IN THE CIRC UIT COURT FOR THE STATE OF OREGON FOR THE THIRD JUDICIAL DISTRICT PO Box 12869 Salem, Oregon 97309-0869 State of Oregon ) DEFENDAN TS AFFIDAVIT Plaintiff ) (Trial by Affidavit) v ) ) Case #_____________________________________________________ ) Defendant ) STATE OF OREGON ) ) ss. County of Marion ) I, __________________________________, hereby waive my right to trial by personalappearance in Court and submit my evidence by this affidavit to the Court. I understand that Iwill be notified by mail of the findings. The testimony that I wish to submit for consideration by the Court is as follows, and I swear/affirm the following is true: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ DEFENDANTS AFFIDAVIT - Page 1 of 2 FC (2/22/04)>>>> 2______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Signature:_____________________________________________________________________ Print Name: ___________________________________________________________________ Mailing Address:________________________________________________________________ City, State, Zip:_________________________________________________________________Subscribed and sworn before me this______day of ____________________, 20_____ _____________________________________ Notary Public/Deputy Court Administrator My Commission Expires:_________________DEFENDANTS AFFIDAVIT - Page 2 of 2 FC (2/22/04)