Certificate Of Mailing To DCS (9A)
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Certificate Of Mailing To DCS (9A) Form. This is a Oregon form and can be use in Circuit Court Statewide.
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Tags: Certificate Of Mailing To DCS (9A), Oregon Statewide, Circuit Court
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FORM 6
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IN THE CIRCUIT COURT OF THE STATE OF OREGON
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FOR THE COUNTY OF LANE
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In the Matter of the Marriage of:
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______________________________,
Co-Petitioner,
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and
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______________________________,
Co-Petitioner.
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Case No. ______________________
CERTIFICATE OF MAILING
TO DCS
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I certify that on ____________________, ______, I mailed a true copy of the Petition for Dissolution
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of Marriage in the above case to the Division of Child Support Services of the Oregon Department of
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Justice at 2885 Chad Drive, Eugene, Oregon 97408.
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DATED this _____ day of _______________________, ______.
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_____________________________________
(Signature)
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_____________________________________
(Print name)
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_____________________________________
(Address)
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_____________________________________
(City, State, Zip Code)
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____________________________________________
(Telephone)
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Certificate of Document Preparation
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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:
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I selected this document for myself
I was provided this document by an attorney.
I completed this document without paid assistance.
I paid or will pay money to ______________________ for assistance in preparing this
document/form.
___________________________________
(Signature)
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CERTIFICATE OF MAILING - PAGE 1
C:\Local Documents\Forms\Family Abuse\Family Forms\9A\Certificate of mailing to DCS.wpd
Revised 1/04
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