Modification - Response Page 1 of 2 (Aug 2019) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF Case No: Petitioner and RESPONSE TO MOTION TO MODIFY JUDGMENT Respondent 1. I disagree with the following changes requested by the other party: (be specific and use the children222s first names where appropriate) a. Spousal/partner support (explain) b. Custody of minor children (explain) c. Parenting time (explain) d. Child support (explain) e. Medical insurance, uninsured medical costs, or cash medical support (explain) f. Other (explain) Additional page attached 2. Information Required by the Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) List the places where the minor children of the parties have lived in the last five years and the names of the people they lived with at that time Dates (from/to) County, State Name of Parent/ Caretaker Contact Address of Parent/ Caretaker Which Children Additional page attached titled 223UCCJEA224 I have not participated in any case concerning custody, visitation, parenting time or placement of the children in this or any other state American LegalNet, Inc. www.FormsWorkFlow.com Modification - Response Page 2 of 2 (Aug 2019) or I have participated in the following case: Name of Court State Case No. Date Result Additional page attached titled 223UCCJEA224 I do not know of any other child support, domestic violence, custody, parenting time, placement, or guardianship proceeding involving the children, or of any other court case which could affect this case, pending in any state except for: (identify court, case number, and kind of proceeding) I do not know any person other than my spouse/partner who has physical custody of the children or who claims to have custody, visitation or parenting time rights except for: (list name and address) 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 in court and I am subject to penalty for perjury. Date Signature Print Name Contact Address City, State, Zip Contact Phone American LegalNet, Inc. www.FormsWorkFlow.com