Fill and Sign the Oregon Child Support 497323965 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: ) ) , ) Petitioner, ) Case No. ) and ) PETITIONER’S CERTIFICATE OF MAILING TO THE DIVISION ) OF CHILD SUPPORT , ) Respondent. ) I certify that on ____________________, ______, I mailed a true copy of the Petition for Dissolution of Marriage in the above case to the Division of Child Support of the Oregon Department of Justice at 1495 Edgewater NW, Salem, Oregon 97304. DATED this _____ day of _______________________, ______. _____________________________________ (Signature) _____________________________________ (Print name) 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 _____________________________________ (Address) _____________________________________ (City, State, Zip Code) _____________________________________ (Telephone) Certificate of Document Preparation You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks 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/form. ___________________________________ (Signature) Petitioner’s Certificate of Mailing to the Division of Child Support 2