Certificate of Mailing To Division Of Child Support
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Certificate of Mailing To Division Of Child Support Form. This is a Oregon form and can be use in Circuit Court Statewide.
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Tags: Certificate of Mailing To Division Of Child Support, 4A, 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.
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Case No. ______________________
CERTIFICATE OF
MAILING TO THE DIVISION
OF CHILD SUPPORT
I certify that on __________________, 20______, I mailed a true copy of the Ex Parte Motion for Order to
Show Cause re: Modification of Judgment in the above case to the local branch office of the Department of Justice,
Division of Child Support (list address):____________________________________________________________
____________________________________________________________________________________________.
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.
DATED this _____ day of _______________________, 20_____.
________________________________________
‘ Petitioner, ‘ Respondent, Signature
________________________________________
Print Name
________________________________________
Address or Contact Address
________________________________________
City, State, Zip Code
________________________________________
Telephone or Contact Telephone
Page 1 of 1, CERTIFICATE OF MAILING TO THE DIVISION OF CHILD SUPPORT
Modification-4A: CertMail4AVer01.wpd (12/03)
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