Fill and Sign the Utah Child Support Form

Name: Address: Phone:                         IN THE       JUDICIAL DISTRICT COURT OF       COUNTY, STATE OF UTAH       , Petitioner, vs.       , Respondent. * * * * * * * * * AFFIDAVIT OF INCOME VERIFICATION AND COMPLIANCE WITH THE UNIFORM CHILD SUPPORT GUIDELINES Case No.       Judge:       Petitioner certifies that the income of the parties has been verified pursuant to U.C.A. 78 - 45 - 7.3 in that: 1. A Child Support Worksheet; a. has been submitted b. is attached. 2. The year - to - date income for Petitioner: a. has been submitted b. is not applicable. 3. The year - to - date income for Respondent: a. has been submitted b. is not applicable. 4. Tax returns are attached for i. Petitioner, ii. Respondent, Or a verified statement of defaulting party's income has been previously served upon that party. 5. The Petitioner is employed at       and grosses $       per month. 6. The Respondent is employed at       and grosses $       per month. 7. The child support amount requested meets the minimum level of support required under the Utah Child Support Guidelines. Dated this       day of       ,       . ___________________________ Petitioner Signature STATE OF UTAH COUNTY OF             appeared before me on the       day of       ,       with satisfactory evidence to prove to me his/her identity.       then signed this document in my presence and affirmed that he/she had read this document and understood its contents and that the contents were true to his/her personal knowledge. DATED this       day of       ,       . ______________________________ Notary Public/Deputy Clerk