NOTICE OF CHANGE OF ADDRESS Page 1 of 1 Linn County 226 10/2018 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN Case No. , Petitioner, NOTICE OF CHANGE OF ADDRESS and PURSUANT TO ORS 107.159 , Respondent I, Petitioner Respondent give notice of change of address. ALL NOTICES AND DOCUMENTS REGARDING THIS CASE SHOULD BE SENT TO THE NEW CONTACT ADDRESS AS OF (Effective Date) , UNLESS OTHERWISE ORDERED BY THE COURT. Former Contact Address: Street: City: State and Zip Code: Telephone Number: NEW Contact Address: Street: City: State and Zip Code: Telephone Number: In compliance with ORS 107.159, I give notice of my intent to move to a residence more than 60 miles further distant from the other parent of my child/ren as of (month/day/year) Certificate of Mailing I certify that on (date): I placed a true and complete copy of this Notice of Change of Address in the United States mail to Petitioner Respondent at (address): 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: Petitioner Respondent (signature) Print Name Contact Address City, State, Zip Contact Phone American LegalNet, Inc. www.FormsWorkFlow.com