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Acceptance Of Service Form. This is a Oregon form and can be use in Linn Local County.
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Tags: Acceptance Of Service, 7, Oregon Local County, Linn
FORM 7
IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE COUNTY OF LINN
In the Matter of the Marriage of:
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________________________________,
Petitioner,
and
________________________________,
Respondent.
STATE OF ________________________
County of _________________________
Case No. ______________________
ACCEPTANCE OF SERVICE
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I, ____________________________________, being first duly sworn, say: I am the respondent in this matter and on
________________________ I received a true copy of the Petition and Summons , notice of continuation of health coverage, a
copy of ORS 107.089, and Confidential Information Form in the County of _____________________, State of ______________.
Cer tificate of Document Pr epar ation. 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.
_____________________________________________________________________________________________________
Signature of Respondent
Print Name
_____________________________________________________________________________________________________
Contact Address
City, State, Zip
Contact Telephone
SIGNED AND SWORN to before me this _________ day of __________________, 20_____.
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Notary Public for ____________/Court Clerk
My Commission Expires: ______________
Page 1 of 1 - ACCEPTANCE OF SERVICE
Linn County Form Disso-1BC: Form 7 Acceptance of Service.wpd (8/09)
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