Here is the text we could read:
IN THE __________DISTRICT JUVENILE COURT,
_______________________ COUNTY, STATE OF UTAH
VERIFIED PETITION AGAINST
SUBSTANTIATION IN DCFS
LICENSING DATABASE
(FORM A)
ase No. ______________
udge _________________
C
J
__________________________________
Petitioner=s Name
__________________________________
Street Address
__________________________________
City, State, ZIP Date of Birth
ivision of Child and Family
Services, Respondent
195 North 1950 West
Salt Lake City, Utah 84116
(801) 538-4100
s.
v
D
1)
Petitioner received notice on or about ______________ that the Division of Child
and Family Services had made a supported finding of severe abuse or neglect against the
Petitioner, and that Petitioner would be included in the Division of Child and Family Services
licensing database. (Attach copy of notice from agency).
2)
Petitioner has NOT been subject to any of the following court determinations
with respect to the alleged incident of abuse or neglect: conviction; juvenile court adjudication;
plea of guilty; plea of guilty and mentally ill; or no contest.
(3)
Petitioner challenges the finding made by Division of Child and Family Services,
and inclusion in the Licensing Database. Petitioner requests a court hearing because: [Describe
in detail facts which you believe contradict the finding of the Division of Child and Family
Services, including what happened, where, who was involved (including minor children
and family and household members), and if medical or police intervention was required.
Attach relevant medical, dental, or police records.]
(
(
etitioner swears that the following is true:
pril 2011 / Revised July 31, 2020
1
_
_
_
P
A
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(4)
For these reasons, Petitioner respectfully requests that the Court enter an order
establishing that the finding of the Division of Child and Family Services was unsubstantiated, or
without merit, and to order that Division of Child and Family Services remove Petitioner=s name
from the Licensing Database.
Petitioner: __________________________________
SUBSCRIBED and SWORN to before me on _________________, 20 ___.
THIS PETITION MUST BE SERVED
PLEASE FOLLOW THE INSTRUCTIONS THAT ACCOMPANY THIS FORM
_____________________________
Clerk, Deputy or Notary
_
pril 2011 / Revised July 31, 2020
2
A
NOTICE OF HEARING
THE STATE OF UTAH, JUVENILE COURT TO THE DIVISION OF CHILD AND
AMILY SERVICES: You are directed to appear at a hearing and answer the above claim:
On Date: __________________
At Time: ______________ at
ddress:______________________________________________________________________
ated _____________, 20 _____ ______________________________
Clerk or Deputy
n compliance with the Americans with Disabilities Act, individuals needing special
accommodations (including auxiliary communicative aids and services) during this proceeding
should call the court clerk at (phone)_________, at least three working days prior to the
proceeding.
pril 2011 / Revised July 31, 2020
3
D
F
A
I
A
SUBSTANTIATION PROCEEDINGS:
INSTRUCTIONS TO THE PETITIONER
Substantiation proceedings are governed by Utah Code 63G-4-402(2), and 78A-6-323. If you
have any questions not addressed in these instructions, refer to the Utah Code. You should be able to
locate a copy on the State Court Website at https://www.utcourts.gov/ (for procedural rules), or the
Legislature=s Website at https://le.utah.gov/Documents/code_const.htm (for the Utah Code).
HOW TO FILE FOR A HEARING
. FILING SUIT. You are the >PETITIONER= in this case and the >RESPONDENT= is
the Division of Child and Family Services. If the judge determines that the finding of the Division of
Child and Family Services is Aunsubstantiated@ or Awithout merit@ as defined in Utah Code 62A-4a-
101, the judge will order that your name be removed from the Licensing Information System. In this
action, no claims can be made for money. The Juvenile Court has exclusive jurisdiction over
substantiation proceedings to make a finding of Asubstantiated@, Aunsubstantiated@, or Awithout
merit@. If the court finds that Division of Child and Family Services claim is unsubstantiated, or
without merit, the Court will order Division of Child and Family Services to remove your name from
the Licensing Database.
. COURT HEARING. You must prepare the Petition, sign it in the presence of a
notary public or court clerk, have your signature notarized, file it with the court clerk, and pay the
filing fee listed on the petition cover sheet. The Petition should be typewritten, but will be accepted
if legibly handwritten.
he clerk will set two hearing dates (pre-trial, and adjudicatory hearing) and give you a copy of the
Petition with the hearing dates on it. The first hearing will be a pre-trial hearing, and is intended for
parties to inform the court of the legal and factual issues to be presented at the adjudicatory hearing.
Any stipulations or agreements between the parties should be presented at the pre-trial hearing. The
second hearing, the adjudicatory hearing, is a trial to resolve all of the legal and factual issues.
f you fail to appear at the hearing, your case may be dismissed Awith prejudice@ and you may
not be able to re-file your claim.
n compliance with the Americans with Disabilities Act, individuals needing special
accommodations (including auxiliary communicative aids and services) during this proceeding
should call the court clerk at least three working days prior to the proceeding.
3.
SERVICE. Once you receive hearing dates from the court, it is your responsibility to
serve notice of the hearings on the Division of Child and Family Services. The Petition must be
served on the Division of Child and Family Services at least 45 calendar days before the adjudicatory
hearing. You cannot serve the petition yourself. Service can be made in one of two ways:
a) MAIL (with proof of receipt). Mail a copy of the Petition to the Division of
1
2
T
I
I
A
pril 2011 / Revised July 31, 2020
4
Child and Family Services by registered or certified mail with return receipt
requested to be signed by an agent of the Division of Child and Family Services
authorized to accept service. If you serve the Respondent by mail, you must fill out
and file with the court the Proof of Service (Form B). The Proof of Service Form
must be filed with the court within 10 calendar days of service and must have the
original receipt signed by the Respondent attached.
b) DELIVERY. Have the Petition served on the Division of Child and Family Services
by the Sheriff's department, a Constable, or any person regularly engaged in the business
of serving process, and pay for the service. You will need to make sure the Petition has
been served and proof of the service has been filed with the Court Clerk.
. POSTPONING THE ADJUDICATORY HEARING. If you want to change an
adjudicatory hearing date, you must request a AContinuance.@ The judge is not obligated to grant you
a continuance. Fill out the Request for Continuance form available at the court. You must serve a
copy of your request for a continuance on the Division of Child and Family Services (see instructions
for AService@ above). The court may grant your request if both parties agree, or for good cause. The
court must receive your Request for Continuance at least five calendar days before the hearing.
. EVIDENCE AND WITNESSES. Bring with you to the adjudicatory hearing all
witnesses and papers necessary to prove your claim or defense. If you fail to do this, the case
may be decided against you. No later than 30 days prior to the adjudicatory hearing, the parties
shall provide to each other information they will rely upon to support their claim or defense.
Irrelevant or unduly repetitious evidence will be excluded. Evidence should be offered through the
statements of live witnesses at the adjudicatory hearing, or as otherwise permitted by the Utah Rules
of Evidence.
f you need the testimony of a witness who will not attend the adjudicatory hearing voluntarily,
you should ask the court or your attorney to issue a Subpoena (Form C) requiring that person to
attend. It is your responsibility to have the Subpoena served and to pay the witness fee and service
fee. A subpoena must be served at least 5 calendar days before the adjudicatory hearing. You may
have a witness appear voluntarily without a subpoena, but the judge will not continue the
adjudicatory hearing if the witness fails to appear.
. FINDINGS AND APPEAL. At the conclusion of the adjudicatory hearing, the judge will
make a finding that the determination of abuse or neglect is substantiated, unsubstantiated, or
without merit. Either party may appeal the findings within 30 calendar days before the Utah Court
of Appeals.
4
5
I
6
pril 2011 / Revised July 31, 2020
5
A
PROOF OF SERVICE
OF PETITION
(FORM B)
ase No. ______________
udge _________________
C
J
IN THE __________DISTRICT JUVENILE COURT,
_______________________ COUNTY, STATE OF UTAH
__________________________________
Petitioner=s Name
__________________________________
Street Address
__________________________________
City, State, ZIP Date of Birth
ivision of Child and Family
Services, Respondent
195 North 1950 West
Salt Lake City, Utah 84116
(801) 538-4100
s.
v
D
ated ________________ , 20 ______
____________________________________
Petitioner
his form.
D
_
_
_
_
T
t
A
THIS FORM MUST BE FILED WITH THE COURT
PLEASE FOLLOW THE INSTRUCTIONS THAT ACCOMPANY THIS FORM
pril 2011 / Revised July 31, 2020
6
Petitioner certifies that the Petition was mailed to the Division of Child and Family Services.
he original document acknowledging receipt signed by Respondent is attached to the bottom of
INSTRUCTIONS FOR PROOF OF SERVICE OF PETITION
If you served notice of hearing by mail, you must prove that the Division of Child and Family
Services received notice at least 45 calendar days before the adjudicatory hearing. By filing proof of
service with the court, you may be able to get a default judgment if the representatives of the
Division of Child and Family Services do not appear for the hearing.
he Proof of Service (Form B) must be filed with the court within 10 days of service. To do so, you
must provide the document (not a copy) signed by the other party indicating receipt. The document
must show the date that the Division of Child and Family Services received the Petition. This
document must be attached to the bottom left corner of the Proof of Service form in a way that still
allows anything under the document to be seen (for example, staple only along left margin). If the
document covers more than half the page, attach document to 8 x 11 paper and staple behind Proof
of Service. The Respondent must sign the document indicating receipt.
If you choose to serve the Affidavit or Counter Affidavit by mail, and do not show the court
that the other party got the required notice, you will not be able to get a default judgment if
the other party does not appear for trial.
T
pril 2011 / Revised July 31, 2020
7
A
IN THE __________DISTRICT JUVENILE COURT,
_______________________ COUNTY, STATE OF UTAH
SUBPOENA
(FORM C)
ase No. ______________
udge _________________
C
J
__________________________________
Petitioner=s Name
__________________________________
Street Address
__________________________________
City, State, ZIP Date of Birth
o: __________________________________
__________________________________
__________________________________
ivision of Child and Family
Services, Respondent
195 North 1950 West
Salt Lake City, Utah 84116
(801) 538-4100
s.
v
D
OU ARE COMMANDED TO appear in the _______________ Juvenile Court at the
place, date and time specified to testify in the above case.
______________________________________________ ___________________________
ISSUING OFFICER'S SIGNATURE AND TITLE
DATE
(INDICATE IF CLERK, OR ATTORNEY FOR PLAINTIFF OR DEFENDANT)
THIS SUBPOENA MUST BE SERVED
PLEASE FOLLOW THE INSTRUCTIONS THAT ACCOMPANY THIS FORM
pril 2011 / Revised July 31, 2020
8
_
_
_
T
Y
_
A
NOTICE TO PETITIONERS ARRANGING TO SERVE A SUBPOENA
Service of subpoena shall be made as provided in the instructions for the service of process above
AND if the person=s appearance is commanded, by tendering (e.g., attaching a check or other
form of payment) to that person of the fees for one day=s attendance and the mileage allowed by
law.
NOTICE TO PERSONS SERVED WITH A SUBPOENA
This subpoena commands you to appear to give testimony at a hearing, and you must appear in
person at the place designated in the subpoena.
ou have the right to object if the subpoena:
a. imposes an undue burden or expense upon you; OR
b. does not allow you a reasonable time to comply, which may be less than 14 days, depending on
the circumstances.
To object to complying with the subpoena, you must file with the court issuing the subpoena a
motion to quash or modify the subpoena. You must comply with the subpoena unless you have
obtained a court order granting you relief from the subpoena.
Note: This form is for a subpoena commanding a person=s appearance at a hearing to testify. For a
subpoena allowing for depositions, or review of records, please consult Form 40 of the Utah Rules of
Civil Procedure.)
n compliance with the Americans with Disabilities Act, individuals needing special
accommodations (including auxiliary communicative aids and services) during this proceeding
should call the court clerk at (phone)_________, at least three working days prior to the
proceeding.
Y
(
I
