Response - Separation Page 1 of 3 (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 RESPONSE TO PETITION FOR SEPARATION OF MARRIAGE RDP Respondent and counterclaims 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: 1. I, Respondent, appear and oppose the Petition. List sections opposed and reasons: Section Number Explain Additional page attached titled 223Section 1224 2. I make the following counterclaims: (see Instructions for information about counterclaims including retirement benefits and support for a child, spouse, or partner) a b c d Additional page attached titled 223Section 2224 3. My former name of (use FULL name 226 first, middle, last) should be restored 4. I should be allowed to move more than 60 miles farther away from Petitioner without written notice to Petitioner or the court (explain): Additional page attached titled 223Section 4224 American LegalNet, Inc. www.FormsWorkFlow.com Response - Separation Page 2 of 3 (Aug 2019) 5. Child Support Offsets Social Security or apportioned veteran222s benefits are paid to (or on behalf of) some or all of the children named in the Petition as a result of my disability or retirement. I ask that child support be reduced dollar-for-dollar. The amounts per child are included in the attached Uniform Support Declaration. Survivors222 and Dependents222 Educational Assistance under 38 USC Chapter 35 is paid to (or on behalf of) some or all of the children named in the Petition as a result of my disability or retirement, and child support must be reduced dollar-for-dollar. The amounts per child are included in the attached Uniform Support Declaration. 6. (Optional) Exception to Income Withholding of Child Support: I understand that payments will be made by income withholding unless an exception applies I request an exception to the income withholding requirement of ORS 25.378 so that payment can be made another way because good cause exists Petitioner and Respondent have agreed in writing to the following alternative payment method: Other exception under ORS 25.396 (explain): 7. 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 223Section 7224 I have not participated in any litigation concerning custody, visitation, parenting time or placement of the children in this or any other state or I have participated in the following litigation: Name of Court State Case No. Date Result Additional page attached titled 223Section 7224 American LegalNet, Inc. www.FormsWorkFlow.com Response - Separation Page 3 of 3 (Aug 2019) I do not know of any other domestic violence, custody, parenting time, or placement 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 Respondent (signature) Respondent Name Contact Address City, State, Zip Contact Phone Certificate of Mailing I certify that on (date): I placed a true and complete copy of this Response in the United States mail to Petitioner at (petitioner222s address): Date Respondent (signature) Respondent Name American LegalNet, Inc. www.FormsWorkFlow.com