Free Certificate of Service - Oregon

CERTIFICATE OF SERVICE I certify that on the _____ day of ________________, 20____, I served the foregoing
(month)

____________________________________________________________________________
(name of document)

on the parties to this appeal, TC-MD No. _______________________, by the method indicated below, and addressed to the following:

Name of party/representative: ____________________________________________ Mailing address: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________

_____ Hand delivered _____ U.S. Mail, postage prepaid _____ Overnight Mail, fees prepaid _____ Facsimile

Signed: ___________________________________
(Plaintiff, Defendant, or Representative)

CERTIFICATE OF SERVICE

Rev. 9/07