Fill and Sign the Oregon Child Support 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, ) ) PETITIONER’S CERTIFICATE OF MAILING TO THE DIVISION and ) OF CHILD SUPPORT ) ________________________________, ) Respondent. ) ) I certify that on ___________________, ______, I mailed a true copy of the Petition for Custody and Parenting Time __ _ and Support in the above case to the Division of Child Support of the Oregon Department of Justice at the following address: 1495 Edgewater NW, Suite 170, Salem, Oregon 97304. DATED this _________ day of ________________________, ______. ______________________________________ Petitioner, Pro Se (signature) Petitioner’s Certificate of Mailing to the Division of Child Support 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 ______________________________________ Print name ______________________________________ Address ______________________________________ City, State, Zip Code ______________________________________ Telephone 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. __________________________________________ Petitioner’s signature Petitioner’s Certificate of Mailing to the Division of Child Support 2