Acceptance Of Service (4A)
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Acceptance Of Service (4A) Form. This is a Oregon form and can be use in Circuit Court Statewide.
Tags: Acceptance Of Service (4A), Oregon Statewide, Circuit Court
IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE COUNTY OF
In the Matter of □ the Marriage of:
ACCEPTANCE OF SERVICE
, being first duly sworn, say: I am the □ Petitioner □ Respondent
in this matter and on
I received a true copy of the Motion, Affidavit and Order re:
Modification of Judgment Re: Custody and/or Parenting Time and/or Child Support, Notice of CIF Filing,
□ and a Notice About a Written Response to a Motion to Modify, □ with attached notices on mediation and
provided by the court clerk in the County of
Certificate of Document Preparation. You are required to truthfully complete this certificate
regarding the document you are filing with the court. Check all boxes and complete all blanks that apply:
□ I selected this document for myself and I completed it without paid assistance.
for assistance in preparing this form.
□ I paid or will pay money to
Signature of □ Petitioner □ Respondent
Address or Contact Address
Telephone or Contact Telephone
City, State, Zip
SIGNED AND SWORN to before me this
Notary Public for
My Commission Expires:
ACCEPTANCE OF SERVICE - PAGE 1 OF 1
Modification-4A: AccSrv4AVer03.doc (9/10)
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