Utah > Statewide > Small Claims
Counter Affidavit And Summons - Utah
| Counter 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 Defendant Attorney for the Defendant and my Utah Bar number is _______ In the Justice Court of Utah __________ Judicial District ________________ County Court Address ______________________________________________________ _____________________________________ Counter Affidavit and Summons Plaintiff Case Number ___________________ v. Judge _________________________ _____________________________________ Defendant And _____________________________________ Defendant I swear that the following is true. (1) Plaintiff owes me plus the filing 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, if qualified for prejudgment interest. Counter 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) 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 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. I have not included any non-public information in this document. Date: Sign here Printed Name. Defendant or Defendant's Agent 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. Date: Sign here Notary or Court Clerk Notary Seal Counter 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 Plaintiff: 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. The original trial date remains unchanged and is on: has been changed to: Time : a.m. p.m. Date Room Notice to the Plaintiff. 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 Certificate of Service I certify that I mailed a copy of this Counter Affidavit to the following people. Person's Name Address Date Sent Date Sign here Court Clerk Counter 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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