Utah > Statewide > Small Claims
Affidavit And Summons - Utah
| Affidavit And Summons Form. This is a Utah form and can be used in Small Claims Statewide . |
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My Name Address City, State, Zip Phone Email I am the Plaintiff Attorney for the Plaintiff and my Utah Bar number is _______ In the Justice Court of Utah __________ Judicial District ________________ County Court Address ______________________________________________________ _____________________________________ Affidavit and Summons Plaintiff v. Defendant Case Number ___________________ _____________________________________ Judge _________________________ And _____________________________________ Defendant I swear that the following is true. (1) Defendant owes me plus the filing fee of plus an estimated service fee of plus estimated attorney fees of for a total of: $ $ $ $ $ (Attach statute or contract showing you are authorized to claim attorney fees.) for the claim described in paragraph (2). plus prejudgment interest, if qualified for prejudgment interest. Affidavit and Summons Approved Board of Justice Court Judges September 22, 2010 Revised October 2011 Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com (2) The events happened on _________________________ (date). My claim is based on the following facts. (3) (4) (5) (6) Defendant resides within the jurisdiction of the court. The events happened within the jurisdiction of the court. I am not suing a government entity. I am not suing a government employee for the employee's on-the-job conduct. I am not suing on a claim that has been assigned to me. I am filing this affidavit in the First District Court for Cache County because the defendant resides in unincorporated Cache County or in a municipality within Cache County that does not have a justice court and the cause of action arose in unincorporated Cache County or in a municipality within Cache County that does not have a justice court. I understand that I may be barred from later bringing any claims arising out of the event or transaction if the claims are not described in this affidavit. (7) I have not included any non-public information in this document. Sign here Date Typed or Printed Name I certify that __________________________, who is known to me or who presented satisfactory identification, has, while in my presence and while under oath or affirmation, voluntarily signed this document and declared that it is true. Sign here Date Typed or printed name (Court Clerk or Notary Public) Notary Seal Affidavit and Summons Approved Board of Justice Court Judges September 22, 2010 Revised October 2011 Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Summons The State of Utah to the Defendant(s): Defendant Name and Address Defendant Name and Address You are summoned to appear at trial to answer the above claim. The trial will be held at the court address shown above. If you fail to appear, judgment may be entered against you for the total amount claimed. Date Room Notice to the Defendant. A small claims case has been filed against you. This imposes upon you certain rights and responsibilities. You may obtain small claims information and instructions at www.utcourts.gov/howto/ Disability Accommodations. If you need accommodation of a disability, contact a judicial service assistant at least 3 days before the hearing. Date: Sign here Court Clerk Time : a.m. p.m. Affidavit and Summons Approved Board of Justice Court Judges September 22, 2010 Revised October 2011 Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com
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