Small Claims Proof Of Service Under Urcp4 By Mail - Salt Lake City Justice Court Page 2

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Certificate of Service
I certify that I served a copy of this Small Claims Proof of Service Under URCP4(Service By Mail) on the following people.
Business or Person’s Name
Method of Service
Served at this Address
Served on this Date
Mail
Hand Delivery
Fax (Person agreed to service by fax.)
Email (Person agreed to service by email.)
Left at business (With person in charge or in
receptacle for deliveries.)
Left at home (With person of suitable age &
discretion residing there.)
Mail
Hand Delivery
Salt Lake City Justice
333 S 200 E
Electronic File
Court (Clerk of Court)
SLC UT 84111
Mail
Hand Delivery
Fax (Person agreed to service by fax.)
Email (Person agreed to service by email.)
Left at business (With person in charge or in
receptacle for deliveries.)
Left at home (With person of suitable age and
discretion residing there.)
Mail
Hand Delivery
Fax (Person agreed to service by fax.)
Email (Person agreed to service by email.)
Left at business (With person in charge or in
receptacle for deliveries.)
Left at home (With person of suitable age and
discretion residing there.)
I declare under criminal penalty of Utah Code Section 78B-5-705 that this Certificate of Service is true and correct.
Sign here ►
Date
Typed or printed name
Disability Accommodations. If you need accommodation of a disability, contact a judicial service assistant at least 3
days before the hearing.

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