Form 4 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN In the Matter of the Marriage of: ___________________________________, Petitioner, and ___________________________________, Respondent. ) ) ) ) ) ) ) ) Case No. ______________________ RESPONDENT'S CERTIFICATE OF MAILING I certify that on ____________________, 20______, I placed a true copy of the Response and (Must list all documents) __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ in the above case in the United States mail to Petitioner Attorney's address / Petitioner's home address (ONLY IF NO ATTORNEY): __________________________________________________________________________________________________________ Address City State Zip in a sealed envelope with postage paid. 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. DATED this _____ day of _______________________, 20_____. Submitted by: ________________________________________ Signature of Respondent ________________________________________ Print name ________________________________________ Contact Address ________________________________________ City, State, Zip Code Page 1 of 1, RESPONDENT'S CERTIFICATE OF MAILING Linn County Form 4 Respondent Certificate of Mailing.doc(8/09) American LegalNet, Inc. www.FormsWorkFlow.com