Small Claims Counter Affidavit And Summons
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Small Claims Counter Affidavit And Summons Form. This is a Utah form and can be use in Small Claims Statewide.
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Tags: Small Claims Counter Affidavit And Summons, Form E, Utah Statewide, Small Claims
JUSTICE/DISTRICT COURT OF ____________________ COUNTY/CITY
_____________ JUDICIAL DISTRICT
ADDRESS: _______________________________________________
______________________________________________, Plaintiff
Name
______________________________________________________
Street Address
______________________________________________________
City, State, Zip
SMALL CLAIMS
COUNTER AFFIDAVIT
AND SUMMONS
(FORM E)
VS.
____________________________________________, Defendant
Name
______________________________________________________
Street Address
______________________________________________________
City, State, Zip
Case No.
_____________________
AND
____________________________________________, Defendant
Name
______________________________________________________
Street Address
______________________________________________________
City, State, Zip
COUNTER AFFIDAVIT
I swear that the following is true:
(1)
Plaintiff owes me
$
plus the court filing fee of
plus an estimated service fee of
for a total of:
for the claim described in
paragraph (2).
$
$
$
plus prejudgment interest to the date of judgment, if qualified for prejudgment interest.
(2)
This claim arose on _____________________ for:
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Defendant’s or Agent’s Signature
Subscribed and sworn to before me on ________________________.
Clerk’s or Notary’s Signature
SUMMONS
THE STATE OF UTAH TO THE PLAINTIFF: You are summoned to appear at a trial to answer
the above claim.
[ ] The original trial date remains unchanged.
[ ] The original trial date has been changed to:
Date of trial
Time of trial
If you fail to appear, judgment may be entered against you for the amount listed above.
I certify that I mailed a copy of this counter affidavit to plaintiff at the address on file with the
court.
Date
Clerk’s Signature
ADA NOTICE: If you need special accommodations (including communication aids and
services) during this proceeding should call (name)__________________ at (phone)_________,
at least three days before the proceeding.
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