This is a private record.

Name

Address

City, State, Zip

Phone

Email

I am the [ ] Petitioner
[ ] Respondent
[ ] Attorney for the [ ] Petitioner [ ] Respondent and my Utah Bar number is _________

In the District Court of Utah

__________ Judicial District ________________ County

Court Address ______________________________________________________

Request for Contempt Hearing

(Use only if a commissioner has certified the
issue of contempt to be heard by a judge.)

_____________________________________ _______________________________
Petitioner Case Number

_______________________________
v. Judge

_____________________________________ _______________________________
Respondent Commissioner

The court commissioner has certified the issue of contempt to the district court judge for
consideration, and I request that a hearing be scheduled.

I declare under criminal penalty under the law of Utah that everything stated in this document is true.

Signed at ______________________________________________________ (city, and state or country).

Signature ►
Date
Printed Name
Request for Contempt Hearing Approved Board of District Court Judges December 2, 2011 Page 1 of 2
Revised May 8, 2018
 Certificate of Service
I certify that I filed with the court and served a copy of this Request for Contempt Hearing on the following
people.

Served at this Served on

Person’s Name Method of Service Address this Date
[ ] 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.)
[ ] 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.)

Signature ►
Date
Printed Name

Request for Contempt Hearing Approved Board of District Court Judges December 2, 2011 Page 2 of 2
Revised May 8, 2018