Petition - Separation Page 1 of 12 (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 PETITION FOR SEPARATION and OF MARRIAGE RDP Filing fees at ORS 21.155 (marriage) & 21.135 (RDP) Respondent Claim { is is not } subject to mandatory arbitration and Unmarried children 18, 19, or 20 years old (per ORS 107.108) (full names) I need an interpreter: Spanish Russian other: Date of marriage or registration of RDP: Place of marriage or registration of RDP: (County, State) 1. (Check all that apply) My spouse or partner and I have differences so great that our marriage/RDP cannot be repaired My spouse or partner and I have an agreement that will be filed with the court suspending all rights and obligations as husband and wife/domestic partners for a period of at least one year 2. Duration The separation should be unlimited or (fill in amount of time or end date) 3. Residency Marriage Only: At least one spouse currently lives in the county in which this Petition is being filed Registered Domestic Partnership Only: At least one partner currently lives in the county in which this Petition is being filed or Neither partner currently lives in Oregon and this Petition is being filed in the county where { Petitioner Respondent} last lived 4. Children of Petitioner and Respondent conceived, born, or adopted during or prior to the marriage/RDP and any children otherwise legally recognized as children of both parties: Name Age American LegalNet, Inc. www.FormsWorkFlow.com Petition - Separation Page 2 of 12 (Aug 2019) Additional children listed on page attached titled 223Section 4 226 Additional Children224 Name and age of any child conceived or born during this marriage/RDP who is NOT the child of both parties Neither party is now pregnant Petitioner Respondent is pregnant (and) the other party is is not the parent of this child. The expected date of the child222s birth is 5. By filing this petition, I acknowledge that I am bound by the terms of the Statutory Restraining Order (SRO) prohibiting either party from disposing of marital/partnership assets. I understand that this restraining order is effective as soon as this Petition and the Summons are served on Respondent. 6. Other Case Information 6A. Pending Cases List any other domestic relations case that has been started but not yet finished in any state between the parties (including child or spousal/partner support, dissolution (divorce), annulment, separation, custody, paternity, juvenile court, or modifications) Name of Court or Agency Case No. Involves: (check all that apply) Dissolution, annulment, or separation Spousal/partner support Child Support Custody/Parenting Time Restraining Order Juvenile Dependency/Delinquency Dissolution, annulment, or separation Spousal/partner support Child Support Custody/Parenting Time Restraining Order Juvenile Dependency/Delinquency Additional information attached 6B. Existing Orders or Judgments List any existing order or judgment in this or any other state between the parties and attach a copy of the signed order or judgment (including child support (whether or not it is currently effective), dissolution (divorce), annulment, separation, custody, paternity, juvenile court, modification, or restraining/protective orders) American LegalNet, Inc. www.FormsWorkFlow.com Petition - Separation Page 3 of 12 (Aug 2019) Name of Court or Agency Case No. Date Signed Invo lves: (check all that apply) Dissolution, annulment, or separation Spousal/partner support Child Support Custody/Parenting Time* Restraining Order Juvenile Dependency/Delinquency *Result (if custody/par enting time): Dissolution, annulment, or separation Spousal/partner support Child Support Custody/Parenting Time Restraining Order Juvenile Dependency/Delinquency *Result (if custody/parenting time): Dissolution, annulment, or separation Spousal/partner support Child Support Custody/Parenting Time Restraining Order Juvenile Dependency/Delinquency *Result (if custody/parenting time): Dissolution, annulment, or separation Spousal/partner support Child Support Custody/Parenting Time Restraining Order Juvenile Dependency/Delinquency *Result (if custody/parenting time): Additional information attached CHILDREN A No-Contact Order (criminal or other) prohibits Respondent from exercising parenting time Case # County/State: 7. UCCJEA (Uniform Child Custody Jurisdiction and Enforcement Act) You must advise the court if any of this information changes 7A. Besides those listed above, list any case about the CUSTODY or PARENTING TIME (visitation) of the minor children named in this case that you participated in (include any that were filed but dismissed or denied by the court, and any filed by or against someone other than the Petitioner and Respondent in this case.) American LegalNet, Inc. www.FormsWorkFlow.com Petition - Separation Page 4 of 12 (Aug 2019) Name of Court State Case No. Date of final decision Result (include names of affected children) 7B. List any OTHER legal proceeding that may affect the outcome of this case (including enforcement of domestic violence or protective orders, adoption, termination of parental rights, or guardianship involving any of the children pending in any state) Name of Court or Agency State Case No. Type of Case Affected Children 7C. List the places where any of the children in Section 4 has lived in the last five years, the names of the people they lived with at that time, and current contact addresses for those people Current: Child222s Name Current Address Lives with: Petitioner Respondent Other: Petitioner Respondent Other: Residences: Dates From/To County, State Name of Parent/Caretaker Contact Address of Parent/Caretaker Which Children Additional page attached; see section titled 223Section 7A-UCCJEA224 American LegalNet, Inc. www.FormsWorkFlow.com Petition - Separation Page 5 of 12 (Aug 2019) Additional Caregivers: Dates From/To Name of Parent/Caretaker Where did they live with this caretaker? Contact Address of Parent/Caretaker Which Children 7D. The children listed in Section 4 have continuously lived in Oregon for the six months before the filing of this Petition, except for the children named below The following children have not lived in Oregon continuously for six months: (names) There is another legal basis for Oregon to address custody of these children. Explain: 7E. I do not know any person besides the other parent who has physical custody of the children or who claims to have custody, visitation or parenting time rights except for (list name and address and affected children): 8. Custody and Parenting Time Custody of the children should be awarded as follows: Parties should have joint custody of the following children (list names): I should be awarded sole custody of the following children (list names): Respondent should be awarded sole custody of the following children (list names): Parenting time should be awarded as set forth in the attached Parenting Plan, labeled Exhibit or as follows Parenting time should be supervised by Any cost of supervision should be paid by Petitioner Respondent Other: Respondent should not be granted parenting time because this would endanger the health or safety of the children. State supporting facts: Relocation I should be allowed to move more than 60 miles farther away from the respondent without American LegalNet, Inc. www.FormsWorkFlow.com Petition - Separation Page 6 of 12 (Aug 2019) advance written notice because good cause exists (explain): Contact Information I should not be required to provide contact information to Respondent or to contact Respondent in case of emergency circumstances or substantial change in the health of the children (explain): Parental Authority under ORS 107.154 Respondent should not have authority under ORS 107.154 (explain): 9. Support A. Child Support There IS an existing child support order in the monthly amount of $ from (county, state) The court case # is and the Child Support Program (CSP)# is I do not want to change this amount (skip to section 9D, below) I do want to change this