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 __________________________________________ ) ) 9 __________________________________________ ) Case No: __________ (Present Name(s) of Minor Child/ren) ) 10 ) PROOF OF MAILING __________________________________________ ) NOTICE OF PETITION11 ) FOR CHANGE OF NAME __________________________________________ ) 12 (Proposed Name(s) of Minor Child/ren) ) ) 13 __________________________________________ ) (Petitioner/Guardian Ad Litem) ) 14 STATE OF OREGON ) 15 ) ss. County of Marion ) 16 I, _________________________, being first duly sworn, do hereby declare and say: on17 ______________________________, I mailed written notice of the petition and a copy of the18 petition to change the child/rens name(s) to______________________________, who is the19 _______________________(relationship) of the child/ren. The return receipt from the post20 office and the notice that I mailed are attached. 21 _______________________________22 Petitioner 23 SIGNED AND SWORN to before me on _______________________________. 24 ______________________________________________________25 Deputy Court Administrator/Notary Public for the State of_______ My commission expires:__________________________________ 26 27 28 PROOF OF M AILIN G NOTIC E OF PETITION FOR CHAN GE OF NA ME - Page 1 of 2 FC(3/1/04)(Form 7M )>>>> 2 1 Submitted by: 2 ______________________________________ 3 Attorney/Petitioners Name Bar No. (if any) 4 ______________________________________ Address 5 ______________________________________ 6 City State Zip Phone No. 7 ______________________________________ Trial Attorney if other than above Bar No. 8 9 Certificate of Document Preparation10 If this document was not completed by an attorney, I hereby certify that the following statements are true: (check all boxes and complete all blanks that apply)11 A. G I selected this document for myself, and I completed it without paid assistance. B. G I paid or will pay money to _________________ for assistance in preparing this12 form/document 13 __________________________ Signature14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 PROOF OF M AILIN G NOTIC E OF PETITION FOR CHAN GE OF NA ME - Page 2 of 2 FC(3/1/04)(Form 7M )