State of Utah – General Civil Case Cover Sheet

(Utah District & Justice Courts)

[// GUIDANCE: This template tracks the Utah State Courts’ most recent “Civil Cover Sheet” requirements (Approved Board of District Court Judges 08/17) and Rule 26(c), Utah R. Civ. P. Tailor all bracketed items before filing. Verify the current form version, filing fees, and any local‐court supplements immediately prior to use.*]

I. COURT INFORMATION

1. Judicial Department: ☐ District Court  ☐ Justice Court
2. Judicial District: [FOURTH / ETC.] Judicial District
3. County: [UTAH / SALT LAKE / ETC.] County
4. Assigned Judge/Commissioner (if known): _______
5. Clerk’s Case No.: (To be completed by Clerk) _____

II. CASE INFORMATION

1. Type of Filing: ☐ Complaint ☐ Petition ☐ Appeal ☐ Other: ______
2. Tier Designation (Rule 26(c))
   ☐ Tier 1  (≤ $50,000)  ☐ Tier 2 ($50,001 – $300,000)  ☐ Tier 3 (> $300,000)
3. Jury Demand: ☐ Yes ☐ No
4. Requested Trial Days: ____ days (estimate)
5. Relief Sought (check all that apply):
   ☐ Monetary  ☐ Non-Monetary  ☐ Declaratory  ☐ Injunctive  ☐ Other: ___

III. PARTY INFORMATION

(Attach additional sheets if necessary.)

A. PLAINTIFF(S)
| # | Full Legal Name | Entity Type | State of Inc. / Citizenship | Address | Phone | Email |
|---|-----------------|------------|----------------------------|---------|-------|-------|
| 1 | [PLAINTIFF 1] | ☐ Individual ☐ Corp. ☐ LLC ☐ Other | _ | _ | _ | _ |
| 2 | [PLAINTIFF 2] | ☐ Individual ☐ Corp. ☐ LLC ☐ Other | _ | _ | _ | _ |

B. DEFENDANT(S)
| # | Full Legal Name | Entity Type | State of Inc. / Citizenship | Address for Service | Phone | Email |
|---|-----------------|------------|----------------------------|---------------------|-------|-------|
| 1 | [DEFENDANT 1] | ☐ Individual ☐ Corp. ☐ LLC ☐ Other | _ | _ | _ | _ |
| 2 | [DEFENDANT 2] | ☐ Individual ☐ Corp. ☐ LLC ☐ Other | _ | _ | _ | _ |

C. PLAINTIFF’S ATTORNEY
• Name: ____ Utah Bar No.: _
• Firm: _______
• Address: _____
• Phone: __ Email: _______

D. SERVICE CONTACT FOR EACH PARTY (if different):

IV. NATURE OF SUIT / CASE CATEGORY

Check ONE primary category and sub-category.
[// GUIDANCE: Utah clerks code filings by the category selected below. Selecting the most specific, accurate code prevents rejection and fee mis-calculation.]

A. CONTRACT / COMMERCIAL
☐ 101 Debt Collection   ☐ 102 Employment   ☐ 103 Insurance
☐ 104 Purchase/Sale of Goods & Services  ☐ 105 Other Contract: ___

B. TORT
☐ 201 Personal Injury   ☐ 202 Property Damage   ☐ 203 Wrongful Death
☐ 204 Defamation      ☐ 205 Medical Malpractice  ☐ 206 Other Tort: ___

C. PROPERTY / REAL ESTATE
☐ 301 Unlawful Detainer (Eviction) ☐ 302 Quiet Title  ☐ 303 Foreclosure
☐ 304 Easement / Boundary     ☐ 305 Other Real Property: ___

D. CIVIL RIGHTS / STATUTORY
☐ 401 Civil Rights  ☐ 402 Administrative Appeal  ☐ 403 Tax
☐ 404 Extraordinary Relief (Rule 65B)  ☐ 405 Other Statutory: ___

E. PROBATE / TRUST
☐ 501 Guardianship  ☐ 502 Estate Probate  ☐ 503 Trust  ☐ 504 Other Probate

F. MISCELLANEOUS
☐ 601 Interpleader  ☐ 602 Declaratory Judgment  ☐ 603 Miscellaneous

V. FILING FEE SCHEDULE & PAYMENT INFORMATION

1. Base Filing Fee (UT Code Jud. Admin. R. 3-402): $ [INSERT]
2. Surcharge / Conservation Fee (if applicable): $ [INSERT]
3. Other Statutory Fees (e.g., unlawful detainer, probate): $ [INSERT]
4. Total Due at Filing: $ ____ (payable to “Clerk of Court”)

[// GUIDANCE: Confirm the current fee schedule at https://www.utcourts.gov/howto/filing/fees/ immediately prior to submission. Incorrect payment will delay docketing.]

Method of Payment: ☐ Cash ☐ Check ☐ Credit Card ☐ e-Payment

VI. ATTORNEY CERTIFICATION & SIGNATURE

I certify that the information provided in this Cover Sheet is accurate to the best of my knowledge and that this case has not been previously filed in, or removed from, any Utah state or federal court. I further certify that I have complied with Rule 3-111, Utah R. Jud. Admin., regarding personal identifying information.

Date: [MM/DD/YYYY]

[ATTORNEY NAME], Esq.
Counsel for Plaintiff(s) | Utah Bar No. __

VII. CLERK’S USE ONLY (Do Not Write Below This Line)

• Filing Accepted: ☐ Yes ☐ No If “No,” reason: ____
• Filing Fee Rec’d: $ _  Receipt #: ____
• Case Category Code Entered: _  Tier:
• Case Number Assigned: __
• Initial Judge Assignment: ___
• Data Entry Completed By: __ Date: //______

[// GUIDANCE: File the completed Cover Sheet as the lead document when commencing a civil action, or attach it to any first‐appearance filing (e.g., removal, transfer) in Utah state courts. Retain a conformed copy for your records.]