IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF WASHINGTON In the Matter of the Name Change of Case No. _________________ _________________________________ (Minor's Present Legal Name ­ First Middle Last) to _________________________________ (Your New Name ­ First Middle Last) DECLARATION OF POSTING NOTICE OF GENERAL JUDGMENT OF NAME CHANGE (Form 12) In accordance with ORS 33.420, a written notice of the name change ordered and adjudged by this Court on _____________________, 20___, was posted by me on the Washington County Courthouse Bulletin Board, 150 North First Avenue, Hillsboro, Oregon as required by law. I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and is subject to penalty of perjury. Dated:_______________________ ____________________________________ Signature of Guardian Ad Litem Page 1 - DECLARATION OF POSTING NOTICE OF GENERAL JUDGMENT OF NAME CHANGE American LegalNet, Inc. www.FormsWorkFlow.com