IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of the Marriage of: , Petitioner, and , Respondent. STATE OF County of ) ) ) ) ) ) ) ) ) ) ss. ) , being first duly sworn, say: I am the Case No. AFFIDAVIT IN SUPPORT OF MOTION FOR POST-JUDGMENT TEMPORARY STATUS QUO ORDER UNDER ORS 107.138 1. I, (print your name) Petitioner Respondent in this proceeding. 2. The name(s) and year(s) of birth of the minor child/ren that should be protected by this order are: YEAR OF BIRTH NAME 3. My child/ren's present address is: . My child/ren have lived continuously at this address for a period of three consecutive months, excluding any periods of parenting time to the non-custodial parent. 4. The child/ren have resided at this address at least (number) (date) . 5. nights per week since Since the date listed in paragraph 4, the child/ren have had parenting time with according to the following schedule: __________________________________________________________________________________________ _________________________________________________________________________________________. AFFIDAVIT IN SUPPORT OF MOTION FOR POST-JUDGMENT TEMPORARY STATUS QUO ORDER American LegalNet, Inc. UNDER ORS 107.138 - Page 1 of 2 Post-Judgment Status Quo-6B: Affidavit-6BPostJudgmentVer04.doc (08/13) www.FormsWorkFlow.com 5. List the places where the minor child/ren of the parties have lived in the last five years and the names of the people they lived with at that time. Dates County, State Parent(s)/Caretaker Current Address/Contact Address of Parent/Caretaker Which Children Additional page attached 7. I have have not participated in any litigation concerning the custody, visitation, parenting time or placement of the child/ren in this or any other state. If "yes," I have participated in the following litigation: Name of Court State Case No. Date Result 8. I do not know of any other domestic violence, custody, visitation, parenting time or placement proceeding involving the child/ren, or of any other court case which could affect this case, pending in this or any other state except for: (identify court, case number and the kind of proceeding) 9. I do not know any person other than the other parent who has physical custody of the child/ren or who claims to have custody, visitation or parenting time rights except for: (list name and address) 10. There are are not any other custody, parenting time, visitation or restraining orders affecting the child/ren. I have attached copies of any existing orders to this affidavit. Certificate of Document Preparation. You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks that apply: I selected this document for myself and I completed it without paid assistance. I paid or will pay money to for assistance in preparing this form. DATED ,20 . Petitioner Respondent, Signature Address or Contact Address SIGNED AND SWORN to before me this Print Name City, State, Zip Telephone or Contact Telephone day of Notary Public for My Commission Expires: , 20 . / Court Clerk I certify that this is a true copy: Petitioner Respondent, Signature AFFIDAVIT IN SUPPORT OF MOTION FOR POST-JUDGMENT TEMPORARY STATUS QUO ORDER UNDER ORS 107.138 - Page 2 of 2 American LegalNet, Inc. Post-Judgment Status Quo-6B: Affidavit-6BPostJudgmentVer04.doc (08/13) www.FormsWorkFlow.com