
Introduction
I, [YOUR NAME], being duly sworn, depose and state as follows:
Statements
On [SERVICE DATE], at approximately [SERVICE TIME], I, as a process server authorized to serve legal documents in the State of Oregon, served the following documents:
Summons for Divorce Proceedings
Petition for Dissolution of Marriage
The person(s) served with the aforementioned documents is/are:
Name of Individual(s): [DEFENDANT'S NAME]
Relationship to the Case: Defendant
Address of Service: [DEFENDANT'S ADDRESS]
The method of service employed was:
Personal Service
I approached [DEFENDANT'S NAME] at their residence at the aforementioned address and handed them the documents personally.
The individual(s) served was/were identified as follows:
[DEFENDANT'S NAME] confirmed their identity by presenting their state-issued driver's license, which matched the name and address on the documents.
I declare under penalty of perjury under the laws of the State of Oregon that the foregoing is true and correct.
Executed on this day of [DATE].
Signature

[YOUR NAME]
Sworn and subscribed before me on this [DATE].

[NOTARY PUBLIC'S NAME]
Notary Public
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