Free Form 5 Waiver of Personal Service - Oregon

Form 5 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN IN THE MATTER OF THE MARRIAGE OF SEPARATION OF CUSTODY PROCEEDING ________________________________________ PETITIONER, AND _________________________________________ RESPONDENT. ) ) ) ) ) ) ) ) ) ) ) )

Case No.

WAIVER OF PERSONAL SERVICE

In order to maintain the confidentiality of my residential address, I hereby waive my right to personal service if I am subsequently charged with contempt. I am giving the following contact address for service of process and select the following method of substituted service: (Check ONE box only.)

Mailing address, Business address, Specified agent:
________________________________________________ ________________________________________________ ________________________________________________ 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_____

Submitted by: ____________________________________________________________________________________ Petitioner, Respondent, Signature Print Name SIGNED AND SWORN to before me this _________ day of ______________, 20_____, _________________________________ Notary Public for ____________/Court Clerk My Commission Expires: ______________
Page 1 of 1, WAIVER OF PERSONAL SERVICE
Linn Co unty Fo rm 6 D -Z. M iscF orm s: Form 5 Waiver of Personal Service.wpd (2/22/02)