IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF_________________________ In the Matter of the Marriage of: ________________________________, Petitioner, and ________________________________, Respondent. ) ) ) ) ) ) ) ) ) Case No. ______________________ DECLARATION OF SERVICE Personal Service (ORCP 7D(2)(a)) Substitute Service (ORCP 7D(2)(b)) Office Service (ORCP 7D(2)(c)) Service by Mail, Return Receipt Requested (ORCP 7D(2)(d)) I,___________________________________________, declare I am a resident of the County of_________________, State of_______________. I am a competent person 18 years of age or older and not a party to or attorney in this proceeding. I certify that the person, firm, or corporation served is the identical one named in this action. (Check one of the following): 1. Personal Service. On the _______day of _____________________, 20____, at __________ a.m./p.m., I served true copies of the original Petition and Summons (with attached Notice of Statutory Restraining Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on mediation and other information provided by the court clerk) by delivering them to Petitioner Respondent ______________________________________(name) in person at the following address ___________________________ within the County of _______________________, State of . 2. Substitute Service. On the________day of________________, 20____, at___________a.m./p.m., I served true copies of the original Petition and Summons (with attached Notice of Statutory Restraining Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on mediation and other information provided by the court clerk) by delivering them to ____________(name), who is a person age 14 or older and a member of the household of the party to be served, at the following address______________________________________within the County of __________________, State of . (Complete the section below only if the undersigned performed the follow up mailing required by ORCP 7D(2)(b). If a party or other person other than the undersigned did the follow up mailing, s/he must use a separate Affidavit/Certificate of Mailing.) On the__________day of__________________, 20______, I personally deposited a true copy of the Petition and Summons (with attached Notice of Statutory Restraining Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on mediation and other information provided by the court clerk) with the United States Postal Service, via first class mail, in a sealed envelope, postage prepaid, addressed to the party to be served: Petitioner Respondent ____________ (name), at the party’s home address listed above, together with a statement of the date, time, and place that the documents were hand-delivered to the party’s dwelling (residence). DECLARATION OF SERVICE - Page 1 of 2 SummDisso-1A: AffServ1SVer02.doc (9/10) American LegalNet, Inc. www.FormsWorkFlow.com 3. Office Service. On the _________day of______________, 20____, at_____________ a.m./p.m., I served true copies of the original Petition and Summons (with attached Notice of Statutory Restraining Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on mediation and other information provided by the court clerk) by delivering them, in person, to the office of the party to be served, located at: _________________________________________(address), during normal working hours for that office, where I left the documents with_______________________________ (name), who is a person apparently in charge and who has a business duty to provide the documents to the party to be served. (Complete the section below only if the undersigned performed the follow-up mailing required by ORCP 7D(2)(c). If a party or other person other than the undersigned did the follow up mailing, s/he must use a separate Affidavit/Certificate of Mailing.) On the ________day of______________________, 20_____, I personally deposited a true copy of the Petition and Summons (with attached Notice of Statutory Restraining Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on mediation and other information provided by the court clerk) with the United States Postal Service, via first class mail, in a sealed envelope, postage prepaid, addressed to the party to be served: Petitioner Respondent ____________ (name), at the party’s: home address located at: ___________________(address), OR business address, listed above, together with a statement of the date, time and place that the documents were hand-delivered to the party’s office. 4. Service by Mail, Return Receipt Requested. On the _______ day of_____________, 20_____, I personally deposited two true copies of the Petition and Summons (with attached Notice of Statutory Restraining Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on mediation and other information provided by the court clerk) with the United States Postal Service, one via first class mail, and the other by certified or registered, return receipt requested, or by express mail, with postage on both copies fully paid, addressed to the party to be served: Petitioner or Respondent __________________________(name), at the party’s: home address located at: ____________________________(address). (NOTE: If mailed return receipt requested, the return receipt should be attached to this Affidavit of Service.) Certificate of Document Preparation. You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks that apply: I selected this document for myself and I completed it without paid assistance. I paid or will pay money to ____________________________ for assistance in preparing this form. 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. Dated this _______ day of ______________________, 20 _____. Signature of Server Address or Contact Address DECLARATION OF SERVICE - Page 2 of 2 SummDisso-1A: AffServ1SVer02.doc (9/10) Print Name City, State, Zip Telephone or Contact Telephone American LegalNet, Inc. www.FormsWorkFlow.com