PAGE 1 226 ACKNOWLEDGMENT OF SERVICE and WAIVER OF PARTICIPATION BY ADULT CHILD ATTENDING SCHOOLIN THE CIRCUIT COURT OF THE STATE OF OREGONFOR THE COUNTY OF MULTNOMAHFamily Law DepartmentIn the Matter of: Petitioner, and Respondent, and Adult Child Attending School ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) )Case No. ACKNOWLEDGMENT OF SERVICE andWAIVER OF PARTICIPATION BY ADULTCHILD I declare that the following are true statements:1.My name is . I am years old andam the adult child of the parties identified above as the Petitioner and the Respondent. I am notmarried.2.I received on (date) a copy of the (check one) 221 Summonsand Petition 221 Motion and Affidavit in this case that includes a request that child support be paid (ornot paid) for my benefit.3.My situation is the following: 224IN SCHOOL NOW: (all the following are true)I am attending school (or a high school equivalency program or vocational training or the Job Corps), andI am carrying at least one-half of what my school or program considers a full courseload, andI am making satisfactory academic progress, according to my school or program. or224ON SCHOOL BREAK NOW BUT WILL ATTEND NEXT TERM:My school is on a regularly scheduled summer or other break, but I intend to attend school (or ahigh school equivalency program or vocational training or the Job Corps) the next scheduled termor semester and carry one-half of what my school or program considers a full courseload.or224SOMETHING OTHER THAN THE TWO SITUATIONS JUST DESCRIBED. American LegalNet, Inc. www.FormsWorkFlow.com PAGE 2 226 ACKNOWLEDGMENT OF SERVICE and WAIVER OF PARTICIPATION BY ADULT CHILD ATTENDING SCHOOLIf child support for an adult child attending school is paid through the Division of Child Support (DCS) ofthe Oregon Department of Justice, information about reporting requirements and other rules is available onthe DCS website at www.dcs.state.or.us. 4.I DO NOT WANT TO PARTICIPATE IN THE LEGAL PROCEEDINGS that will determinewhether and how much one or both of my parents should pay for my support.5.I understand that my interests may not be the same as one or both of my parents. I know that if any ofmy parents has an attorney, that attorney represents the interests only of that parent, not my interests. Iunderstand that I can hire my own attorney to represent my own interests. 6.I am not in the military service. 7.I am not incapacitated in a manner that limits my ability to handle my own affairs. No court hasappointed a guardian or conservator to protect me or my property. I hereby declare that the above statements are true to the best of my knowledge and belief, and that Iunderstand they are made for use as evidence in court and are subject to penalty for perjury.Sign NameDatePrint NamePrint AddressPrint City/State/Zip Code American LegalNet, Inc. www.FormsWorkFlow.com