Notice Of Appeal From Justice Court Page 2

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I declare under penalty of Utah Code Section 78B-5-705 that everything stated in this document is true.
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Date
Typed or Printed Name
Certificate of Service
I certify that on ____________________
a copy of this Notice of Appeal from
(date)
Justice Court was served on all parties listed here by the method indicated below:
Mailed
Hand-
Emailed
Name
Mailing or Email Address
delivered
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
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Date
Typed or Printed Name
Notice of Appeal from Justice Court
Revised October 4, 2016
Page 2 of 2

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