IN THE ____________________ DISTRICT JUVENILE COURT 
__________________________________ COUNTY, STATE OF UTAH 

_________________________________ 

Petitioner, 

ORDER TO TRANSFER 
CHILD PROTECTIVE ORDER 
TO DISTRICT COURT 

_________________________________ 

Respondent 

udge _____________________________ 

ase No. __________________________ 

    _

   

  _

 
 

vs. 

A petition was filed on this matter in the Juvenile Court on___________________. The 
Court has reviewed Petitioner’s Verified Petition for Child Protective Order and Petition for Ex 
Parte Child Protective Order. These additional records were available for review and/or are 
attached: 

 

Child/Family’s juvenile court case file(s) 
 
Child/Family’s district court case file(s)  
 
Petitions, orders, or investigations related to the child or 
the parties to the case in SAFE, the DCFS Management 
Information System  
 
Records of law enforcement agencies identified by 
the petitioner as having investigated abuse of the child  
 
Other: _________________________________  

Available? 

________ 
 
________ 
 

________ 
 

________ 
 
________ 

Attached 
 
________ 
 
________ 
 

________ 
 

________ 
 
________ 

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Created May 3. 2004 

 

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__________________________________ 
Petitioner’s Name 
__________________________________ 
Address (may be omitted for privacy) 
__________________________________ 
City, State, ZIP 
__________________________________ 
Telephone (may be omitted) 
 

______________________________________ 
JUVENILE COURT JUDGE 

 
 

Created May 3. 2004 

Based on the evidence and information presented, the Court has found that the above-

named child/ren is/are being or is in imminent danger of being physically or sexually abused, and 
has entered an ex parte child protective order. 

The Court further finds that the petitioner and respondent are the natural parent, adoptive 

parent, or step parent of the child/ren who is/are the object of the petition; that the district court 
has had a prior order or has a paternity, custody, parent-time or divorce action pending in which 
the petitioner and respondent are parties; and the best interests of the child will be better served 
in the district court. 

Based on the above, the Court orders that the above-captioned case, a copy of the Ex 

Parte Child Protective Order and the documents listed above be TRANSFERRED to the court 
location listed below for a hearing to be held within 20 days in the district court: 

udge ____________________________________________________ 

District Court Case Number: _________________________________ 

______________ District Court, ________________________ County 

Address: _________________________________________________ 

_________________________________________________________ 

Date: ____________________________________________________ 

Time: ____________________________________________________ 

INDING THAT POTENTIAL HARM TO THE CHILD/REN OUTWEIGHS PUBLIC 

INTEREST, THE DOCUMENTS LISTED ABOVE ARE DESIGNATED AS PRIVATE WITHIN 

THE DISTRICT COURT FILE AND SHALL NOT BE DISCLOSED TO THE PUBLIC. 

Y THE COURT: 

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ATED: ___________________________ TIME: _____________________________ 

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