Fill and Sign the Document Preparation Form

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF _______________ ) ) , ) Case No. Petitioner (your name), ) ) PETITIONER’S CERTIFICATE OF DOCUMENT PREPARATION and ) ) , ) Respondent (person to be restrained). ) ) You are required to truthfully complete this certificate regarding the document(s) you are filing with the court. Check or complete all blanks that apply. Certificate of Document Preparation I certify that: (check all that apply) ___ I selected the document(s) for myself. ___ I was provided the document(s) by an attorney. ___ I completed the documents without paid assistance. Petitioner’s Certificate of Document Preparation 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ___ I paid or will pay money to ____________________________ for assistance in preparing the document(s)/form(s). DATED: _________________________________________, _____. __________________________________________ Signature of Petitioner __________________________________________ Print Name __________________________________________ Address or contact address __________________________________________ City, State, Zip Code __________________________________________ Telephone Petitioner’s Certificate of Document Preparation 2