Name Address City, State, Zip Phone Email I am the [ ] Plaintiff [ ] Attorney for the Plaintiff and my Utah Bar number is _______ In the Justice Court of Utah __________ Judicial District ________________ County Court Address ______________________________________________________ _____________________________________ Interpleader Affidavit and Summons Plaintiff _______________________________ v. Defendant Case Number _____________________________________ _______________________________ Judge And _____________________________________ Defendant I swear that the following is true. (1) I am holding $________________ because Interpleader Affidavit and Summons Approved Board of Justice Court Judges September 22, 2010 Revision Approved by Supreme Court July 18, 2016 Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com (2) (3) Defendants each say or may say that they each should have the money. [] [] Defendants reside within the jurisdiction of the court. The events happened within the jurisdiction of the court. Plaintiff has paid the money into court. Plaintiff will pay the money as directed by the court. I am filing this affidavit in the First District Court for Cache County because the defendant resides in unincorporated Cache County or in a municipality within Cache County that does not have a justice court and the cause of action arose in unincorporated Cache County or in a municipality within Cache County that does not have a justice court. (4) [] [] (5) [] I understand that I have the right to file this case in the district court where I could ask for a jury trial. By deciding to file this case in the justice court, I waive my right to a jury trial. I have not included any non-public information in this document. Date: Sign here Printed Name. Plaintiff or Plaintiff's Agent I certify that __________________________, who is known to me or who presented satisfactory identification, has, while in my presence and while under oath or affirmation, voluntarily signed this document and declared that it is true. Date: Sign here Notary or Court Clerk Notary Seal Interpleader Affidavit and Summons Approved Board of Justice Court Judges September 22, 2010 Revision Approved by Supreme Court July 18, 2016 Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Summons The State of Utah to the Defendants: You are summoned to appear at trial to answer the above claim. The trial will be held at the court address shown above. If you fail to appear, judgment may be entered against you for the total amount claimed. Se le cita a comparecer a juicio para responder al reclamo arriba descrito. El juicio tendrá lugar en la dirección del tribunal que se muestra arriba. Si usted no comparece, se podría dictar un fallo contra usted por el total de la cantidad reclamada. Date (Fecha) Room (Sala) Time (Hora) Judge (Juez) Notice to the Defendant A small claims case has been filed against you. This imposes upon you certain rights and responsibilities. You can find small claims information and instructions at https://www.utcourts.gov/howto/smallclaims/. The court's Finding Legal Help web page (www.utcourts.gov/howto/legalassist/) provides information about the ways you can get legal help, including the Self-Help Center, reduced-fee attorneys, limited legal help and free legal clinics. Un caso de reclamos menores ha sido presentado contra usted. Esto le impone a usted ciertos derechos y obligaciones. Usted puede encontrar información e instrucciones sobre reclamos menores en https://www.utcourts.gov/howto/smallclaims/. La página del tribunal sobre Como Encontrar Ayuda Legal (www.utcourts.gov/howto/legalassist/) proporciona información acerca de las maneras en que usted puede obtener ayuda legal, incluyendo el Centro de Ayuda del tribunal, abogados a precio reducido, ayuda legal limitada y talleres jurídicos gratuitos. Attendance. You must attend. If you do not attend, the relief requested might be granted. You have the right to be represented by a lawyer. Asistencia. Presentarse es obligatorio. Si usted no llegara a presentarse, el remedio solicitado podría ser otorgado. Usted tiene el derecho de que lo represente : [ ] a.m. [ ] p.m. Interpleader Affidavit and Summons Approved Board of Justice Court Judges September 22, 2010 Revision Approved by Supreme Court July 18, 2016 Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com un abogado. Evidence. Bring with you any evidence that you want the court to consider. Pruebas. Traiga con usted cualquier prueba que quiera que el tribunal tome en cuenta. Interpretation. If you do not speak or understand English, contact court staff at least 3 days before the hearing, and an interpreter will be provided. Interpretación. Si usted no habla ni entiende el Inglés contacte al personal del tribunal por lo menos 3 días antes de la audiencia y le proveerán un intérprete. Disability Accommodation. If you have a disability requiring accommodation, including an ASL interpreter, contact court staff at least 3 days before the hearing. Atención en caso de incapacidades. Si usted tiene una incapacidad por la cual requiere atención especial, favor de contactar al personal del tribunal por lo menos 3 días antes de la audiencia. Right to Jury Trial. If you want to have a jury trial in this case, you must file documents to remove the case to district court. See the Small Claims web page for information about that process, and forms: https://www.utcourts.gov/howto/smallclaims/. El derecho a juicio por jurado. Si usted quiere tener un juicio con jurado, usted deberá presentar documentos pidiendo que el caso sea transferido al tribunal de distrito. Vea la página de internet de Reclamos Menores para más información sobre el proceso y formularios: https://www.utcourts.gov/howto/smallclaims/. Date: Sign here Court Clerk Interpleader Affidavit and Summons Approved Board of Justice Court Judges September 22, 2010 Revision Approved by Supreme Court July 18, 2016 Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com