Fill and Sign the Juvenile Court Petition Cover Sheet Utah Courts Form

Utah Juvenile Court Petition Cover Sheet This cover sheet must accompany any petition filed in the Juvenile Court. Choose one: State Petition (No filing fees) Private Petition (Filing fees required. May be waived if Petitioner is indigent) Child Welfare Petition Termination of Parental Rights Voluntary Relinquishment Adoption $360 Child Welfare Petitions (abuse, neglect, terminations) $360 Adoptions $ 8 Vital Statistics Fee (per child) $360 Administrative Appeals $360 Petition For Substantiation $225 Notice of Appeal $ 5 Petition to Marry $135 Petition for Expungement $ 50 Petition for Emancipation $ 0 Petition for Protective Order on Behalf of Children Name of Petitioner: ____________________________________________________________________________ Address:____________________________________________________________________________________ Telephone: _______________________ Child 1: (Please include information for each child named in the petition) Name of minor/child: ___________________________________________ Address:_____________________________________________________________________________ Date of Birth: _________________ If child welfare petition, allegation is against Father Mother Other Name of Father and Address (if petition relates to a child): _____________________________________ ____________________________________________________________________________________ Name of Mother and Address (if petition relates to a child) : ____________________________________ ____________________________________________________________________________________ Attorney Name, Bar # and Address: _______________________________________________________ ____________________________________________________________________________________ Child 2: (Please include information for each child named in the petition) Name of minor/child: ___________________________________________ Address:_____________________________________________________________________________ Date of Birth: _________________ If child welfare petition, allegation is against Father Mother Other Name of Father and Address (if petition relates to a child): _____________________________________ ____________________________________________________________________________________ Name of Mother and Address (if petition relates to a child) : ____________________________________ ____________________________________________________________________________________ Attorney Name, Bar # and Address: _______________________________________________________ ____________________________________________________________________________________ Child’s Race check 1 or more Child’s Ethnicity check only one Child’s Gender check only one … Am. Indian … Pac. Islander … Latino/Hispanic … Male … Asian … White … Not Latino/Hispanic … Female … Black/African Am … Can’t Determine … Can’t Determine Child’s Race check 1 or more Child’s Ethnicity check only one Child’s Gender check only one … Am. Indian … Pac. Islander … Latino/Hispanic … Male … Asian … White … Not Latino/Hispanic … Female … Black/African Am … Can’t Determine … Can’t Determine For Expungement Petition Only: Name and address of the prosecutor’s office (city attorney, county attorney, or district attorney) that prosecuted the case. (If more than one, list all.) Effective: August 1, 2010