Acceptance Of Service (With Children)
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Acceptance Of Service (With Children) Form. This is a Oregon form and can be use in Linn Local County.
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Tags: Acceptance Of Service (With Children), 9, Oregon Local County, Linn
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 _________________________
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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 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_____.
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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 9 Acceptance of Service.wpd (12/28/01)
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