UNITED STATES BANKRUPTCY COURT DISTRICT OF OREGON In re ) ) ) ) ) ) ) ) ) ) ) ) ) CERTIFICATE OF SERVICE OF SUMMONS Case No. __________________ Debtor(s) Plaintiff(s) v. Adv. Proc. No. ______________ Defendant(s) I, __________________________________________________________________________ (name) of _______________________________________________________________________________ (mailing address) certify under penalty of perjury: That I am, and at all times hereinafter mentioned was, more than 18 years of age; That on __________, I served a copy of the within summons, together with the complaint filed in this proceeding, on: the defendant in this proceeding, by (describe here the mode of service): on the said defendant at: Executed on __________ (date) 305 (12/1/10) ___________________________________ (signature) American LegalNet, Inc. www.FormsWorkFlow.com