IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF __________________ In the Matter of ‘ the Marriage of: ________________________________, Petitioner, and ________________________________, Respondent. 1. ) ) ) ) ) ) ) ) Case No. ____________________ GOVERNING CHILD SUPPORT JUDGMENT (SUPPLEMENTAL JUDGMENT) This matter came before the Court: a. ‘ On the Petition of ‘ Petitioner ‘ Respondent ‘ the State of Oregon; b. ‘ On the Court’s own motion; c. ‘ At a hearing held on __________________ (date), at which the following persons were present: ‘ Petitioner ‘ Petitioner’s Attorney _____________________________ ‘ Respondent ‘ Respondent’s Attorney ____________________________ ‘ Other: _____________________________________________________________ 2. Findings: The Court considered the: ‘ Documents on file herein ‘ Evidence presented ‘ Other: , and found that: a. There exist two or more child support judgments involving the same obligor and child[ren] and the same time period, copies of which are attached hereto and incorporated herein by reference, as follows: Exhibit # Agency Case # Court Case # County Entry/ Effective Date Amount of Child Support Ordered Payment Start Date Additional Information about Judgment 1 2 3 4 ‘ Additional sheets attached as “Attachment #2(a)-Multiple Judgments.” Page 1 of 7 - GOVERNING CHILD SUPPORT JUDGMENT (SUPPLEMENTAL JUDGMENT) GovernCSJudg-14: GovJudgment14Ver04.wpd (1/04) American LegalNet, Inc. www.FormsWorkflow.com b. ‘ The presumption that the terms of the last-issued child support judgment are the controlling terms and supersede contrary terms of each earlier-issued child support judgment has been rebutted as follows: i. ‘ The last-issued child support judgment should be set aside under the provisions of ORCP 71 for the following reason(s): 1. ‘ The mistake, inadvertence, surprise, or excusable neglect of G Petitioner G Respondent; 2. ‘ There is newly discovered evidence which by due diligence could not have been discovered in time to move for a new trial under Rule 64F; 3. ‘ The fraud, misrepresentation or other misconduct of G Petitioner G Respondent; 4. ‘ The judgment is void; 5. ‘ The judgment has been satisfied, released or discharged, or a prior judgment upon which it is based has been reversed or otherwise vacated, or it is not longer equitable that the judgment should have prospective application. ii. ‘ The last-issued child support judgment was issued without prior notice to the issuing court, administrator or hearing officer that: G there was a pending support proceeding involving the child[ren], or G there existed another child support judgment involving the child[ren], in this state or any other jurisdiction. iii. ‘ The last-issued child support judgment was issued after an earlier child support judgment and did not enforce, modify or set aside the earlier child support judgment in accordance with ORS 25._______. c. Notice has been provided to all affected parties as required by law. IT IS HEREBY ORDERED AND ADJUDGED that: 1. CONTROLLING TERMS. (Choose one.) a. ‘ The terms of the last-issued child support judgment dealing with monetary support and health insurance are the controlling terms and supersede contrary terms of each earlier-issued child support judgment (See Exhibit # ). b. ‘ The terms of the last-issued child support judgment are the controlling terms and supersede contrary terms of each earlier-issued child support judgment, except that: ‘ the last-issued child support judgment is silent about monetary support, and thus the monetary support terms of the preceding judgment issued most recently continue (See Exhibit # ). ‘ the last-issued child support judgment is silent about health insurance, and thus the health insurance terms of the preceding judgment issued most recently continue (See Exhibit # ). /// /// /// Page 2 of 7 - GOVERNING CHILD SUPPORT JUDGMENT (SUPPLEMENTAL JUDGMENT) GovernCSJudg-14: GovJudgment14Ver04.wpd (1/04) American LegalNet, Inc. www.FormsWorkflow.com c. ‘ The presumption that the terms of the last-issued child support judgment are the controlling terms having been rebutted, or ‘ a substantial change in circumstance having been established by ‘ Petitioner ‘ Respondent, the controlling terms with respect to monetary support and health insurance shall be as follows: i. ‘ As contained in the earlier-issued judgment dated (See Exhibit # ). ii. ‘ Modified as follows: . The effect of this modification on all preceding judgments identified in Paragraph 2(a) above is that all terms contained therein regarding monetary support and health insurance are hereby terminated as of the date this judgment is entered, and all other terms that do not relate to monetary support and/or health insurance are hereby affirmed, except as follows: 2. EFFECTIVE DATE of CONTROLLING TERMS. The effective date of each controlling term in each of the child support judgments identified in Paragraph 2(a) above is as follows: Exhibit # 1 Controlling Term Effective Date Other Monetary Support Health Insurance 2 Monetary Support Health Insurance 3 Monetary Support Health Insurance Page 3 of 7 - GOVERNING CHILD SUPPORT JUDGMENT (SUPPLEMENTAL JUDGMENT) GovernCSJudg-14: GovJudgment14Ver04.wpd (1/04) American LegalNet, Inc. www.FormsWorkflow.com 4 Monetary Support Health Insurance ‘ Additional sheet attached as “Attachment #2-Effective Dates.” 3. ARREARS and/or CREDITS. Check one. ‘ The Court having determined the validity and effective dates of the judgments identified in Paragraph 2(a) above, monetary support arrears and/or credits for overpayments is reconciled as follows: Exhibit # Effective Dates for Accrual of Child Support (Mo/Yr) Amount of Child Support Arrearage Credits for Overpayments Per Annum Interest Not Already Included ‘ Additional sheets attached as “Attachment #3 - Arrears/Credits.” OR ‘ The Court having determined that one or more of the judgments identified in Paragraph 2(a) above are Agency orders and/or that the Administrator possesses the necessary record of support payments to determine arrears, the establishment of arrears is deferred to the Administrator in a separate proceeding to be commenced by: ‘ Petitioner ‘ Respondent ‘ State of Oregon ‘ Other . 4. FILING CERTIFIED COPIES WITH THE COURT OR THE CHILD SUPPORT PROGRAM ADMINISTRATOR. ‘ Petitioner ‘ Respondent ‘ Other: shall file a certified copy of this Governing Child Support Judgment with each court and/or the agency that issued an earlier child support judgment. A party who fails to file a certified copy as required by this judgment is subject to monetary sanctions, including but not limited to attorney fees, costs and disbursements. 5. Money Award. Child Support Obligation ‘ included ‘ not included. JUDGMENT CREDITOR (This is the party receiving payment from Judgment Debtor) G Petitioner G Respondent G Wife G Husband JUDGMENT DEBTOR (This is the party required to pay Judgment Creditor) G Petitioner G Respondent G Wife G Husband Full Name Page 4 of 7 - GOVERNING CHILD SUPPORT JUDGMENT (SUPPLEMENTAL JUDGMENT) GovernCSJudg-14: GovJudgment14Ver04.wpd (1/04) American LegalNet, Inc. www.FormsWorkflow.com JUDGMENT CREDITOR (This is the party receiving payment from Judgment Debtor) G Petitioner G Respondent G Wife G Husband JUDGMENT DEBTOR (This is the party required to pay Judgment Creditor) G Petitioner G Respondent G Wife G Husband Address or Contact Address Attorney’s Name, Telephone Number and Address The following information is required ONLY for the party designated as the “Judgment Debtor” above. Date of Birth Social Security Number Do not list. Provided by UTCR 2.100 Affidavit Do not list. Provided by UTCR 2.100 Affidavit Driver’s License Number and State of Issuance The following information is to be provided by the party designated as the “Judgment Creditor” above. Others Entitled to Portions of Judgment Type of Judgment The following person(s) or public bod(ies) are known by judgment creditor to be entitled to a portion of a payment made on the judgment (other than the judgment creditor’s attorney): ‘ None or ‘ JUDGMENT CREDITOR (This is the party receiving payment from Judgment Debtor) JUDGMENT DEBTOR (This is the party required to pay Judgment Creditor) G Petitioner G Respondent G Wife G Husband Amount of Judgment G Petitioner G Respondent G Wife G Husband Child Support Award ‘ per 1. $ month or ‘ Other: , starting on the ‘ first day or ‘ Other: of the month following the date of the judgment Prejudgment Interest $ (Note: ORS 21.607(1) disallows interest on fees that have been deferred.) Page 5 of 7 - GOVERNING CHILD SUPPORT JUDGMENT (SUPPLEMENTAL JUDGMENT) GovernCSJudg-14: GovJudgment14Ver04.wpd (1/04) American LegalNet, Inc. www.FormsWorkflow.com Type of Judgment JUDGMENT CREDITOR (This is the party receiving payment from Judgment Debtor) JUDGMENT DEBTOR (This is the party required to pay Judgment Creditor) G Petitioner G Respondent G Wife G Husband G Petitioner G Respondent G Wife G Husband Postjudgment Interest Amount of Judgment percent ( %) per annum simple interest on the total judgment amount(s) of . $ Interest begins accruing on the date the judgment is entered until fully paid. (Note: ORS 21.607(1) disallows interest on fees that have been deferred.) per month, 1. $ starting on the ‘ first day or ‘ Other: of the month following the date of the judgment until the total is paid amount of $ in full; or Accrued Arrears (if any, on judgments to be paid on a periodic basis) 2. A lump sum payment of $ to be paid by: (date). Costs and Service Expenses (e.g., filing fees, hearing fees, trial fees, process fees) $ Attorneys Fees (if any) $ DATED this ______ day of ______________________, 20____. Circuit Court Judge Print Name Page 6 of 7 - GOVERNING CHILD SUPPORT JUDGMENT (SUPPLEMENTAL JUDGMENT) GovernCSJudg-14: GovJudgment14Ver04.wpd (1/04) American LegalNet, Inc. www.FormsWorkflow.com 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. Dated this _______ day of ________________________, 20_____. Submitted by: ____________________________________________________________________________________________ Print Name ‘ Petitioner ‘ Respondent ‘ State of Oregon, Signature ____________________________________________________________________________________________ Address or Contact Address City, State, Zip Telephone or Contact Telephone Certificate of Mailing. I certify that I mailed a copy of this judgment and attachments thereto by U.S. Mail with postage paid to the other party at the following address: _______________________________________ on the following date:_________________________________. ‘ Petitioner ‘ Respondent ‘ State of Oregon, Signature Print Name I certify that this is a true copy: ‘ Petitioner ‘ Respondent ‘ State of Oregon, Signature Page 7 of 7 - GOVERNING CHILD SUPPORT JUDGMENT (SUPPLEMENTAL JUDGMENT) GovernCSJudg-14: GovJudgment14Ver04.wpd (1/04) American LegalNet, Inc. www.FormsWorkflow.com