Counter Affidavit And Summons (Small Claims) Form

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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
_____________________________________
(Small Claims)
Plaintiff
v.
_______________________________
Case Number
_____________________________________
Defendant
_______________________________
Judge
And
_____________________________________
Defendant
I swear that the following is true.
(1) Plaintiff owes me
$
for the claim described in paragraph (2).
plus the filing fee of
$
plus estimated
(Attach statute or contract showing you
attorney fees of
are authorized to claim attorney fees.)
for a total of:
$
plus prejudgment, if qualified for prejudgment interest.
Counter Affidavit and Summons (Small Claims)
Approved Board of Justice Court Judges September 22, 2010
Page 1 of 4
Revisions Approved by Supreme Court July 18, 2016

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