Extreme Risk Protection Order 226 Certificate of Service Page 1 of 1 (Aug 2019) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of: Case No: CERTIFICATE OF Respondent SERVICE Extreme Risk Protection Order I, (name) , declare that I am a resident of the state of . I am a competent person 18 years of age or older. I am not a party to or lawyer in this case, and not the employee of a party. I certify that on (date) at (time) (am/pm), I served the Respondent in person by delivering the following documents to (address or location of service) I served true copies of the original Extreme Risk Protection Order with the Notice to Respondent/ Request for Hearing Other (name all forms or documents served) I hereby declare that the above statements are true to the best of my knowledge and belief. I understand they are made for use as evidence in court and I am subject to penalty for perjury. Date Signature of Server Print Name If person serving is NOT a sheriff or sheriff222s deputy, address and phone number of server: American LegalNet, Inc. www.FormsWorkFlow.com