Free Certificate of Service by Mail - Oregon

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN ) ) ) ) ) ) ) ) ) CASE NO:__________________________ CERTIFICATE OF SERVICE BY MAIL [Elderly Persons and Persons with Disabilities Abuse Prevention Act]

_____________________________________
Petitioner (your name) Guardian Petitioner,
vs. _____________________________________ Respondent (person to be restrained)

I, _________________________________________________________________, certify that: (name) 1. I am the Petitioner the Guardian Petitioner an authorized agent for the Petitioner. the attorney for the Petitioner/Guardian Petitioner. 2. On the __________ day of ____________________, 20 , I caused certified true copies of the Restraining Order to Prevent Abuse, the Petition for Restraining Order to Prevent Abuse, and the Notice to Respondent/Request for Hearing in this case to be served upon the above-named respondent by mailing said documents in a sealed envelope with the postage prepaid by first class mail and by certified mail, return receipt requested, to the respondent at the following address: ________________________________________ (Name of Respondent) ________________________________________ (Address of Respondent) ________________________________________ ________________________________________ 3. The above-listed address is the address to which the Petitioner, or the elderly/disabled person on whose behalf the petition was filed, would have sent any payment for the goods or services promoted in the sweepstakes promotions described in the original Petition for Restraining Order to Prevent Abuse. __________________________________________ Signature of Process Server __________________________________________ (Address) __________________________________________ Telephone Number(s) _______________________ ___________________ Address _____________________

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