Petitioners Certificate Of Mailing To The Division Of Child Support (4A)

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of the Marriage of: , Petitioner, and , Respondent. ) ) ) ) ) ) ) ) Case No. PETITIONER'S CERTIFICATE OF MAILING TO THE DIVISION OF CHILD SUPPORT I certify that on , 20 , I mailed a true copy of the Ex Parte Motion for Order to Show Cause re: Modification of Judgment in the above case to the local branch office of the Department of Justice, Division of Child Support (list address): 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 . Petitioner, Signature Print Name Address or Contact Address City, State, Zip Code Telephone or Contact Telephone PETITIONER'S CERTIFICATE OF MAILING TO THE DIVISION OF CHILD SUPPORT - PAGE 1 OF 1 Modification-4A: CertMail4AVer01.doc (1/08) American LegalNet, Inc. www.FormsWorkFlow.com