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Affidavit Of Service Form. This is a Oregon form and can be use in Circuit Court Statewide.
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Tags: Affidavit Of Service, Oregon Statewide, Circuit Court
IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE COUNTY OF
In the Matter of the □ Marriage of:
)
)
)
)
)
)
)
)
________________________________,
Petitioner,
and
________________________________,
Respondent.
Case No.
AFFIDAVIT OF SERVICE
□ Personal Service (ORCP 7D(2)(a))
□ Substitute Service (ORCP 7D(2)(b))
□ Office Service (ORCP 7D(2)(c))
□ Service by Mail, Return Receipt Requested
(ORCP 7D(2)(d))
I,
, declare I am a resident of the County of
, State of
. I am a competent person 18 years of
age or older and not a party to or attorney in this proceeding. I certify that the person, firm, or corporation served is the
identical one named in this action.
(Check one of the following):
1. □ Personal Service. On the _______day of _____________________, 20____, at __________ a.m./p.m.,
I served true copies of the original Petition and Summons (with attached Notice of Voluntary Dismissal Without
Prejudice) by delivering them to □ Petitioner □ Respondent _________________________ (name) in person at the
following address within the County of _______________________, State of ________________.
2. □ Substitute Service. On the
day of
, 20____, at
a.m./p.m., I
served true copies of the original Petition and Summons (with attached Notice of Voluntary Dismissal Without
Prejudice) by delivering them to
(name), who is a person age 14 or older and
a member of the household of the party to be served, at the following address :
within the County of
, State of ________________. (Complete the section
below only if the undersigned performed the followup mailing required by ORCP 7D(2)(b). If a party or other person
other than the undersigned did the follow up mailing, s/he must use a separate Affidavit/Certificate of Mailing.)
□ On the
day of
, 20
, I personally deposited a true copy of
the Petition and Summons (with attached Notice of Voluntary Dismissal Without Prejudice) with the United States
Postal Service, via first class mail, in a sealed envelope, postage prepaid, addressed to the party to be served:
□ Petitioner □ Respondent
(name), at the party’s home address listed above, together with
a statement of the date, time and place that the documents were hand-delivered to the party’s dwelling (residence).
AFFIDAVIT OF SERVICE - Page 1 of 2
Dismissal-18: AffidavitSrv18Ver03 (3/08)
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3. □ Office Service.
On the
day of
, 20____, at
a.m./p.m., I served true copies of the original Petition and Summons (with attached Notice of Voluntary Dismissal
Without Prejudice) by delivering them, in person, to the office of the party to be served, located at:
(address), during normal working hours for that office,
where I left the documents with
(name), who is a person apparently in
charge and who has a business duty to provide the documents to the party to be served.
(Complete the section below only if the undersigned performed the followup mailing required by ORCP 7D(2)(c). If a
party or other person other than the undersigned did the follow up mailing, s/he must use a separate Affidavit/Certificate
of Mailing.)
□ On the
day of
, 20
, I personally deposited a true copy of
the Petition and Summons (with attached Notice of Voluntary Dismissal Without Prejudice) with the United States
Postal Service, via first class mail, in a sealed envelope, postage prepaid, addressed to the party to be served:
□ Petitioner □ Respondent
(name), at the party’s: □ home address located at:
(address), OR □ business address, listed
above, together with a statement of the date, time and place that the documents were hand-delivered to the party’s office.
4. □ Service by Mail, Return Receipt Requested. On the
20
day of
,
, I personally deposited two true copies of the Petition and Summons (with attached Notice of Voluntary
Dismissal Without Prejudice) with the United States Postal Service, one via first class mail, and the other sent certified
or registered, return receipt requested, or express mail, with postage on both copies fully paid, addressed to the party to
be served: □ Petitioner □ Respondent
(name), at the party’s: □ home
address located at:
(address).
(NOTE: If mailed return receipt requested, the return receipt should be attached to this Affidavit of Service.)
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.
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 for perjury.
Dated this _______ day of ______________________, 20 _____.
Signature of Server
Address or Contact Address
AFFIDAVIT OF SERVICE - Page 2 of 2
Dismissal-18: AffidavitSrv18Ver03.doc (3/08)
Print Name
City, State, Zip
Telephone or Contact Telephone
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