Acceptance of Service Page 1 of 1 (Aug 2019) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF Case No: Plaintiff /Petitioner v. ACCEPTANCE OF SERVICE Defendant /Respondent I am the Plaintiff/Petitioner Defendant/Respondent in this matter. On (date) I received a true copy of (check all that apply): Petition Summons Claim Information on mediation Complaint Other: And for Domestic Relations cases: Notice of Statutory Restraining Order Preventing Dissipation of Assets Notice of CIF (Confidential Information Form) Filing Information on continuation of insurance coverage (COBRA) Order to Show Cause re: Modification with Motion and Declaration Statement of Assets and Liabilities Uniform Support Declaration Other forms: I hereby declare that the above statements are true to the best of my knowledge and belief. I understand they are made for use in court and I am subject to penalty for perjury. Date Signature Name (printed) Address City/State/Zip Telephone American LegalNet, Inc. www.FormsWorkFlow.com