The form of the notice of lien required by ORS § 147.287 shall be substantially as follows:

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Terms Used In Oregon Statutes 147.289

  • City: includes any incorporated village or town. See Oregon Statutes 174.100
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Oath: A promise to tell the truth.
  • Person: includes individuals, corporations, associations, firms, partnerships, limited liability companies and joint stock companies. See Oregon Statutes 174.100
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.

______________________________________________________________________________

Notice is given by this form that the Department of Justice has provided assistance to ____________, a person who was injured on or about the ___ day of ______ in the city of ______ and State of ______, and the Department of Justice asserts a lien to the extent provided in ORS § 147.285 for the amount of the assistance upon any amount due and owing ________ (name of injured person) under a judgment, settlement or compromise from ______ alleged to have caused such injuries and from any other person or entity liable for the injury or obligated to compensate the injured person on account of such injuries.

 

Department of Justice

 

by ____________,

Attorney General or designee.

 

I, ____________, being first duly sworn on oath say: That I am the Attorney General or designee; that I have read the foregoing notice of lien and know the contents of the notice of lien and believe the contents to be true.

Subscribed and sworn to before me this ___ day of ______, ______.

______________________________________________________________________________ [2005 c.383 § 6]

 

[Amended by 1961 c.389 § 1; renumbered 133.857]