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appendix-page-27 — Appendix or form source excerpt — physical PDF page 27

Crook, Jefferson County Supplementary Local Rules (2026) · physical PDF page 27 · 2026

Page 27 of 29 
Reissued: February 1, 2026  
22nd Judicial District 
Crook/Jefferson Counties 
  
  
Appendix 3 
SLR 16.005 - Trial by Declaration Packet 
 
In the Circuit Court of the State of Oregon 
for the County of  Crook  Jefferson 
   
State of Oregon  Case No:  
           v.   
  DEFENDANT’S DECLARATION  
  
Defendant  (Trial by Declaration) 
 
I waive my right to appear personally at trial and submit my evidence by this Declaration to 
the court. I understand that I will be notified by mail of the court’s decision.  
             
             
             
             
             
             
             
 Additional page attached 
 
 
I hereby declare that the above statement is 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. 
 
 
              
Date      (signature) 
 
             
      Print Name 
 
              
Contact Address     City, State, Zip   Contact Phone

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Captured 2026-10-18T22:30:41.802948+00:00 · 2026 SLR publisher source, retrieved 2026-10-18; later amendments and case orders require separate verification

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