Certificate Of Service Form printable pdf download

N THE

IRCUIT

OURT OF THE

TATE OF

REGON

FOR THE

OUNTY OF WASHINGTON

Case No: ____________________

___________________________

CERTIFICATE OF SERVICE

Plaintiff

(ORCP 7D(2))

□ (a) Personal Service

□ (b) Substitute Service

___________________________ □ (c) Office Service

Defendant

□ (d) Service by Mail

I, (name) ____________________, declare that I am a resident of the state of

___________________. I am a competent person 18 years of age or older and not a party to

or lawyer in this case. I certify that the person served is the person named below.

I served true copies of the original Complaint and Summons by (check a, b, c, or d and complete

all information):

(a) □ Personal Service on (date)_____________ , at ___________a.m./p.m., to

{□ Plaintiff □ Defendant } _______________________(name) in person at the following

address ________________________________________________ in the County of

______________________, State of _________________.

(b) □ Substitute Service on (date)_____________ , at _________ a.m./p.m., by

delivering them to the following address ______________________________________

in the County of _______________ , State of ___________. Delivered to (name)_______

____________________, who is a person age 14 or older and who lives there.

(Complete the section below only if the server also did the follow-up mailing required by ORCP

7D(2)(b). If a person other than the server did the follow-up mailing, that person must

complete a separate Certificate of Service Mailing.)

□ On (date)_____________ , I personally deposited a true copy of the same

documents served with the U.S. Postal Service, via first class mail, in a sealed envelope, postage

paid, addressed to the party to be served: □ Plaintiff □ Defendant ___________________

____________(name), at the party’s home address listed above, together with a statement of

the date, time and place that the documents were hand-delivered to the party’s dwelling

(residence).

delivering them to the office of the party to be served, located at: _____________________

__________________________(address), during normal working hours for that office,

where I left the documents with ____________________________(name), who is a

person apparently in charge, to give the documents to the party to be served.

Certificate Of Service Form