Form 9 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN In the Matter of the Marriage of: ________________________________, Petitioner, and ________________________________, Respondent. STATE OF ________________________ County of _________________________ ) ) ) ) ) ) ) ) ) ) ss. ) Case No. ______________________ ACCEPTANCE OF SERVICE 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 parent training packet in the County of _____________________, State of ____________________. 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. Submitted by: ________________________________________________ __________________________________________ Signature of Respondent Print Name ___________________________________________________________________________________________ Address or Contact Address City, State, Zip Telephone or Contact Telephone SIGNED AND SWORN to before me this _________ day of __________________, 20_____. . ___________________________________ Notary Public for ____________/Court Clerk My Commission Expires: ______________ American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 1 - ACCEPTANCE OF SERVICE Linn County Form Disso-1BC: Form 9 Acceptance of Service.wpd (12/28/01) American LegalNet, Inc. www.FormsWorkflow.com