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Affidavit Of Service (Petition And Summons) (1BC) Form. This is a Oregon form and can be use in Circuit Court Statewide.
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Tags: Affidavit Of Service (Petition And Summons) (1BC), 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 Statutory Restraining
Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on
mediation and other information provided by the court clerk) by delivering them to □ Petitioner
□ Respondent
(name) in person at the following address
within the County of
,
State of
.
, 20____, at
a.m./p.m., I
2. □ Substitute Service. On the day of
served true copies of the original Petition and Summons (with attached Notice of Statutory Restraining
Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on
mediation and other information provided by the court clerk) 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 Statutory Restraining Order Preventing Dissipation of
Assets in Domestic Relations Actions, Notice of CIF Filing, notices on mediation and other information
provided by the court clerk) 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
Disso-1BC: AffServ1BCVer10.doc (9/10)
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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 Statutory Restraining
Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing, notices on
mediation and other information provided by the court clerk) 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 Statutory Restraining Order Preventing Dissipation of
Assets in Domestic Relations Actions, Notice of CIF Filing, notices on mediation and other information
provided by the court clerk) 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.
day of
, 20
,
4. □ Service by Mail, Return Receipt Requested. On the
I personally deposited two true copies of the Petition and Summons (with attached Notice of Statutory
Restraining Order Preventing Dissipation of Assets in Domestic Relations Actions, Notice of CIF Filing,
notices on mediation and other information provided by the court clerk) with the United States Postal Service,
one via first class mail, and the other by certified or registered, return receipt requested, or by express mail, with
postage on both copies fully paid, addressed to the party to be served: □ Petitioner or □ 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
Signature of Server
Address or Contact Address
, 20
.
Print Name
City, State, Zip
Telephone or Contact Telephone
AFFIDAVIT OF SERVICE - PAGE 2 OF 2
Disso-1BC: AffServ1BCVer10.doc (9/10)
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