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Small Claims Cover Sheet Form. This is a Utah form and can be use in Small Claims Statewide.
Tags: Small Claims Cover Sheet, Form A, Utah Statewide, Small Claims
JUSTICE/DISTRICT COURT OF ____________________ COUNTY/CITY
_____________ JUDICIAL DISTRICT
ADDRESS: _______________________________________________
______________________________________________, Plaintiff
VS.
_____________________________________________, Defendant
AND
_____________________________________________, Defendant
SMALL CLAIMS
COVER SHEET
(FORM A)
Case No
_____________________
Plaintiff’s Name: ______________________________________
Address: _____________________________________________
_____________________________________________________
Phone Number: _______________________________________
Driver License Number: _________________________ State: __________
Social Security Number: _________________________
Date of Birth: __________________________________
Plaintiff’s Agent’s Name: _______________________________
Address: _____________________________________________
_____________________________________________________
Phone Number: _______________________________________
Plaintiff’s Name: ______________________________________
Address: _____________________________________________
_____________________________________________________
Phone Number: _______________________________________
Driver License Number: _________________________ State: __________
Social Security Number: _________________________
Date of Birth: __________________________________
Plaintiff’s Agent’s Name: _______________________________
Address: _____________________________________________
_____________________________________________________
Phone Number: _______________________________________
Defendant’s Name: ____________________________________
Address: _____________________________________________
_____________________________________________________
Phone Number: _______________________________________
Driver License Number: _________________________ State: __________
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Social Security Number: _________________________
Date of Birth: __________________________________
Defendant’s Agent’s Name: _____________________________
Address: _____________________________________________
_____________________________________________________
Phone Number: _______________________________________
Defendant’s Name: ____________________________________
Address: _____________________________________________
_____________________________________________________
Phone Number: _______________________________________
Driver License Number: _________________________ State: _________
Social Security Number: _________________________
Date of Birth: __________________________________
Defendant’s Agent’s Name: _____________________________
Address: _____________________________________________
_____________________________________________________
Phone Number: _______________________________________
Note: A party’s or agent’s name, address and phone number are necessary. A party’s
social security number, driver license number and date of birth are not necessary, unless a
party wants to perfect a judgment lien against that party. Names and addresses are public
records. All other information is private unless a judgment is entered against that party.
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