Notice of Default Judgment (Small Claims Cases) Approved Board of District Court Judges September 10, 200 Revised M ay 1, 2019 Page 1 of 2 Name Address City, State, Zip Phone Email I am [ ] Plaintiff/Petitioner [ ] Defendant/Respondent [ ] Plaintiff/Petitioner [ ] Defendant/Respondent (Utah Bar #: ) In the Justice C ourt of Uta h Judicial District County Court Address Plaintiff/Petitioner v. Defendant/Respondent Notice of Default Judgment (Small Claims Cases) Case Number Judge PLEASE TAKE NOTICE: A default judgment has been entered against the [ ] Plaintiff [ ] Defendant in this case because of your failure to appear at the trial. A copy of the judgment is enclosed. You may ask to set aside this judgment by filing a Motion to Set Aside with this court within 15 days after the date the judgment was entered. You may appeal this judgment by filing a Notice of Appeal with this court within 28 days after the date the judgment was entered. I declare under criminal penalty under the law of Utah that everything stated in this document is true . Signed at (cit y, and state or country). Sign atu Date Printed Name American LegalNet, Inc. www.FormsWorkFlow.com Notice of Default Judgment (Small Claims Cases) Approved Board of District Court Judges September 10, 200 Revised M ay 1, 2019 Page 2 of 2 Certificate of Service I certify that I filed with the court and am serv ing a copy of this Notice of Default Judgment (Small Claims Cases) on the following people. Service Method S ervice Address S ervice Date [ ] Mai l [ ] Hand Delivery [ ] E - filed [ ] 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.) [ ] M ail [ ] Hand Delivery [ ] E - filed [ ] 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 [ ] E - filed [ ] 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.) Sig n atu Date Printed Name American LegalNet, Inc. www.FormsWorkFlow.com