Certificate Of Service
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1
2My Name
Address
City, State, Zip
Phone
Email
I am the [ ] Plaintiff/Petitioner
[ ] Defendant/Respondent
[ ] Attorney for the [ ] Plaintiff/Petitioner [ ] Defendant/Respondent and my
Utah Bar number is __________
In the [ ] District Court [ ] Justice Court of Utah
__________ Judicial District ________________ County
Court Address ______________________________________________________
_____________________________________
Certificate of Service
Plaintiff/Petitioner
Case Number ___________________
v.
Judge _________________________
_____________________________________
Defendant/Respondent
Commissioner ___________________
I certify that I served a copy of ________________________________
(document name)
on the following people. I declare under criminal penalty of Utah Code Section 78B-5-
705 that this Certificate of Service is true and correct.
Served at this
Served on
Person’s Name
Method of Service
Address
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
(Other Party or Attorney)
and discretion residing there.)
Certificate of Service
Approved Board of District Court Judges May 21, 2008
Page 1 of 2
Revised April 15, 2015
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