IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF MALHEUR 251 B Street W #3, Vale OR 97918 _________________________________, Plaintiff, vs. _________________________________, Defendant. STATE OF OREGON ) ) ss. Count of MALHEUR ) I, __________________________________________, being first duly sworn, depose and say: Case No. ____________________ AFFIDAVIT OF JUDGMENT CREDITOR 1. I am the Plaintiff Defendant. I am submitting this affidavit pursuant to ORS 24.125 and ORS 24.129 in connection with the filing of a foreign judgment in favor of _____________________________, judgment creditor. 2. The name and last known post office address of the judgment creditor is: _____________________________________ _____________________________________ _____________________________________ AFFIDAVIT OF JUDGMENT CREDITOR - Page 1 American LegalNet, Inc. www.FormsWorkFlow.com 3. The name and last known post office address of the judgment debtor is: _____________________________________ _____________________________________ _____________________________________ 4. I certify that this Judgment being filed herewith is being registered in Malheur County Circuit Court and not being filed in any other court in Oregon. ______________________________ Creditor's or Creditor's Attorney Signature SUBSCRIBED AND SWORN to before me this _______ day of __________________, 20_____. ______________________________ Notary Public of Oregon My Commission Expires: ____________ Submitted by: Attorney/Petitioner's Name City, State, Zip If Attorney: Bar No. Address Phone Number Email Certificate of Document Preparation If this document was not completed by an attorney, I hereby certify that the following statements are true: (check all boxes and complete all blanks that apply) A. I selected this document for myself, and I completed it without paid assistance. B. I paid or will pay month to for assistance in preparing this form/document. ________________________________ Signature Fax AFFIDAVIT OF JUDGMENT CREDITOR - Page 2 American LegalNet, Inc. www.FormsWorkFlow.com