FORM 14 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN In the Matter of the Marriage of: ________________________________, Petitioner, ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Case No. and ________________________________, Respondent and ________________________________, Child who is at least 18 and under 21 years of age, unmarried and unemancipated. (ORS 107.108) GENERAL JUDGMENT OF DISSOLUTION OF MARRIAGE/DOMESTIC PARTNERSHIP and MONEY AWARD 1. This matter came before the Court: On the motion and affidavit of Petitioner, the default of Respondent having been found. On the motion of Petitioner, the default of Respondent having been found, and Respondent being represented by a guardian ad litem or another person described in Rule 27. On the motion and affidavit of Petitioner, Respondent having filed a Waiver of Further Appearance. On the stipulations of the parties, as shown by the signatures below. The court has waived the 90 day waiting period based on the following: the parties have entered into a stipulated (agreed to) judgment, or other: At a hearing held , at which the following persons were present: Date) Petitioner Petitioner's attorney Respondent Respondent's attorney: 2. Findings. The Court considered the: Affidavit Affidavit and stipulations Evidence presented and found that: A. Irreconcilable differences have caused the irremediable breakdown of this marriage/domestic partnership. B. Spouses Only: Petitioner Respondent has/have been a resident of and domiciled in the state of Oregon continuously for six months immediately prior to the filing of the Petition for Dissolution of Marriage. GENERAL JUDGMENT OF DISSOLUTION OF MARRIAGE/DOMESTIC PARTNERSHIP; AND MONEY AWARD - Page 1 of 13 American LegalNet, Inc. Linn County Form 14 General Judgment with Children 2010.doc (9/10) www.FormsWorkFlow.com  Domestic Partnership Only: One or both of the parties to this case currently live in the county where this petition has been filed, or neither party currently resides in Oregon but the petition has been filed in the county where Petitioner or Respondent last resided. C. Children of the Marriage/Domestic Partnership. The following children were born to/ adopted by the parties before or during this marriage/domestic partnership (list name(s), date of birth(s) and age(s)): Name Date of Birth Do not list here. List the information on the UTCR 2.130 Confidential Information Form (CIF). Do not list here. List the information on the UTCR 2.130 Confidential Information Form (CIF). Do not list here. List the information on the UTCR 2.130 Confidential Information Form (CIF). Do not list here. List the information on the UTCR 2.130 Confidential Information Form (CIF). Petitioner Respondent is not the father, or paternity has not been established, of the children (list names): born during the marriage/domestic partnership on the following date(s): Neither party is now pregnant. Petitioner Respondent is now pregnant. Petitioner Respondent is not the parent of the child/ren due (date). D. Child Custody Jurisdiction. (Check appropriate boxes) I. Oregon has jurisdiction under the Uniform Child Custody Jurisdiction and Enforcement Act to hear the custody parenting time issue because: Oregon is the child/ren's home state (i.e., the child/ren have lived here continuously for the six month period immediately before this case was filed). Other reason: Age II. Oregon does not have jurisdiction under the Uniform Child Custody Jurisdiction Act because: GENERAL JUDGMENT OF DISSOLUTION OF MARRIAGE/DOMESTIC PARTNERSHIP; AND MONEY AWARD - Page 2 of 13 American LegalNet, Inc. Linn County Form 14 General Judgment with Children 2010.doc (9/10) www.FormsWorkFlow.com E. Child/ren Who Are At Least 18 and Under 21 Years of Age. (child/ren's name) is at least 18, 19, or 20 years of age, is unmarried and unemancipated and has: Waived further appearance in these proceedings. Signed and stipulated to the terms of judgment evidenced by the signature below. Fully participated in the proceedings and the judgment effectively binds him/her to the terms. NOW, THEREFORE, IT IS HEREBY ORDERED: The terms of this judgment are effective immediately. The marital/domestic partner status of the parties shall terminate on the date this judgment is signed by the judge. 1. Parenting Plan Custody of the child/ren is awarded as follows: Petitioner is awarded sole custody of the following child/ren (list names): Respondent is awarded sole custody of the following child/ren (list names): The parties have agreed to joint custody of the following child/ren (list names): Petitioner Respondent should have parenting time with the child/ren as set forth in the attached Parenting Plan, labeled Exhibit ____, or Other: Petitioner Respondent shall not have parenting time because this would endanger the health and safety of the child/ren. Parenting time shall be supervised by Any cost of the supervision shall be paid by Petitioner Respondent Other: Petitioner and Respondent shall each provide contact addresses and contact telephone numbers to the other and notify each other of any emergency circumstances or substantial changes in the child/ren's health. Neither parent shall move to a residence 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, or the requirement of ORS 107.159 regarding notice of move is suspended for good cause found. 2. Cash Child Support. Complete either (a) or (b) below: (a) Cash child support must be paid by Petitioner to Respondent (or) Respondent to Petitioner beginning on the first or of the month following the date of the judgment and continuing on the same day of each month thereafter. The total payment per month is $ for children. GENERAL JUDGMENT OF DISSOLUTION OF MARRIAGE/DOMESTIC PARTNERSHIP; AND MONEY AWARD - Page 3 of 13 American LegalNet, Inc. Linn County Form 14 General Judgment with Children 2010.doc (9/10) www.FormsWorkFlow.com The cash child support: Is the amount presumed to be appropriate under the support guidelines. Is different from the presumed appropriate amount of $ reasons) (b) No cash child support is ordered in this judgment because: because (list . An order, including medical support, for child support in the monthly amount of $ has already been ordered in Circuit Court case number in County, Oregon. Other reason: 3. Medical Support. Complete section (