City, State, Zip
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
I swear that the following is true.
(1) Plaintiff owes me
for the claim described in paragraph (2).
plus the filing fee of
(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