IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR JACKSON COUNTY SMALL CLAIMS DEPARTMENT Plaintiff Case Number: vs. PROOF OF SERVICE BY CERTIFIED MAIL Defendant I, , certify that I made service of the Notice of Name , by certified mail. Claim upon the defendant, The "return receipt" card showing the signature of the defendant and the date signed is attached. ________________________________ Date SmClaims Proof Service Certified Mail ________________________________ Plaintiff's Signature Page 1 of 1 2/22/08 American LegalNet, Inc. www.FormsWorkFlow.com