IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of the Marriage of: ) ) Case No. , ) Petitioner, ) SUPPLEMENTAL JUDGMENT re TEMPORARY ) MODIFICATION OF JUDGMENT re and ) CUSTODY ) PARENTING TIME , ) CHILD SUPPORT Respondent, ) DUE TO MILITARY DEPLOYMENT ) and , ) Child who is at least 18 and under 21 years of ) age and unmarried. (ORS 107.108) ) ) Respondent. ) 1. This matter came before the Court: On the motion and declaration of Petitioner Respondent, the default of Petitioner Respondent having been found. On the motion of Petitioner Respondent, the default of Petitioner Respondent having been found, and Petitioner Respondent being represented by a guardian ad litem or another person described in Rule 27. On the motion and affidavit of Petitioner Respondent, Petitioner Respondent having filed a Waiver of Further Appearance. On the stipulations of the parties, as shown by the signatures below. At a hearing held , at which the following persons were present: (date) Petitioner Petitioner222s attorney Respondent Respondent222s attorney 2. Findings re Custody Jurisdiction. The Court considered the: Affidavit Stipulations Evidence presented and found that: (a) Child Custody Jurisdiction I. Oregon has jurisdiction under the Uniform Child Custody Jurisdiction and Enforcement Act to hear the custody parenting time issue because: Oregon is the child/ren222s home state (i.e., the child/ren have lived here continuously for the six month period immediately before this case was filed). Other reason: /// /// SUPPLEMENTAL JUDGMENT re TEMPORARY MODIFICATION OF JUDGMENT DUE TO MILITARY DEPLOYMENT 226 PAGE 1 OF 11 Modification-4D: Judgment4DVer02 (12/14) American LegalNet, Inc. www.FormsWorkFlow.com II. Oregon does not have jurisdiction under the Uniform Child Custody Jurisdiction Act because: 3. Findings re Modification Due to Deployment. The following changes to Custody Parenting Time Child Support (check all that apply) will reasonably accommodate the circumstances relating to deployment and are in the best interests of the child/ren. 4. Child/ren Who Are At Least 18 and Under 21 Years of Age. (child/ren222s name) is at least 18, 19 or 20 years of age and unmarried and has: Waived further appearance in these proceedings. Signed and stipulated to the terms of judgment evidenced by the signature below. Fully participated in the proceedings and the judgment effectively binds him/her to the terms. IT IS THEREFORE ORDERED that: The Judgment(s) signed on (date(s)) is temporarily modified during Petitioner222s Respondent222s military deployment as follows: 1. Custody. (a) Petitioner Respondent is awarded sole custody of the child/ren (list names): (Name/s and year/s of birth) (b) The parties have agreed to joint custody of the following child/ren (list names): (Name/s and year/s of birth) (c) Other: 2. Parenting Time. Petitioner Respondent shall have parenting time with the child/ren as follows (fill in both sections): (a) Parenting time while deployed and not on leave: (b) Parenting time while deployed but on leave: as follows: (c) as set forth in the attached Parenting Plan, labeled Exhibit . /// /// /// SUPPLEMENTAL JUDGMENT re TEMPORARY MODIFICATION OF JUDGMENT DUE TO MILITARY DEPLOYMENT 226 PAGE 2 OF 11 Modification-4D: Judgment4DVer02 (12/14) American LegalNet, Inc. www.FormsWorkFlow.com 3. Notice re Change of Address and Phone. The Petitioner Respondent (nondeployed parent) shall provide the court and the deployed parent with written notice 30 days before a change of address or phone number during the period of deployment. 4. Cash Child Support. The cash child support order currently in effect is terminated and no cash child support shall be ordered during Petitioner222s Respondent222s deployment. The current cash support order paid by Petitioner Respondent in the amount of $ shall change as follows (complete (a) and (b) below): or No child support order currently exists but child support will be ordered as follows (complete (a) and (b) below): (a) Cash child support shall be paid by Petitioner to Respondent or Respondent to Petitioner: In the amount of $ for children. This is the amount presumed correct under the Oregon child support guidelines. or In the amount of $ for children. The amount presumed correct under the Oregon child support guidelines, $, would be unjust or inappropriate for the following reasons: . (The reasons must also be shown on the support worksheets you attach to this judgment.) The child support worksheet on which the support amount was calculated is labeled 223Exhibit224 and attached to and incorporated in this judgment. (b) Petitioner Respondent shall pay cash child support beginning on: The first (or ) day of the month following the date of the judgment and continuing on the same day of each month thereafter. or , the date Petitioner Respondent was served with the motion or any later date, and continuing on the same day of each month thereafter (check this option only if requested in the motion or agreed to by the parties). 5. Medical Support. The medical support order (including any cash medical support) currently in effect is terminated and no medical support shall be ordered during Petitioner222s Respondent222s deployment. The current medical support order, including cash medical support paid by Petitioner Respondent, shall change as follows (complete (a) or (b), and (c) or (d) below): or No medical support order, including cash medical support, currently exists but medical support shall be provided as follows (complete (a) or (b), and (c) or (d) below): Complete (a) or (b): (a) Private Health Care Coverage is Appropriate and Available. Petitioner Respondent Both Petitioner and Respondent has/have appropriate private (or military) health care coverage available for the parties222 child/ren through an employer, spouse, domestic partner or other source. Petitioner Respondent Both Petitioner and Respondent is/are ordered to obtain and/or maintain this coverage throughout the period of the support obligation for the benefit of the SUPPLEMENTAL JUDGMENT re TEMPORARY MODIFICATION OF JUDGMENT DUE TO MILITARY DEPLOYMENT 226 PAGE 3 OF 11 Modification-4D: Judgment4DVer02 (12/14) American LegalNet, Inc. www.FormsWorkFlow.com parties222 child/ren. (b) No Private Health Care Coverage is Appropriate or Available. Neither Petitioner nor Respondent has appropriate private health care coverage available for the parties222 child/ren. Petitioner Respondent Both Petitioner and Respondent must provide appropriate private health care coverage for the child/ren when such coverage becomes available to them at a reasonable cost through any source. The custodial parent shall enroll or maintain the child/ren in public health care coverage. Complete (c) or (d): (c) Cash Medical Support Ordered. Because the parent receiving cash child support is ordered to maintain private (or military) health care coverage and the parent paying cash child support is not ordered to maintain private health insurance, in addition to cash child support Petitioner Respondent must pay $ for cash medical support to Petitioner Respondent, or Because neither parent has appropriate private health care coverage available for the parties222 child/ren: Petitioner must pay cash medical support in the monthly amount of $ to Respondent and/or Respondent must pay cash medical support in the monthly amount of $ to Petitioner. (d) Cash Medical Support Not Ordered. Cash medical support is not ordered for the following reasons: The parent paying cash child support is also providing health care coverage. Section (e) below requires the parties to share the cost of the child/ren222s uninsured medical expenses. Petitioner222s Respondent222s gross monthly income is at or below the Oregon minimum wage for full-time employment. Other reason: (e) Responsibility for Uninsured Health Expenses. After the custodial parent pays the first $250 per year per child, Petitioner must pay % and Respondent must pay % of the reasonably incurred uninsured health, accidental, dental, orthodontic, and optical costs incurred by the child/ren, including costs for prescriptions. This o