Page 1 of 1 --- Proof of Personal Service (12/2015) Form G IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF MULTNOMAH Probate Department In the Matter of the Guardianship of Case No. PROOF OF PERSO NAL SERVICE A Minor Of Notice of Petition to Appoint Guardian , Of Minor A Minor. (ORS 125.065) I, , declare I am a resident of the County of , State of . I am a competent person 18 years of age or older and not a party to this case or an attorney in this case. I certify that the person(s) served is/are the identical one(s) that I have named below. I served true copies of the following documents: I) and J). Mother (Name ) At the following address in County:: Street City/State/ZIP On (date) at a.m./p.m.( time ) . Father (Name ) At the following ad dress in County:: Street City/State/ZIP On (date) at a.m./p.m.( time ) . Child (Name ) At the f Street City/State/ZIP On (date) at a.m./p.m.( time ) . I hereby declare that the above statements are true to the best of my knowledge and belief. I understand that they are made for use as evidence in court and are subject to penalty for perjury. Signature Street: Print Name: City/State/Zip: Phone Number: American LegalNet, Inc. www.FormsWorkFlow.com