Page 1 of 2 - Proof of Service of Notice of Petition to Appoint Guardian of a Minor - County ( 201) Form H IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of the Guardianship of: ) Case Number: ) ) PROOF OF SERVICE OF ) NOTICE OF PETITION TO APPOINT Minor Child(ren) ) GUARDIAN FOR A MINOR ) ORS 125.065 (Complete after Personal ) Service on Parent(s) of Minor and Minor ) (14 or older) ) ) ss. STATE OF OREGON County of ) I, , being first duly sworn, under oath, say: I am a competent person, 18 years of age or older. I am not a party in this proceeding, nor am I an attorney in this proceeding. I am not an officer, director or employee of a party in this proceeding. I am a resident of Oregon (or the state in which personal service occurred). Specifically, I reside in the County of: , State of . I served a true copy of the following documents: FORM A: Petition for Appointment of Guardian FORM F: Consent to Guardianship by FORM B: Notice to Respondent of Petition to Father Appoint Guardian FORM G: Consent to Guardianship by FORM C: Mother to Appoint Guardian of a Minor FORM I: Blank Objection to Petition to FORM D: Consent to Guardianship by Minor Appoint Guardian of a Minor FORM E: Notice to Interested Parties of FORM J: Request for Notice Petition to Appoint Guardian of a Minor by personally delivering the documents mailing the documents to the following person(s) at the address(es) listed below, on the date(s) and time(s) listed: NAME: NAME: ADDRESS: ADDRESS: Date and Time of Personal Service: Date and Time of Personal Service: Date of Service via US MAIL: Date of Service via US MAIL: American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 - Proof of Service of Notice of Petition to Appoint Guardian of a Minor - County ( 201) The original Petition had already been filed with the Court at that time. The copy served was identical to the one on file with the Court. Signature of Server (Affiant) Signed and Sworn to before me, this day of , 20 . Notary Public for /Court Clerk My Commission Expires: American LegalNet, Inc. www.FormsWorkFlow.com