Response To Request For Verification Of Employment Form

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My Name
Address
City, State, Zip
Phone
Email
In the [ ] District [ ] Justice Court of Utah
__________ Judicial District ________________ County
Court Address ______________________________________________________
_____________________________________
Response to Request for
Plaintiff/Petitioner
Verification of Employment
v.
Case Number ___________________
_____________________________________
Judge _________________________
Defendant/Respondent
Commissioner ___________________
Instructions to the presumed employer. You are required to respond within 10 days after receipt of the
Request for Verification of Employment.
[ ]
Yes, I currently employ the person identified in the Request as the
judgment debtor.
[ ]
No, I do not employ the person identified in the Request as the judgment
debtor.
I declare under criminal penalty of Utah Code Section 78B-5-705 that this Response to
Request for Verification of Employment is true and correct.
Date
Sign here ►
Typed or printed name
Response to Request for Verification of
Approved Board of District Court Judges October 17, 2008
Page 1 of 2
Employment
Revised April 6, 2015

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