Proof Of Posting Notice Of Name Change Judgement
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IN THE CIRCUIT COURT OF THE STATE OF OREGON
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FOR THE THIRD JUDICIAL DISTRICT
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In the Matter of the Change of Name of:
)
)
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__________________________________________
)
Case No: __________
(Former Name)
Petitioner
)
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)
PROOF OF POSTING
to:_________________________________________
)
NOTICE OF NAME
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(New Name)
)
CHANGE JUDGMENT
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STATE OF OREGON
)
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) ss.
County of Marion
)
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I, ___________________, being first duly sworn, do hereby declare and say: on
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______________________________, I posted written notice the judgment changing my name,
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dated ________________, on the bulletin board at the Marion County courthouse.
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_______________________________
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Petitioner (New name)
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SIGNED AND SWORN to before me on ________________________________.
__________________________________________________________
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Deputy Court Administrator/Notary Public for the State of ___________
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My commission expires: ______________________________________
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Submitted by:
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_____________________________________________________________________________
Attorney/Petitioner’s Name Bar No. (if any)
Address
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_____________________________________________________________________________
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City
State Zip
Phone No.
Trial Attorney (if other than above) Bar No.
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Certificate of Document Preparation
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If this document was not completed by an attorney, I hereby certify that the following statements
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are true: (check all boxes and complete all blanks that apply)
G
A.
I selected this document for myself, and I completed it without paid assistance.
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G
B.
I paid or will pay money to _________________ for assistance in preparing this
form/document
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_______________________________
Signature
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PROOF OF POSTING - Page 1 of 1
FC(3/1/04)(Form 6)
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