Fill and Sign the Oregon Acceptance Service 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 ______________ In the Matter of: ) ) ________________________________, ) Case No. Petitioner, ) ) ACCEPTANCE OF SERVICE and ) ) ________________________________, ) Respondent. ) ) STATE OF ________________________ ) ) ss. County of _________________________ ) I, ____________________________________, being first duly sworn, say: I am the respondent in this matter and on ________________________ I received true copies of the Petition and Summons (with attached Notices on COPE, mediation and other information Acceptance of Service 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 provided by the court clerk) in the County of _______________________, State of _____________________. ______________________________________ Signature ______________________________________ Print name ______________________________________ Address ______________________________________ City, State, Zip Code ______________________________________ Telephone SUBSCRIBED AND SWORN to before me this ___________ day of ______________, ______, by __________________________________________. ___________________________________ Notary Public for ____________/Court Clerk My Commission Expires: ______________ Acceptance of Service 2 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 Certificate of Document Preparation I certify that: (check all that apply) ___ 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. ____________________________________________ Signature Acceptance of Service 3