Acceptance Of Service (Petition And Summons) (1A)
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Acceptance Of Service (Petition And Summons) (1A) Form. This is a Oregon form and can be use in Circuit Court Statewide.
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Tags: Acceptance Of Service (Petition And Summons) (1A), Oregon Statewide, Circuit Court
IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE COUNTY OF ____________________
In the Matter of the Marriage of:
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________________________________,
Petitioner,
and
________________________________,
Respondent.
STATE OF ________________________
County of ________________________
Case No. ______________________
ACCEPTANCE OF SERVICE
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I, ____________________________________, being first duly sworn, say: I am the Respondent in this
matter and on ________________________ I received a true copy of the Petition, Summons (with attached
notices of statutory restraining order preventing dissipation of assets, continuation of health coverage, mediation
and other information provided by the court clerk: _____________________________________________) in
the County of _____________________, State 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.
I paid or will pay money to _________________________ for assistance in preparing this form.
____________________________________________ _____________________________________________
Signature of Respondent
Print Name
__________________________________________________________________________________________
Address or Contact Address
City, State, Zip
Telephone or Contact Telephone
SIGNED AND SWORN to before me this _________ day of __________________, 20_____,
by _________________________________________________.
___________________________________
Notary Public for ____________/Court Clerk
My Commission Expires: ______________
ACCEPTANCE OF SERVICE - Page 1 of 1
SummDisso-1A: AccServ1AVer01 (1/08)
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