Free Form #14M - 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 posted written notice of this petition to change the 18 child/ren's name(s) on the bulletin board at the Marion County courthouse. The notice remained 19 posted until ___________________________. 20 21 22 23 24 25 26 27 28
PROOF OF POS TIN G NO T IC E OF PE TIT ION FO R CH A NG E O F N A M E - Page 1 of 2 FC (3/1/04) (Form 14M)

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 POSTING 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: _________________________________

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Submitted by: ______________________________________ Attorney/Petitioner's Name Bar No. ______________________________________ Address ______________________________________ City State Zip Phone No. ______________________________________ Trial Attorney if other than above Bar No. Certificate of Document Preparation

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PROOF OF POS TIN G NO T IC E OF PE TIT ION FO R CH A NG E O F N A M E - Page 2 of 2 FC (3/1/04) (Form 14M)

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