TO PETITIONER AND RESPONDENT: NOTICE OF HEARING The Court has scheduled a hearing as follows: Date: Courtroom: (To Be Completed by Court Staff Only) Time:
IN THE CIRCUIT COURT OF THE STATE OF OREGON COUNTY OF ___________________________ ) ) ) ) ) ) ) ) ) Case No. PETITIONER'S RESPONDENT'S MOTION, AFFIDAVIT, and ORDER TO SHOW CAUSE RE: MODIFYING RESTRAINING ORDER (Family Abuse Prevention Act)
Petitioner (your full name),
________________________________ Respondent (full name of person to be restrained).
MOTION I, Petitioner Respondent, request the court to issue an Order to Show Cause requiring Petitioner Respondent to appear in Circuit Court in the ___________________County Courthouse in , Oregon to show cause why this court should not grant the following relief concerning the parties' joint child/ren listed below: NAME DATE OF BIRTH AGE GENDER/SEX
1. I request the following changes be made regarding custody parenting time of the minor child/ren: __________________________________________________________________________________________ __________________________________________________________________________________________
MOTION, AFFIDAVIT, AND ORDER TO SHOW CAUSE RE: MODIFYING RESTRAINING ORDER Page 1 of 4
I request an order for a peace officer to assist in recovering the custody of the child/ren. The
most likely address(es) where the child/ren may be found is:
AFFIDAVIT STATE OF OREGON County of ) ) )
I, ____________________________________, swear/affirm that I am the Petitioner Respondent in this matter, that the above statements are true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and is subject to penalty for perjury. The following facts support this motion (please explain the reason why you are requesting the changes to custody and/or parenting time provisions listed above):
I believe the children are most likely at the addresses listed above in paragraph 2 of my motion because:
This instrument was acknowledged before me this
day of , 20 by
(Print Name of Petitioner) NOTARY PUBLIC FOR OREGON/COURT CLERK My commission expires: NOTICE READ THESE PAPERS CAREFULLY IF YOU FAIL TO APPEAR AT THE SCHEDULED HEARING, THE COURT MAY GRANT THE RELIEF REQUESTED. IF YOU HAVE ANY QUESTIONS, YOU SHOULD SEE AN ATTORNEY IMMEDIATELY.
MOTION, AFFIDAVIT, AND ORDER TO SHOW CAUSE RE: MODIFYING RESTRAINING ORDER Page 2 of 4
ORDER TO: IT IS HEREBY ORDERED: A. PERSONAL APPEARANCE You must appear in person before the court, on the date and time listed on the top left corner of the first page of this document, to show cause why an order should not be entered modifying the Restraining Order previously entered in this matter on ______________________ (date original order was issued), and granting the relief requested in the attached motion. B. WRITTEN RESPONSE You must appear by written response within thirty (30) days after this order was served on you, to show cause why an order should not be entered granting the relief requested in the attached Motion. C. MOTION DENIED , Petitioner Respondent:
__________________________________________ JUDGE (Signature) __________________________________________ Print, Type or Stamp Name of Judge
Certificate of Document Preparation You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks that apply: I selected this document for myself and I completed it without paid assistance. I paid or will pay money to for assistance in preparing this form.
Print Name, Petitioner Respondent Attorney for Petitioner or Respondent
OSB No. (if applicable)
Address or Contact Address /// ///
City, State, Zip
Telephone or Contact Telephone Number
MOTION, AFFIDAVIT, AND ORDER TO SHOW CAUSE RE: MODIFYING RESTRAINING ORDER Page 3 of 4
RELEVANT DATA PETITIONER (you)_______________________________________________ Female Male Name ***Residence/Contact Address ________________________________________________________________ Number, Street and Apt. Number (if applicable) City County State Zip Telephone/Contact Telephone Number __________________________________________________________ Birthdate____________________ Age _______ Race/Ethnicity ________________________________ Height _____________ Weight_____________ Eye Color_____________ Hair Color ______________
***If you wish to have your residential address or telephone number withheld from Respondent, use a contact address or telephone number so the Court and the Sheriff can reach you if necessary.
RESPONDENT ___________________________________________________ Female Male Name Residence Address __________________________________________________________________________ Number, Street, Apt. Number (if applicable) City County State Telephone Number Birthdate_________________ Age ______ Race/Ethnicity Height_____________ Weight_____________ Eye Color _____________ Zip
Hair Color ______________
PLEASE FILL OUT THIS INFORMATION TO AID IN SERVICE OF THE RESTRAINING ORDER Where is Respondent most likely to be located? Residence Hours _________________ Employment Hours _________________ Address: ___________________________________________ ___________________________________________________ Other Hours _________________ Address: ___________________________________________ ___________________________________________________ Description of Vehicle __________________________________________________________________________________________ Is there anything about the Respondent's character, past behavior, or the present situation that indicates that the Respondent may be a danger to others? to him/herself? EXPLAIN: _________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Does the Respondent have any weapons, or access to weapons? EXPLAIN: ___________________________ Has the Respondent ever been arrested for or convicted of a violent crime? EXPLAIN: __________________ __________________________________________________________________________________________
MOTION, AFFIDAVIT, AND ORDER TO SHOW CAUSE RE: MODIFYING RESTRAINING ORDER Page 4 of 4