needs will be met by the Uninsured Medical

Expenses provision below

Other (explain):

iii. Uninsured Medical Expenses

Uninsured medical expenses are not awarded

Petitioner must pay % and Respondent must pay % of the

unreimbursed costs of the children’s reasonable medical, dental, and vision

care. This does not include ordinary nonprescription expenses like

bandages,

vitamins, and copays for regular checkups, which the parents must provide for

the children in proportion to their parenting time. This obligation is in addition

to any child support and will be offset by any cash medical support ordered

above.

This obligation is in addition to any child support and cash medical

support ordered above

C. Payment

□ Income withholding is not ordered at this time because there is no support

arrearage and

NOTICE OF INCOME WITHHOLDING

This child support order is enforceable by income withholding under ORS 25.378 to 25.390,

25.414 to 25.372, and 25.375. Withholding shall occur immediately whenever there is an

arrearage at least equal to the support payment for one month, whenever the obligated

parent requests such withholding, or whenever the obligee requests withholding for good

cause. The District Attorney or, as appropriate, the Division of Child Support of the

Department of Justice, will assist in securing such withholding. Exceptions may apply in

some circumstances.

CHANGES TO HEALTH INSURANCE AVAILABILITY

Both the payor and the recipient of child support must notify the Division of Child

Support (DCS) in writing of any change in the availability of health insurance within

10 days of the change if collection services are provided by DCS.

Judgment – Custody/Parenting Time/Support OJD Official

Page 6 of 11

(Feb 2023)

□ The parents (or the State, if support rights are assigned) have agreed in writing to

an alternative arrangement which is approved by the court; or

□ Good cause not to require withholding is found because there is proof of timely

payment of previously-ordered support and income withholding would not be in the

best interests of the child

In all cases, select one of the following:

□ All support payments must be made to the Department of Justice, Child Support

Accounting Unit, P.O. Box 14506, Salem, Oregon, 97309

An exception to income withholding applies as noted above. All support payments

must be deposited to the recipient’s checking or savings account. The receiving parent is

ordered to provide the paying parent with current deposit slips or bank name, account

name, and account number.

Other (explain)

Adult Child Attending School

The Division of Child Support will pay support for an adult child attending school

directly to the child unless good cause exists for payment to be made another way

GOOD CAUSE exists not to pay support directly to a child attending school

Payments must be made to Petitioner Respondent in the amount of

$ per month

D. Length of child support

Support ends when the last child becomes self-supporting, emancipated, or married,

or (check one):

reaches age 18, or if the child qualifies as a child attending school under ORS

107.108, age 21

reaches age 18

E. Tax Dependents

Parties are advised that this judgment is not binding on the IRS and will not provide a

defense if the parties fail to comply with IRS regulations in any given tax year

As between the parties, Petitioner Respondent may claim the following children as

dependents for tax purposes beginning with the tax year this judgment is entered. The

other parent must complete any IRS waivers or forms necessary to accomplish this

judgment in each tax year and must not file contradictory tax returns.

List names:

Other (specify):

F. Life Insurance Coverage for Children

The party paying support must carry life insurance for the benefit of the parties’

children throughout the period of the support obligation if he or she is insurable. The

coverage must be at least $ .

The party paying support must

provide to the party receiving support a true copy of the policy. The party paying

Judgment – Custody/Parenting Time/Support OJD Official

Page 7 of 11

(Feb 2023)

support must also provide to the party receiving support written notice of any action

that will reduce the benefits or change the designation of the beneficiaries under the

policy.

(or)

Neither party is ordered to carry life insurance for the benefit of the parties’

children

6. Additional Provisions

□ Additional page attached titled “Section 6”

7. Court Costs and Fees Whether Paid or Deferred

Each party is responsible for paying his or her own court costs and service fees

Petitioner Respondent will reimburse the other party $ for

costs and fees

Judgment is awarded to the State of Oregon for deferred costs or fees of $

Other:

8. Information Required by ORS 25.020

As required by UTCR 2.130, a Confidential Information Form (CIF) has been completed for

each party and filed with the court. The CIF contains all information required by ORS 25.020

that is identified as confidential by UTCR 2.130.

Both parties must inform the Court and the Department of Justice (P.O. Box 14506, Salem,

Oregon 97309) in writing of any change in the information within ten (10) days of such change.

The Department of Justice or the District Attorney may not disclose the information in the CIF

to the other party.

Money Award

Support obligation included and child support must be paid to Dept. of Justice

PETITIONER

RESPONDENT

Full Name

Contact Address

Year of Birth

NOTICE ABOUT PERIODIC REVIEWS

If you are receiving child support services through the Department of Justice, either parent may

request that the Department of Justice/Division of Child Support review the amount of support

ordered after 3 years from the date the order took effect or at any time upon a substantial change

of circumstances.

Judgment – Custody/Parenting Time/Support OJD Official

Page 8 of 11

(Feb 2023)

Social Security # (last 4 digits)

Driver License # (last 4

digits) and State

Lawyer Name, Address,

Phone #

NOTE: a party RECEIVING a money award is the JUDGMENT CREDITOR; a party PAYING a money

award is the JUDGMENT DEBTOR.



If an adult child is awarded support to be paid directly to the child AND there is no

support awarded for minor children of the parties, or if the judge tells you that the

adult child is a Judgment Creditor, fill out this box:

The adult child named (full name and contact address)

is a judgment creditor on this judgment

Adult child’s lawyer’s name, address, phone #:

The following information must be provided by any party entitled to receive a money

award as listed in this Judgment

The following person or public body is known to be entitled to a portion of a

payment made on the judgment (other than payee’s lawyer):

Petitioner

None or Name: ______________________________

______________________________________________

Respondent

None or Name: ______________________________

______________________________________________

Adult Child

Name: ______________

None or Name: ______________________________

______________________________________________

Type of

Judgment

Amount Beginning / Ending

Child Support WHO PAYS

□ Petitioner

□ Respondent

$ per

month for cash medical

support

and

$___________

per month for child

support

Beginning the first day of the

month following entry of this

judgment

the date of service of the

Petition

(date)__________

Other _____________

and due on the first day of

each month thereafter

Judgment – Custody/Parenting Time/Support OJD Official

Page 9 of 11

(Feb 2023)

Type of

Judgment

Amount Beginning / Ending

WHO RECEIVES

□ Petitioner

□ Respondent

□

Adult Child

Ending when the last child

turns

18 or 21 (if the

child remains a Child

Attending School)

Prejudgment

Interest

WHO RECEIVES

□ Petitioner

□ Respondent

$ ___

Post-judgment

Interest

WHO RECEIVES

□ Petitioner

□ Respondent

9% per year simple

interest on the unpaid

balance of the total

judgment amount of

$______________

Interest accrues from the

date the judgment is entered

and continues until the

judgment is fully paid

□Court Costs

and Service Fees

paid

WHO PAYS

□ Petitioner

□ Respondent

Checked party reimburses the other party’s costs and fees

of:

Directly to the awarded party

□ Deferred

Court Costs and

Service Fees

WHO PAYS

□ Petitioner

□ Respondent

Checked party must pay deferred costs and fees of:

$___________________

To the State of Oregon through this court

Judge Signature:

Certificate of Readiness

This proposed judgment is ready for judicial signature because (check all that apply):

Service is not required under UTCR 5.100. The other party has been found in default or an

order of default is being requested with this proposed judgment;

this judgment is submitted ex

parte as allowed by statute or rule; or

this judgment is being submitted in open court with all

parties present.

Each party affected by this judgment has stipulated to or approved the judgment, as shown by

the signatures on the judgment.

I have served a copy of this judgment and written notice of the 7-day objection period set out in

UTCR 5.100 on all parties entitled to service (complete service information below). And:

No objection has been served on me within that time frame.

I received objections that I could not resolve with the other party despite reasonable efforts

Judgment – Custody/Parenting Time/Support OJD Official

Page 10 of 11

(Feb 2023)

to do so. I have filed with the court a copy of the objections I received and indicated which

objections remain unresolved.

After conferring about objections, the other party agreed to file any remaining objection

with the court.

Certificate of Service under UTCR 5.100

I certify that on (date): I placed a true and complete copy of

this proposed Judgment in the United States mail to (name)

at (address)

Submitted by: Petitioner Respondent

Signature Print Name

Guide & File selected and completed this form and I did not pay anyone to review the completed form

I understand that I am subject to penalty for perjury for giving false information to the court.

All factual information in this Judgment is true to the best of my knowledge and belief. I agree

to the terms of this Judgment. I understand that this Judgment is enforceable by the court.

Petitioner, Signature Date

Petitioner, Name (printed)

Respondent stipulates (agrees) to the terms of this judgment

Respondent, Signature Date

Respondent, Name (printed)

Contact Address City, State, Zip Contact Phone

□Child 18, 19, or 20 years of age stipulates (agrees) to the terms of this judgment

Child, Signature Date

Child, Name (printed)

Contact Address City, State, Zip Contact Phone

Judgment – Custody/Parenting Time/Support OJD Official

Page 11 of 11

(Feb 2023)

Optional: APPLICATION FOR FULL CHILD SUPPORT PROGRAM SERVICES:

By signing below, I apply for child support services, including enforcement, from the Child

Support Program (CSP). If you never received TANF, tribal TANF or AFDC in any state, an

annual $35 fee will apply if over $550 is collected and distributed to the family each year.

□Petitioner, Signature Date

□Respondent, Signature Date

□Adult Child, Signature Date

NOTICE OF PROPOSED JUDGMENT OR ORDER

To be sent to all other parties before submitting proposed Judgment or Order to the court for

signature. Send the Judgment or Order to the other party with this Notice at least 7 days

before submitting it to the court. This does not apply to judgments submitted with a Motion for

Order of Default or after an Order of Default has been granted.

is notice is to inform you that you can object to the attached proposed Judgment or Order.

iform Trial Court Rule (UTCR) 5.100

allows you to object to the proposed judgment or

order. If you have no objections, you can sign the last page and return it to me.

If you do object to any of the terms of the judgment or order, you may:

1) Contact me within 7 days of the date of this notice. If you contact me and we

are not able to resolve your objections after reasonable efforts, I will include your objections

with the proposed judgment or order when I submit it to the court.

2) Su

bmit your objections directly to the court. If you intend to submit your

objections directly to the court, notify me within 7 days of the date of this notice so that I can

inform the court of your intentions when I submit the proposed judgment or order. If you do

object to the proposed order or judgment, you must contact me within 7 days of the date of this

notice.

Date Signature

Name (printed)

Address City/State/Zip Phone

http://courts.oregon.gov/OJD/programs/utcr/pages/utcrrules.aspx

Motion for Default DR-Gen-Default-Mo-Decl-2019-08-01

Page 1 of 2

(Aug 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: ______________________

Petitioner

and

EX PARTE MOTION FOR

ORDER OF DEFAULT and

DECLARATION IN SUPPORT

Respondent

Motion

Based on the attached Declaration, Petitioner requests that this court grant an Order entering

the default of Respondent and directing entry of judgment.

Statement of Points and Authorities

ORCP 69 requires the court or clerk to enter an order of default on a showing by affidavit or

declaration that a party against whom a judgment is sought has been served with Summons or is

otherwise subject to the jurisdiction of the Court and has failed to plead or otherwise defend

within the time set by law.

Declaration

Respondent was served with the Summons, Petition and other documents required by law in

County, State of , on (date) and

has not made an appearance within the time required by law.

Respondent has not provided me with written notice of intent to appear.

Respondent provided me with written notice of intent to appear and I filed and served

written notice of intent to apply for default at least 10 days before filing this motion, or fewer

days as permitted by the court.

Respondent is not now, and was not at the time of the service of the Petition and Summons,

incapacitated, a minor, a financially incapable person, a protected person, or a Respondent in a

fiduciary protective proceeding, as defined by ORS 125.005,

and

(check one of the following):

□ The Respondent is not now, and was not at the time of service of the Petition and

Summons, in active military service of the United States. Provide facts supporting this

statement:

□ The Respondent is now, or was at the time of service of the Petition and Summons, in

active military service of the United States. Respondent has waived his or her rights

under the Servicemembers’ Civil Relief Act, as shown by the attached waiver, labeled

Exhibit .

Motion for Default

Page 2 of 2

(Aug 2019)

□ I am unable to determine whether or not Respondent is now, or was at the time of the

service of the Petition and Summons, in active military service of the United States.

Provide any facts you do know:

I request the relief specified in the attached Judgment.

Costs and fees are allowable under ORS 107.105(1)(j) or 107.490(4).

I hereby declare that the above statements are true to the best of my knowledge

and belief, and that I understand they are made for use as evidence in court and I

am subject to penalty for perjury.

Date Signature

Name (printed)

Contact Address City, State, ZIP Contact Phone

Order on Motion for

Default Page 1 of 1

(Aug 2019)

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF

Case No: _________________

Petitioner

and

ORDER ON MOTION

FOR DEFAULT

Respondent

Petitioner’s Motion for Order of Default and Entry of Judgment is:

granted

denied

Certificate of Readiness under UTCR 5.100 This proposed judgment is ready for judicial

signature because service is not required under UTCR 5.100 because this judgment is submitted

ex parte as allowed by statute or rule