Free Form #7M - Oregon

1 2 3 4 5 6 7 8 9 10 __________________________________________ 11 12 13 14 STATE OF OREGON 15 County of Marion 16 I, _________________________, being first duly sworn, do hereby declare and say: on 17 ______________________________, I mailed written notice of the petition and a copy of the 18 petition to change the child/ren's name(s) to______________________________, who is the 19 _______________________(relationship) of the child/ren. The return receipt from the post 20 office and the notice that I mailed are attached. 21 22 23 24 25 26 27 28
PRO OF O F M AILIN G N OTIC E OF PETIT ION FOR CH AN GE O F NA ME - Page 1 of 2 FC(3/1/04)(Form 7M)

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE THIRD JUDICIAL DISTRICT

In the Matter of the Change of Name of: __________________________________________ __________________________________________ (Present Name(s) of Minor Child/ren)

__________________________________________ (Proposed Name(s) of Minor Child/ren) __________________________________________ (Petitioner/Guardian Ad Litem) ) ) ss. )

) ) ) ) ) ) ) ) ) ) ) ) ) )

Case No: __________ PROOF OF MAILING NOTICE OF PETITION FOR CHANGE OF NAME

_______________________________ Petitioner SIGNED AND SWORN to before me on _______________________________. ______________________________________________________ Deputy Court Administrator/Notary Public for the State of_______ My commission expires:__________________________________

1 Submitted by: 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
PRO OF O F M AILIN G N OTIC E OF PETIT ION FOR CH AN GE O F NA ME - Page 2 of 2 FC(3/1/04)(Form 7M)

______________________________________ Attorney/Petitioner's Name Bar No. (if any) ______________________________________ Address ______________________________________ City State Zip Phone No. ______________________________________ Trial Attorney if other than above Bar No. Certificate of Document Preparation If this document was not completed by an attorney, I hereby certify that the following statements are true: (check all boxes and complete all blanks that apply) A. G I selected this document for myself, and I completed it without paid assistance. B. G I paid or will pay money to _________________ for assistance in preparing this form/document __________________________ Signature