IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR CLACKAMAS COUNTY
Small Claims Department
DECLARATION OF SERVICE
DECLARATION OF SERVICE MAILING
I, __________________________________, I declare that
I am a competent person over the
age of 18 years and not a party to the case, I am employed in, or am a resident of,
the state of
the state where service took place, which is __________________________.
I am the plaintiff and am serving by substitute service as set forth in ORCP 7D(2)(b)(d).
I served the party by (please check one):
I served a true copy of the Claim and Notice of Claim, Notice to Defendant and Defendant's
Response at the dwelling house or usual place of abode at:
(Address/City/State/Zip where service was made)
with _____________________________________________. Furthermore, I mailed to the (Write
in the name of the person who received papers)
defendant, by first class mail, a true copy of the above noted documents, together with a statement
of the date, time and place where substitute service occurred.
Certificate of Service Mailing
On ____________________________, I mailed the above noted documents, by certified ,
registered or express mail, return receipt requested. The original Return Receipt is attached to this
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.
Signature of Person who served papers
Print/Type Name of Person who served papers
Address/City/State/ZIP/Phone of person who served papers
Declaration of Service/ Declaration of Service Mailing