Declaration in Support of Judgment - Separation Page 1 of 2 (Aug 2019) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of the Marriage or Registered Domestic Partnership (RDP) of: Case No: Petitioner and DECLARATION SUPPORTING GENERAL JUDGMENT OF SEPARATION OF MARRIAGE RDP Respondent and Unmarried children 18, 19, or 20 years old (full names) The statements made in the Petition remain true and accurate except: Section Number Explain Additional page attached Minor Children Children of Petitioner and Respondent (under age 18) conceived, born, or adopted during or prior to the marriage/RDP and any children otherwise legally recognized as children of both parties: Name of Child Age Currently live s with (Name, Address or Contact Address) For how long Additional children listed on page attached titled 223Additional Children224 Petitioner Respondent is pregnant (and) the other party is is not the parent of this child. The expected date of the child222s birth is Child support has been requested. The information included in that worksheet is true and accurate to the best of my knowledge. (attach the worksheets to the General Judgment) The parent who should pay child support (223payor224) does not live in Oregon but (check all that apply) American LegalNet, Inc. www.FormsWorkFlow.com Declaration in Support of Judgment - Separation Page 2 of 2 (Aug 2019) Was personally served with the Petition in Oregon Filed a response in this case Lived in Oregon with at least one of the children Lived in Oregon and paid for prenatal or other costs for at least one of the children At least one child lives in Oregon as a result of an act or instruction by the payor At least one child may have been conceived in Oregon Claimed parenthood on a Voluntary Acknowledgment of Paternity Both parties lived in Oregon for at least 6 months and the non-resident party moved out of Oregon less than one year before the Petition was filed in this case There is another basis for jurisdiction (explain): I ask the court to enter judgment without a hearing under ORS 107.095(4) because: Respondent has not appeared and an Order of Default has been entered Respondent has stipulated (agreed) to the terms of the Judgment Respondent signed a Waiver of Appearance and Consent to Entry of Judgment I hereby declare that the above statements are true and complete to the best of my knowledge and belief. I understand they are made for use as evidence in court and I am subject to penalty for perjury. Submitted by Petitioner Respondent Date Signature Print Name Contact Address City, State, Zip Contact Phone American LegalNet, Inc. www.FormsWorkFlow.com