IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF _________________ In the Matter of the Marriage of: ____________________________________, Petitioner, ) ) ) ) ) ) ) ) ) ) ) ) Case No. ____________________ GENERAL JUDGMENT OF SUMMARY DISSOLUTION OF MARRIAGE/DOMESTIC PARTNERSHIP; and MONEY AWARD STIPULATED GENERAL JUDGMENT OF SUMMARY DISSOLUTION OF MARRIAGE/ DOMESTIC PARTNERSHIP; and MONEY AWARD and ___________________________________, Respondent. This matter came before the Court: On the motion and declaration of Petitioner, the default of Respondent having been found. On the motion and affidavit of Petitioner, Respondent having filed a Waiver of Further Appearance. On the stipulations of the parties, as shown by the signatures below. The court, having noted that this matter was filed before Jauary1, 2012, has waived the 90 day waiting period based on the following: the parties have entered into a stipulated (agreed to) judgment, or Other: At a hearing held ______________________, at which the following persons were present: (Date) Petitioner's attorney _____________________________________ Petitioner Respondent Respondent's attorney _____________________________________ Findings. The Court considered the: Verified Petition Affidavit Stipulations Evidence presented and found that: A. B. Irreconcilable differences have caused the irremediable breakdown of this marriage/registered domestic partnership. Spouses Only: Petitioner Respondent has/have been a resident of and domiciled in the state of Oregon for the six month period immediately prior to filing. Domestic Partnerships Only: Both parties no longer residing in Oregon, this matter was filed in the county of last residence of Petitioner Respondent. There are no unemancipated children under the age of 18 to this marriage, AND no child of this marriage is age 18 to 21 and a "child attending school" as defined in ORS 107.108. The parties have not been married or registered domestic partners for more than 10 years. Neither party is now pregnant. Neither party has any interest in real property. Petitioner has given up all rights s/he may have to spousal support and waives any right to temporary orders as part of this dissolution proceeding, except those under ORS 107.700 to 107.730 or ORS 124.005 to 124.040. C. D. E. F. G. GENERAL JUDGMENT OF SUMMARY DISSOLUTION; and MONEY AWARD - Page 1 of 7 SummDisso-1A: Judgment1A-Ver03.doc (8/12) American LegalNet, Inc. www.FormsWorkFlow.com NOW, THEREFORE, IT IS HEREBY ORDERED: The terms of this judgment are effective immediately. The marital status of the parties shall terminate on the date this judgment is signed by the judge. 1. Spousal Support and Life Insurance. Neither party shall pay spousal support, spousal life insurance or spousal medical coverage. Personal Property (combined net value of $30,000 or less, including motor vehicles and retirement accounts). The Petitioner and Respondent, having divided all personal effects, household goods and other personal property they own separately or together, each shall be awarded those items now in their possession. The Petitioner is awarded the following personal property: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Additional page attached; see section labeled "2. Petitioner-Personal Property continued." The Petitioner should be awarded his/her retirement benefits, pension plan, profit-sharing plan, deferred-compensation plan, and /or stock option plan, free of any interest of the Respondent. The Respondent is awarded the following personal property: 2. Additional page attached; see section labeled "2. Respondent-Personal Property continued." The Respondent should be awarded his or her retirement benefits, pension plan, profit-sharing plan, deferred-compensation plan, and /or stock option plan, free of any interest in the Petitioner. 3. Distribution of Debts. (under $15,000) There are no outstanding debts of this marriage/domestic partnership. Each of the parties is ordered to pay debts as follows: Name of Creditor What debt is for Amount (who money is owed to) Who shall pay (Petitioner or Respondent) Additional page attached, labeled "3. Debts continued." Each party is responsible for the payment of all debts incurred by the parties individually since the date of the separation (date of separation), all debts which are distributed to that party GENERAL JUDGMENT OF SUMMARY DISSOLUTION; and MONEY AWARD - Page 2 of 7 SummDisso-1A: Judgment1A-Ver03.doc (8/12) American LegalNet, Inc. www.FormsWorkFlow.com by the court, and all debts which are secured by property distributed to that party. If any creditor requires a party to pay all or a portion of a debt for which the other party is responsible by order of the court in this action, and he or she does so, the party responsible for that debt shall reimburse the paying party for any monies he/she paid to the creditor after the date this judgment was entered. The date of separation (when the parties began living apart) was: _______________________. 4. Transfer of Property and Debts. Within thirty (30) days of the date of this judgment, each party shall execute, acknowledge and deliver whatever documents are necessary to accomplish the distribution of debts and property ordered by the court. The judgment shall operate to convey title to the party awarded the property if the other party fails to comply with this requirement. 5. 6. Former Name. Petitioner's Respondent's former name of is restored. Court Costs and Fees. A. Deferred Costs and Fees. Each party shall be responsible for paying his or her own deferred court costs and service fees for this case. Any court costs and service fees (if service was completed by the Sheriff) that were deferred by the court shall be paid by: Petitioner Respondent Both parties equally Other: B. Costs and Fees Paid by the Parties. Each party shall be responsible for paying his or her own court costs and service fees for this case. To be paid by both parties equally Petitioner Respondent shall reimburse the other party for his or her court costs and service fees for this case. Other: _______________________________________________________________. Judgment is entered according to the cost and fee allocation listed above. Information Required by ORS