My Name Address City, State, Zip Phone E-mail I am the Plaintiff Attorney for the Plaintiff and my Utah Bar number is _________ In the District Justice Court of Utah
__________ Judicial District ________________ County Court Address ______________________________________________________ _____________________________________ Certificate of Service of Affidavit and Plaintiff Summons v. Case Number ___________________ _____________________________________ Defendant Judge _________________________ And _____________________________________
Defendant
I certify that I served a copy of the Affidavit and Summons on the following defendants by mail or commercial courier service that requires the defendant to sign a receipt and provides for return of that receipt to me. The original document acknowledging receipt is attached. Name Address Method
Mail Commercial Courier Mail Commercial Courier I have not included any non-public information in 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
Date of Receipt
Certificate of Service of Affidavit and Summons
Approved Board of District Court Judges September 10, 2008
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