Affidavit Re UCCJEA Information

Page 1 -- AFFIDAVIT re UCCJEA INFORMATION WHEN PRIOR ORDER EXISTSIN THE CIRCUIT COURT OF THE STATE OF OREGONFOR THE COUNTY OF MULTNOMAHFamily Law DepartmentIn the Matter of, 224 Petitioner 224 Co-Petitioner and, 224 Respondent 224 Co-Petitioner ))))))))))Case No. AFFIDAVIT re UCCJEA INFORMATION WHENPRIOR ORDER EXISTSSTATE OF OREGON)) ss.County of )Being first sworn, I state that I am ,the 224 Petitioner 224 Respondent 224 Co-Petitioner in this matter. The following statements are true to the bestof my knowledge:I am the 224 Mother 224 Father of the children named below who are the subject of this proceeding. Born: Born: Born: Born: Born: LAST ORDER224 A.LAST ORDER WAS FROM OREGON: 1.224Since that order was entered, the child/ren have continuously lived in Oregon.2.224Although the child/ren have not resided continuously in Oregon since the last order wasentered, they have lived in Oregon for at least the six months before the modificationrequest was filed. 3.224Since that order was entered, the child/ren have moved from Oregon to the state orcountry of , but a parent hascontinued to reside in Oregon. The parent who has remained an Oregon resident is(which parent) .4.224Other reason why Oregon should decide this modification matter:.224 B.LAST ORDER WAS FROM STATE of .(List County: & Case # ):1.224Since that order was entered, both parents and the child/ren have moved from the statethat issued the order. Neither parent nor the child/ren now reside in the state that issuedthe last custody or parenting time order.2.224Other reason why Oregon should decide this modification matter: American LegalNet, Inc. www.FormsWorkFlow.com Page 2 -- AFFIDAVIT re UCCJEA INFORMATION WHEN PRIOR ORDER EXISTS . LOCATION OF CHILDREN LAST FIVE YEARSDATESTo/FromWhich ChildrenLived in WhichCounty & Statewith What Parentor CaretakerCurrent Address ofthat Parent/CaretakerI 224 have 224 have not participated in any litigation (court cases) concerning the custody,visitation, parenting time, guardianship, or placement of the child/ren in this or any other state in the last fiveyears. I have participated in the following litigation: Name of CourtStateCase NumberDateResultI do not know of any other abuse prevention, custody, visitation, parenting time, guardianship, orplacement proceedings involving the child/ren (or any other agency proceeding or court case which could affectthis case) CURRENTLY PENDING in this or any other state 224 except for :(identify agency or court, case number, date filed, and type of proceeding or ruling)I do not know any person (other than the other parent) who has physical custody of the child/ren or whoclaims to have custody, visitation, or parenting time rights 224 except for : (list name and address of any such persons)Father(signature)Mother (signature) NameNameStreetStreetCity/State/ZipPhoneCity/State/ZipPhoneSUBSCRIBED AND SWORN TO BEFORE ME BY this day of ,2007.Notary Public/Clerk of the Court American LegalNet, Inc. www.FormsWorkFlow.com