Utah Civil Cover Sheet Form

COVER SHEET FOR CIVIL FILING ACTIONS

- Page 1

Party Identification (Attach additional sheets as necessary) PLAINTIFF/PETITIONER ATTY FOR PLAINTIFF/PETITIONER Name Name Address Address

PLAINTIFF/PETITIONER Name Address

ATTY FOR PLAINTIFF/PETITIONER Name Address

DEFENDANT/RESPONDENT Name Address

ATTY FOR DEFENDANT/RESPONDENT Name Address

DEFENDANT/RESPONDENT Name Address

ATTY FOR DEFENDANT/RESPONDENT Name Address

TOTAL CLAIM FOR DAMAGES $____________________

JURY DEMAND

q Yes

q No

SCHEDULE OF FEES: §78-7-35. CHECK ANY THAT APPLY. (See Case Types for Filing Fees for Complaints other than Claim for Damages.)

---- COMPLAINT FOR DAMAGES ----$50 q Civil or Interpleader: $2000 or less $95 q Civil or Interpleader: $2001 $9999 $155 q Civil or Interpleader: $10,000 and over $155 q Civil Unspecified

---------- SMALL CLAIMS --------$45 q Small Claims: $2000 or less $70 q Small Claims: $2001-$7500 ---------- MISCELLANEOUS --------$75 q Jury Demand $2 q Vital Statistics §26-2-25 per form

Effective:05/01/07