Fill and Sign the Utah Grounds Form

Name Address City, State, Zip Phone Email IN THE ________________ JUDICIAL DISTRICT COURT OF ______________________________ COUNTY, STATE OF UTAH ___________________________________________________________________ (court address) ____________________________________, Petitioner, vs. ____________________________________, Respondent. * * * * * * * * * Petitioner's Affidavit of Jurisdiction and Grounds for Divorce Case No. __________________________ Commissioner: _____________________ Judge: ____________________________ Petitioner, being duly sworn, deposes and states as follows: 1. I am the Petitioner in the above entitled action. 2. I was a resident of _________________ County for at least three months immediately preceding the filing of my divorce petition on _______________ (date) . 3. Respondent and I were married on _____________________, in __________________________________, and are presently married. 4. During my marriage to the Respondent, irreconcilable differences developed. The irreconcilable differences are: _____________________________________________________________________________ Affidavit of Jurisdiction and Grounds for Divorce Page 1 of 2 _____________________________________________________________________________ _ . All attempts to reconcile have failed. I do not feel this marriage can continue. 5. To the best of my knowledge the Findings of Fact and Conclusions of Law, and Decree of Divorce conform to my original Verified Petition for Divorce. Sign here ► Date Typed or Printed Name On this date, I certify that _________________________________________________________ (name) who is known to me or who presented satisfactory identification, in the form of ______________________________________________________ (form of identification), has, while in my presence and while under oath or affirmation, voluntarily signed this document and declared that it is true. Sign here ► Date Typed or printed name (Court Clerk or Notary Public) Notary Seal CERTIFICATE OF MAILING/DELIVERY On _____________ (date) I mailed a copy of the Petitioner's Affidavit of Jurisdiction and Grounds for Divorce, postage prepaid, to Respondent at (Respondent’s address) : ______________________________________ Petitioner’s Signature Affidavit of Jurisdiction and Grounds for Divorce Page 2 of 2