Fill and Sign the Oregon Acceptance Service 497323969 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 the Marriage of: ) ) , ) Case No. _ Petitioner, ) ) ACCEPTANCE OF SERVICE and ) ) , ) Respondent. ) ) STATE OF _ ) ) ss. County of _ _ ) I, ____________________________________, being first duly sworn, say: I am the  petitioner  respondent in this matter and on ________________________ I received true copies of the Order to Show Cause re: Modification, Motion for Order to Show Cause, supporting Affidavit and the Notice about a Written Response to a Motion to Modify Filed in Marion County Circuit Court (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 ______________________. ______________________________________  Petitioner,  Respondent, Pro Se 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