IN THE __________ JUDICIAL DISTRICT COURT,
_______________________ COUNTY, STATE OF UTAH
TABLE OF CONTENTS
∗
_______________________________________
CHILD CUSTODY EVALUATION
Petitioner
Case No. ________________________
vs.
Judge ___________________________
_______________________________________
Respondent
Commissioner ____________________
APPOINTED CUSTODY EVALUATOR: _______________________________
DATE OF SETTLEMENT CONFERENCE: ______________________________
DATE REPORT PERFORMED: _______________________________________
MINOR CHILD(REN) & DATE(S) OF BIRTH: ___________________________
___________________________________________________________________
MOTHER: _________________________________________________________
FATHER: __________________________________________________________
OTHER PARTIES EVALUATED AND RELATIONSHIP TO CHILDREN:
(e.g., stepparent, parent's partner)
___________________________________________________________________
GUARDIAN ad LITEM: ______________________________________________
MOTHER'S COUNSEL: ______________________________________________
FATHER'S COUNSEL: _______________________________________________
∗
These forms and procedures have been approved by the Judicial Council, and the Supreme Court. Any custody
evaluation submitted to the court must conform in substance to these forms.
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