1 2 3 4 IN THE CIRC UIT COURT OF THE STATE OF OREGON 5 FOR THE THIRD JUDICIAL DISTRICT 6 7 In the Matter of the Change of Name of: ) ) 8 *__________________________________________ ) Case No: *_____________ ) 9 ___________________________________________ ) ORDER ALLOWING (Present Name(s) of Minor Child/ren) ) ALTERNATIVE FORM10 ) OF SERVICE *__________________________________________ ) 11 ) ___________________________________________ ) 12 (Proposed Name(s) of Minor Child/ren) ) ) 13 *__________________________________________ ) (Petitioner/Guardian Ad Litem) ) 14 15 Based on the motion of petitioner and the supporting affidavit, 16 IT IS HEREBY ORDERED THAT: service of notice of the petition for name change on17 *_____________________________ may be made as follows: 18 G By publication in a newspaper of general circulation in ____________ County in the19 State of ______________ at least four times in successive calendar weeks; and by mailing20 regular and certified mail to the last known address of the other parent, which is:21 ___________________________________________________________________________ 22 _________________________________________________________________________; or 23 24 25 26 27 ORDER ALLOWING ALTERN ATIVE FORM OF SERVICE - Page 1 of 2 FC(3/1/04)(Form 13M)28 >>>> 2 1 2 G By posting on the bulletin board at the Marion County Courthouse for not less than 14 3 days; or 4 G As follows: __________________________________________________________ 5 ____________________________________________________________________________ 6 7 Dated:_________________ _______________________________ Circuit Court Judge 8 _______________________________ 9 Print, Type or Stamp Name10 11 Submitted by: * 12 ______________________________________ Attorney/Petitioners Name Bar No. (if any) 13 * _____________________________________ 14 Address * 15 ______________________________________ City State Zip Phone No. 16 * ______________________________________ 17 Trial Attorney if other than above Bar No. 18 19 *Certificate of Document Preparation20 If this document was not completed by an attorney, I hereby certify that the following statements21 are true: (check all boxes and complete all blanks that apply) A. G I selected this document for myself, and I completed it without paid assistance.22 B. G I paid or will pay money to _________________ for assistance in preparing this form/document 23 * __________________________24 Signature25 26 27 ORDER ALLOWING ALTERN ATIVE FORM OF SERVICE - Page 2 of 2 FC(3/1/04)(Form 13M)28