Petitioners Request To Dismiss Protective Order

Petitioner's Request to Dismiss Protective Order Petitioner (protected person): Case Number: ________________ District:_____ County: ________________________ State: Utah Judge: __________________________________ Commissioner: ____________________________ This is a private record. First Middle Last Respondent (person Petitioner is protected from): First Middle Last Please dismiss the: Temporary Protective Order (Ex Parte Order) issued on (date): Protective Order issued on (date): because (explain): I have not included any non-public information in this document. Date: ____________________ Petitioner's signature ____________________________________________________________________ Clerk or Notary Public fills out below: Subscribed and sworn before me on (date): ____ ________ in Clerk or Notary's Signature: ____________ County, Utah __________________________________________________________________ Clerk or Notary's Printed Name: Certificate of Mailing A copy of this Request to Dismiss Protective Order was sent to the Respondent by first class, postage prepaid mail at the following address: Respondent's Address: Street City State Zip Date: Clerk's Signature: Clerk's Name: Petitioner's Request to Dismiss Protective Order Approved Board of District Court Judges May 21, 2008 Revised April 1, 2012 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com