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Request For Default Judgment Defendant Status Affidavit Form. This is a Oregon form and can be use in Jackson Local County.
Tags: Request For Default Judgment Defendant Status Affidavit, Oregon Local County, Jackson
IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR JACKSON COUNTY SMALL CLAIMS DEPARTMENT (Please type or print legibly) Plaintiff(s): 1.) _____________________________ CASE NUMBER: ______________ 2.) _____________________________ REQUEST FOR DEFAULT JUDGMENT; DEFENDANT STATUS AFFIDAVIT vs. Defendant(s): 1.) _____________________________ 2.) _____________________________ NOTE: Complete this and attach a completed judgment you propose. I, ______________________________________ request default judgment against ___________________________________________ defendant(s), for the following: A total judgment award of $__________________ which total includes: 1. Money awarded in the amount of $_______________, 2. Prejudgment interest of $_______________, 3. Accrued arrearages of $_______________, if any, 4. Costs and service expenses of $_______________, 5. A prevailing party fee under ORS 20.190 of: $ 85.00 , 6. The amount paid since filing the claim is $_______________. I request the judgment include post judgment interest at a rate of _____% per ________ based on:__________________________. (Note statutory interest is 9% per annum unless a contract/agreement differs.) And, I request the following terms in addition to or in lieu of a money award NONE, or _______________________________________________________________ In furtherance of this request, I state that: 1. The above-named defendant(s) was duly and regularly served with a copy of the claim and failed to pay the claim or demand a hearing or trial within 14 days: 2. The person against whom I seek a judgment by this request: a) is not one of the following defined by ORS 125.005 and protected by ORCP 69 B; a minor, incapacitated, a protected person or respondent; b) is is not I am unable to determine whether this person is a person protected by the Service members Civil Relief Act (50 U.S.C. App 501 to 596). The facts that support this statement are: ___________________________________ _________________________________________________________________. I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and is subject to penalty for perjury. ____________________________ DATED: __________________ Plaintiff’s Name (print) _____________________________ Authorized Signature Public SmClaims Request Default Judgment Page 1 of 1 7/16/10 OJIN code: RQJD American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR JACKSON COUNTY SMALL CLAIMS DEPARTMENT (Please type or print legibly) Plaintiff(s): 1.) _____________________________ CASE NUMBER: ______________ 2.) _____________________________ LIMITED JUDGMENT GENERAL JUDGMENT vs. Defendant(s): 1.) _____________________________ 2.) _____________________________ I hereby give judgment in this case for the Judgment Creditor named in the money judgment/money award below and against the judgment debtor(s) named therin. In addition or in lieu of the money award below, this judgment established the following requirements: None OR _________________________________________________ _________________________________________________________________________ Based upon ____________________________________________________’s failure to appear for the scheduled Mediation Hearing (check box if applicable). MONEY JUDGMENT Judgment Creditor(s): __________________________________________________ Creditor’s Address: __________________________________________________ Judgment Debtor(s): __________________________________________________ Debtor’s Address: __________________________________________________ Judgment Amount: $_______________________ Prejudgment Interest: $_______________________ Costs and Service Fees: $ _______________________ Prevailing Party Fee: $85.00 Post Judgment Interest: __________% per annum _____________________ Date Public SmClaims Default Judgment ____________________________ Circuit Court Judge/Clerk Page 1 of 1 7/16/10 OJIN code: JGLN/JGLM or JGGL/JGGM American LegalNet, Inc. www.FormsWorkFlow.com