Affidavit For Motion To Waive Notice To Putative Father
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IN THE CIRCUIT COURT OF THE STATE OF OREGON
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FOR THE THIRD JUDICIAL DISTRICT
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In the Matter of the Change of Name of:
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__________________________________________
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Case No: __________
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__________________________________________
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AFFIDAVIT FOR
(Present Name(s) of Minor Child/ren)
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MOTION TO WAIVE
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NOTICE TO PUTATIVE
__________________________________________
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FATHER
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__________________________________________
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(Proposed Name(s) of Minor Child/ren)
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__________________________________________
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(Petitioner/Guardian Ad Litem)
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STATE OF OREGON
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) ss.
County of Marion
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I, __________________________, being first duly sworn, do hereby declare and say:
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To the best of my knowledge and belief, the father of this child is: _______________________.
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Paternity of the child has not been established because the mother was not married to the father
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at the time of conception of the child, birth of the child, or after the birth of the child; the father
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has not voluntarily acknowledged paternity by signing the birth certificate or filing an
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acknowledgment of paternity with the State Registrar of the Center for Vital Statistics; and no
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other legal proceeding has declared this person to be the father of this child.
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The child has not lived with the father at any time during the 60 days immediately before
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the filing of this petition for name change, or at any time since the child’s birth if the child was
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less than 60 days old when the petition was filed. The father has not tried to contribute to the
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child’s support in the year before the filing of the petition for this name change, or at any time
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AFFID AV IT FOR MO TION TO W AIV E NO TICE TO P UTA TIVE FAT HER - Page 1 of 2
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