IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE COUNTY OF __________________
In the Matter of the □ Marriage of:
)
)
___________________________________,
)
Petitioner,
)
Case No. ______________________
and
)
RESPONDENT’S CERTIFICATE
)
OF MAILING
___________________________________,
)
Respondent.
)
I certify that on ____________________, 20______, I placed a true copy of the Response in the above
case in the United States mail addressed to Petitioner at (petitioner’s address)
, in a sealed envelope with postage
paid.
Certificate of Document Preparation. You are required to truthfully complete this certificate
regarding the document you are filing with the court. Check all boxes and complete all blanks that apply:
□ I selected this document for myself and I completed it without paid assistance.
□ I paid or will pay money to _______________________ for assistance in preparing this form.
DATED this _____ day of _______________________, 20_____.
Signature of Respondent
Print Name
Address or Contact Address
City, State, Zip Code
Telephone or Contact Telephone
RESPONDENT’S CERTIFICATE OF MAILING - Page 1 of 1
Disso-1E: CertMail1EVer01.doc (3/08)