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Declaration Of Service / Declaration Of Service Mailing Form - The Circuit Court Of The State Of Oregon For Clackamas County

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR CLACKAMAS COUNTY

Small Claims Department

________________________________________

CASE NO.___________________

Plaintiff(s),

DECLARATION OF SERVICE

DECLARATION OF SERVICE MAILING

________________________________________

Defendant(s).

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

Oregon,

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):

Substitute Service

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

form.

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.

_____

Date

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

Declaration Of Service / Declaration Of Service Mailing Form - The Circuit Court Of The State Of Oregon For Clackamas County