Free Proof of Service under URCP 4 - Utah

My Name Address City, State, Zip Phone E-mail

In the District Court of Utah __________ Judicial District ________________ County Court Address ______________________________________________________ _____________________________________ Proof of Service under URCP 4
Plaintiff/Petitioner

Case Number ___________________ v. Judge _________________________ _____________________________________
Defendant/Respondent

Commissioner ___________________

Instructions: Use this document to show the date, place, and manner in which documents were
served under Rule of Civil Procedure 4. Rule 4 requires service by mail OR by personal service (not both). Complete Paragraph (1). Then complete either Paragraph (2) OR Paragraphs (3) and (4).

(1)

The following documents were served by the method described below: Summons Complaint or Petition Amended Complaint or Petition Notice of Mandatory Divorce Education Order to Show Cause Other: ______________________________________________ (describe) Other: ______________________________________________ (describe)

Proof of Service

Approved Board of District Court Judges April 17, 2009

Page 1 of 4

Service by Mail (Note: Service by mail requires a signed receipt. The state and its departments and
agencies cannot be served by mail until after they are parties to the case. A minor or an incapacitated person cannot be served by mail.)

(2)

I served the following person by sending a copy of the documents listed in Paragraph (1) by registered mail or commercial courier service to: Name of Addressee Address City, State Zip Code I have attached a signed receipt proving delivery. It was signed by: the addressee personally. someone authorized by appointment or by law to receive service of process on behalf of the addressee.

Service by Third Person (Note: Certain people and entities must be served in a certain way. This
form includes only the most common ways. Consult URCP 4(d) for others.)

(3) (4)

I am over the age of 18. I am not a party to this action. I am not an attorney for a party to this action. On ______________________ (date), I went to _____________________________________________________ (address), and I delivered the documents listed in Paragraph (1) to _____________________________________________________(name), who is:

(check only one box)

the named party defendant/respondent. the named party plaintiff/petitioner. a person of suitable age and discretion residing at that address, which is the named party's dwelling house. an agent authorized by appointment or by law to receive service of process on behalf of the named party.

Serving defendantrespondent by delivery Serving plaintiffpetitioner by delivery Serving an individual by leaving at his/her home Serving an individual by delivery to an agent

Proof of Service

Approved Board of District Court Judges April 17, 2009

Page 2 of 4

an officer, a managing agent, general agent. OR an agent authorized by appointment or by law to receive service of process and by also mailing a copy of the complaint and summons to the named party. the city/town recorder. the county clerk. the attorney general, AND TO _________________________________________________ (name of any other person or agency required by statute to be served) at _________________________________________________ (address). a member of named party's governing board, executive employee or secretary. Describe how you served the document.

Serving a corporation, partnership, or an unincorporated association

Serving a city or town Serving a county Serving the state

Serving a department or agency of the state Other. See URCP 4.

I have not included any non-public information from this document. I declare under penalty of Utah Code Section 78B-5-705 that everything stated in this document is true and correct. Date Sign here Typed or printed name

Proof of Service

Approved Board of District Court Judges April 17, 2009

Page 3 of 4

Certificate of Service
I certify that I served a copy of this Proof of Service under URCP 4 on the following people. Served at this Person's Name Method of Service Address 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.)

Served on this Date

(Other Party or Attorney)

Left at home (With person of suitable age
and discretion residing there.)

(Clerk of Court)

Mail Hand Delivery Electronic File 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
and discretion residing there.)

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
and discretion residing there.)

Date

Sign here Typed or printed name

Proof of Service

Approved Board of District Court Judges April 17, 2009

Page 4 of 4