Affidavit In Support Of Motion For Waiver Of Mediation (6I)
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Affidavit In Support Of Motion For Waiver Of Mediation (6I) Form. This is a Oregon form and can be use in Circuit Court Statewide.
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Tags: Affidavit In Support Of Motion For Waiver Of Mediation (6I), Oregon Statewide, Circuit Court
IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE COUNTY OF _________________
In the Matter of the Marriage of:
________________________________,
Petitioner,
and
________________________________,
Respondent.
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Case No. ______________________
AFFIDAVIT IN SUPPORT OF MOTION
FOR WAIVER OF MEDIATION
STATE OF __________________________ )
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County of ___________________________ )
I, Petitioner Respondent, being first duly sworn, request a waiver of mediation because of the
following reasons/facts:
Additional page attached, labeled “Affidavit, continued.”
Certificate of Document Preparation. You are required to truthfully complete this certificate
regarding the document you are filing with the court. Check all boxes and complete all blanks that apply:
I selected this document for myself and I completed it without paid assistance.
I paid or will pay money to _____________________________ for assistance in preparing this form.
Petitioner Respondent, Signature
Print Name
Address or Contact Address
Telephone or Contact Telephone
City, State, Zip
SIGNED AND SWORN to before me this ___________ day of _______________, 20 _____.
Notary Public for ____________/Court Clerk
My Commission Expires:
I certify that this is a true copy:
Petitioner Respondent, Signature
AFFIDAVIT IN SUPPORT OF MOTION FOR WAIVER OF MEDIATION - Page 1 of 1
6D-Z.MiscForms: 6I-AffWavMedVer01.doc (2/08)
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