Page 1 226 Form 2.130.1 226 CONFIDENTIAL INFORMATION FORM FOR RESPONDENT IN EPPDAPA CASES226 UTCR 2.130 (Revised 8/2016) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR COUNTY , Petitioner and . Respondent ) ) ) ) ) ) ) ) ) Case No.: CONFIDENTIAL INFORMATION FORM (CIF) FOR PERSON RESTRAINED (RESPONDENT) IN A Elderly Persons & Persons With Disabilities Abus Prevention Act (EPPDAPA) CASE Amended CIF This document is not accessible to the public or other parties. Exceptions may apply. See UTCR 2.130. The information below is about: Respondent Respondent222s Name (Last, First, Middle): The names of the parties and the children, as well as the children222s ages, are NOT confidential. Respondent222s Date of Birth: Employer222s Name, Address, and Telephone Number: I hereby declare that the above statements are true to the best of my knowledge and belief and that I understand they are made for use as evidence in court and are subject to penalty for perjury. Date: Signature: Type or Print Name: COMPLETED AND SUBMITTED BY: Petitioner NOTE TO COURT STAFF: Unless ordered or authorized under UTCR 2.130, this Confidential Information Form is not available to the opposing party or his/her attorney , or to the public; except for the state and law enforcement. ATTENTION COURT STAFF : THIS IS A RESTRICTED - ACCESS DOCUMENT. American LegalNet, Inc. www.FormsWorkFlow.com