Free DECLARATION OF PROOF OF SERVICE - Oregon

IN THE CIRCUIT COURT OF THE STATE OF OREGON COUNTY OF _________________ ) ) ) Case No. ) ) ) DECLARATION OF PROOF OF SERVICE ) (Family Abuse Prevention Act) ) ) ) )

Petitioner (your full name), v.

________________________________ Respondent (full name of person to be restrained).

I, (name)

, declare that I am a resident of the County of , State of . I am a competent person 18 years of age or older, and not an attorney for, or a party to, this proceeding. I certify that the person served is the identical one named in this action. On the day of (month) , 20 (year), I served the following: MOTION, AFFIDAVIT AND ORDER TO SHOW CAUSE RE: MODIFYING RESTRAINING ORDER (FAPA) in this case personally upon the above-named Petitioner Respondent at the following address: in County, State of , by delivering to the Petitioner Respondent a copy of those papers, all of which were certified to be a true copy of the original. I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and is subject to penalty for perjury. 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 and I completed it without paid assistance. I paid or will pay money to for assistance in preparing this form. Dated this day of , 20 .

Signature of Process Server Print or Type Name of Process Server

Address City Telephone Number(s) State Zip

DECLARATION OF PROOF OF SERVICE (FAPA) - Page 1 of 1
(FAPA 6/08)