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Affidavit Of Proof Of Service Form. This is a Oregon form and can be use in Lincoln Local County.
Tags: Affidavit Of Proof Of Service, 4, Oregon Local County, Lincoln
FORM 4 1 2 3 4 5 IN THE CIRCUIT COURT OF THE STATE OF OREGON 6 FOR THE CO UNT Y OF LINCOLN 7 In the Matter of the Marriage of 8 , 9 Petitioner, 10 and 11 , 12 Res pon den t. 13 STATE OF OREGON 14 Coun ty of ) ) ) ) ) ) ) ) ) ) ) NO . AFFIDAVIT OF PROOF OF SERVICE ) ) ss. ) 15 16 I, , swe ar/affirm und er oa th that: (print name) 17 18 19 I am a resident of the State of Oregon or of the state of service. I am a com petent person 18 years of age or older. I am not an attorney fo r or a party to this c ase , or an office r, director or e m ployee of an y party to this cas e. 20 21 On the day of 22 , 20 , I served the Sum m ons, Petition, Notice of (month) (year) Continuance of Health Coverage, Certificate of Residency, Notice of Statutory Restraining Order Prevention Dissipation 23 of Assets, and a copy of ORS 107.089 24 respondent in ______________________________ County, State of _____________________. 25 /// 26 /// 27 /// Yes No in this case personally upon the above named AFFIDAVIT OF PROOF OF SERVICE - Page 1 of 2 S.D.4(12/03) American LegalNet, Inc. www.USCourtForms.com 1 by delivering to th e re spondent a copy of those papers, e ach of which was certifie d to be a true copy of ea ch orig inal. 2 3 Signature of Process Server Address Print or Type Name of Process Server City 4 Sta te Zip 5 Telephone or Contact Telephone Number(s) 6 7 8 SUBSCR IBED AND SW ORN TO before me this day of (month) , 20 , by (year) 9 10 (Print Nam e of Proces s Server) NOTARY PUBLIC FOR OREGON / COURT CLERK My C om m ission exp ires: 11 12 13 14 15 17 18 19 20 Subm itted by: 22 Print Name Petitioner Attorney for Petitioner OSB No. 23 Address or Contact Address 24 City 25 Telephone or Contact Telephone Number(s) 21 26 Zip /// 27 State /// AFFIDAVIT OF PROOF OF SERVICE - Page 2 of 2 S.D.4(12/03) American LegalNet, Inc. www.USCourtForms.com