Fill and Sign the Non Military Affidavit Form

Name Address City, State, Zip Phone Email I am the [ ] Plaintiff/Petitioner [ ] Defendant/Respondent [ ] Attorney for the [ ] Plaintiff/Petitioner [ ] Defendant/Respondent and my Utah Bar number is _________ In the [ ] District [ ] Justice Court of Utah __________ Judicial District ________________ County Court Address ______________________________________________________ ____________________________________ _ Plaintiff/Petitioner v. Military Service Declaration _______________________________ Case Number _______________________________ Judge Military Service Declaration Approved Board of District Court Judges January 22, 2010 Revised June 16, 2016 Page 1 of 4 ____________________________________ _ Defendant/Respondent _______________________________ Commissioner I say as follows: (1) The clerk of court has issued a Certificate showing the default of the: [ ] Plaintiff/Petitioner [ ] Defendant/Respondent Military Service Declaration Approved Board of District Court Judges January 22, 2010 Revised June 16, 2016 Page 2 of 4 (2)(A) [ ] I am unable to determine the military status of the defaulting party. OR (B) [ ] The defaulting party (check one) : [ ] is in military service. [ ] is not in military service. (3) [ ] I have done the following research to support the above conclusion. (4)(A) [ ] (A certificate from the Department of Defense Manpower Data Center is the preferred evidence of the defaulting party’s military service status. Check this box only if you have attached that certificate.) I visited the Department of Defense Manpower Data Center website (https://scra.dmdc.osd.mil/single_record.xhtml) and entered the following information for the defaulting party, which I know to be correct: Name Social Security Number (Last 4 digits only) Date of Birth (4)(B) [ ] I know the identifying information is correct because: (5) [ ] I do not know and am unable to discover the defaulting party’s date of birth or social security number. I have not included any non-public information in this document. I declare under criminal penalty of Utah Code Section 78B-5-705 that the information in this document is true and correct. I understand that for knowingly making a false statement, I can be fined as provided in Title 18, United States Code, or imprisoned for not more than one year, or both. Sign here ► Date Typed or printed name Military Service Declaration Approved Board of District Court Judges January 22, 2010 Revised June 16, 2016 Page 3 of 4 Certificate of Service I certify that I served a copy of this document on the following people. Person’s Name Method of Service Served at this Address Served on this Date (Any Party not in Default or Attorney) [ ] Mail [ ] Hand Delivery [ ] E-filed [ ] Email (Person agreed to service by email.) [ ] Left at business (With person in charge or in receptacle for deliveries.) [ ] Left at home (With person of suitable age and discretion residing there.) (Clerk of Court) [ ] Mail [ ] Hand Delivery [ ] E-filed [ ] Mail [ ] Hand Delivery [ ] E-filed [ ] Email (Person agreed to service by email.) [ ] Left at business (With person in charge or in receptacle for deliveries.) [ ] Left at home (With person of suitable age and discretion residing there.) [ ] Mail [ ] Hand Delivery [ ] E-filed [ ] Email (Person agreed to service by email.) [ ] Left at business (With person in charge or in receptacle for deliveries.) [ ] Left at home (With person of suitable age and discretion residing there.) Sign here ► Date Typed or Printed Name Military Service Declaration Approved Board of District Court Judges January 22, 2010 Revised June 16, 2016 Page 4 of 4