IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF _________________ In the Matter of ‘ the Marriage of: ________________________________, Petitioner, and ________________________________, Respondent, and ‘ ________________________________, Child who is at least 18 and under 21 years of age, unmarried and unemancipated. (ORS 107.108) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Case No. ______________________ ‘ PETITIONER’S ‘ RESPONDENT’S EX PARTE MOTION FOR ORDER TO SHOW CAUSE REGARDING MODIFICATION OF JUDGMENT RE: ‘ CUSTODY ‘ PARENTING TIME ‘ CHILD SUPPORT Motion I, ‘ Petitioner ‘ Respondent, request that the court issue an Order to Show Cause requiring ‘ Petitioner ‘ Respondent to appear in Circuit Court in the ___________________________ County Courthouse in ________________________, Oregon, to show cause why this court should not grant the following relief concerning the parties’ child/ren: [Name(s) and date(s) of birth] 1. ‘ Change custody of the minor child/ren as follows: a. ‘ Petitioner ‘ Respondent to be awarded sole custody of the child/ren (list names and dates of birth): b. ‘ The parties have agreed to joint custody of the following child/ren (list names and dates of birth): Page 1 of 5, ‘ PETITIONER’S ‘ RESPONDENT’S EX PARTE MOTION FOR ORDER TO SHOW CAUSE REGARDING MODIFICATION OF JUDGMENT Modification-4A: MoShowCaus4AVer06.wpd (09/06) American LegalNet, Inc. www.FormsWorkflow.com 2. ‘ Change the current court-ordered parenting time as follows: a. ‘ Petitioner ‘ Respondent should have parenting time with the child/ren ‘ as set forth in the attached Parenting Plan, labeled Exhibit ____, or ‘ Other: b. ‘ Petitioner ‘ Respondent should not be granted parenting time because this would endanger the health and safety of the child/ren. Supporting facts are as follows: c. ‘ Parenting time shall be supervised by: ‘ Any cost of the supervision shall be paid by ‘ Petitioner ‘ Respondent ‘ Other: d. ‘ Petitioner and Respondent should each provide contact addresses and contact telephone numbers to the other and notify each other of any emergency circumstances or substantial changes in the child/ren’s health. e. ‘ Petitioner ‘ Respondent should be allowed to move more than 60 miles further distant from the other parent without advance notice because good cause exists. 3. ‘ Terminate ‘ Petitioner’s ‘ Respondent’s child support obligation due to the requested change in custody. 4. ‘ Require ‘ Petitioner ‘ Respondent to pay child support in the amount of $ per month beginning , 20 , for (list names of children): until the child[ren] is/are 18 years of age or otherwise emancipated, or until age 21, so long as the child[ren] is/are student(s) attending school as defined in ORS 107.108. The support amount was calculated pursuant to the support guidelines set out in Oregon’s Administrative Rules. The support amount ‘ does ‘ does not deviate from the presumed correct amount under the guidelines. /// Page 2 of 5, ‘ PETITIONER’S ‘ RESPONDENT’S EX PARTE MOTION FOR ORDER TO SHOW CAUSE REGARDING MODIFICATION OF JUDGMENT Modification-4A: MoShowCaus4AVer06.wpd (09/06) American LegalNet, Inc. www.FormsWorkflow.com If the amount does deviate, I am requesting the deviation because (explain): ‘ All payments of child support shall be made (check either (a) or (b) below): (a) ‘ To the Oregon Department of Justice, Child Support Accounting Unit, P.O. Box 14506, Salem, Oregon, 97309 or ‘ by electronic payment withdrawal (EPW) or electronic funds transfer (EFT). By ‘ petitioner’s ‘ respondent’s request, collection, accounting disbursement, and enforcement services of this obligation shall be through the State of Oregon’s Department of Justice. (b) ‘ An exception to Income withholding is requested because there is no support arrearage, the paying parent has not previously been granted an exemption from withholding, and: (i) ‘ The parents, and the State, if support rights are assigned, have agreed in writing to an alternative arrangement; or (ii) ‘ Good cause not to require withholding is found because there is proof of timely payment of previously-ordered support and income withholding would not be in the best interests of the child. Pursuant to the above exception, payment is requested to be made directly to ‘ Petitioner’s ‘ Respondent’s checking or savings account. A receipt of deposit shall be kept by the parent paying support as proof of payment. A canceled check is also prima facie evidence that payment has been made. The person receiving support shall provide the paying parent with current deposit slips and/or bank name, account name and account number. 5. ‘ Petitioner ‘ Respondent shall be entitled to claim the following child(ren) as dependent(s) for tax purposes beginning the year this judgment is entered (list names): , OR ‘ Other (specify): /// /// Page 3 of 5, ‘ PETITIONER’S ‘ RESPONDENT’S EX PARTE MOTION FOR ORDER TO SHOW CAUSE REGARDING MODIFICATION OF JUDGMENT Modification-4A: MoShowCaus4AVer06.wpd (09/06) American LegalNet, Inc. www.FormsWorkflow.com 6. Life Insurance Coverage for Child/ren. ‘ Petitioner ‘ Respondent should obtain and maintain life insurance for the benefit of the parties’ child/ren throughout the period of the support obligation. The coverage should be in the amount of $_____________. 7. Medical Insurance Coverage for Child/ren. Throughout the period of the support obligation, ‘ Petitioner ‘ Respondent should name the child/ren as beneficiaries of any health, accident, dental, orthodontic, and optical insurance plan, available through that parent’s employment, group, or union, and is accessible to the children at a reasonable cost that doesn’t make the application of the guidelines unjust or inappropriate. If that parent fails to maintain insurance under these circumstances for the child/ren, that parent should be responsible for any of those expenses incurred after the date of the court order requiring the coverage. If that parent maintains this insurance but the insurance does not provide complete coverage, that parent should pay ______% of the uninsured costs. If the insurance coverage for the child/ren is provided through the parent’s employment, group, or union, and if this employment, group or union membership is then terminated, this parent shall notify the other parent of this fact prior to or immediately upon termination. If insurance is not available to this parent when the final judgment is entered, that parent should provide insurance in the future when it becomes available to him/her. Whenever ‘ Petitioner ‘ Respondent does not have health, accident, dental, orthodontic, or optical insurance available through employment, group or union membership, that parent should pay ______% of the uninsured costs incurred by the child/ren throughout that period, including costs for prescriptions. 8. Court Costs and Fees. (Choose “a” or “b”) Judgment should be entered according to the cost and fee allocation indicated below. a. ‘ Deferred Costs and Fees. Any court costs and service fees (if service completed by the Sheriff) that are deferred (required to be paid at a later date) by the court should be paid by: ‘ Petitioner b. ‘ Respondent. ‘ Both parties equally ‘ Other: ‘ Costs and Fees Paid by the Parties. i. ‘ Each party should be responsible for paying his or her own court costs and service fees for this case. ii. ‘ To be paid by both parties equally Page 4 of 5, ‘ PETITIONER’S ‘ RESPONDENT’S EX PARTE MOTION FOR ORDER TO SHOW CAUSE REGARDING MODIFICATION OF JUDGMENT Modification-4A: MoShowCaus4AVer06.wpd (09/06) American LegalNet, Inc. www.FormsWorkflow.com iii. ‘ Petitioner ‘ Respondent should reimburse the other party for his or her court costs and service fees for this case. iv. 9. Other: Preservation of General Judgment Terms. Any terms in the original Judgment not amended by this Supplemental Judgment should remain in effect. Points and Authorities ORS 107.135(1)(a) allows the court to modify custody, parenting time and support terms in a judgment of dissolution. ORS 109.103 extends the provisions of ORS 107.135 to custody and parenting time cases involving the children of unmarried parents. DATED: _______________________, 20 _____. 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. for assistance in preparing this ‘ I paid or will pay money to form. ‘ Petitioner ‘ Respondent, Signature Address or Contact Address Print Name City, State, Zip Telephone or Contact Telephone I certify that this is a true copy: ____________________________________ ‘ Petitioner ‘ Respondent, Signature Page 5 of 5, ‘ PETITIONER’S ‘ RESPONDENT’S EX PARTE MOTION FOR ORDER TO SHOW CAUSE REGARDING MODIFICATION OF JUDGMENT Modification-4A: MoShowCaus4AVer06.wpd (09/06) American LegalNet, Inc. www.FormsWorkflow.com