In the District Court of Utah 

__________ Judicial District ________________ County 

Court Address ______________________________________________________ 

In the Matter of (select one) 
 

[  ]  the Marriage of (for a divorce with or without 
children, annulment, separate maintenance, or 
temporary separation case) 

[  ]  the Children of (to establish custody, parent-

time or child support) 

[  ]  the Parentage of the Children of (for a 

paternity case) 

Domestic Relations Injunction 
(Utah Rule of Civil Procedure 109) 

_______________________________ 
Case Number 

_______________________________ 
Judge 

____________________________________ 
(name of Petitioner) 

_______________________________ 
Commissioner 

and  

____________________________________ 
(name of Respondent) 
____________________________________________ 
Other parties (if any) 

Because this matter involves divorce, annulment, temporary separation, custody, 
parent-time, child support, or paternity, the court makes the following orders. These 
orders apply to the petitioner and respondent named above. 

1. 

The parties must not:  

a.  harass, intimidate or disturb the peace of the other party, by any means, 

including electronically. 

b.  commit domestic violence or abuse against the other party or a child. 

c.  use the other party’s name, likeness, image, or identification to get credit, 

open an account for service, or obtain a service. 

d.  cancel or interfere with telephone, utility, or other services used by the other 

party. 

e.  cancel, modify, terminate, change the beneficiary, or allow to lapse for 

voluntary nonpayment of premiums (without the written consent of the other 
party or pursuant to further order of the court) any policy of  

i.  health insurance,  

1501FAJ Approved April 22, 2019 / 
Revised May 1, 2022 
 

Domestic Relations Injunction 

Page 1 of 4 

ii.  homeowner's or renter's insurance,  

iii.  automobile insurance, or 

iv.  life insurance  

2. 

If the petition involves the division of property, personal property or debts, 
the parties must not: 

transfer, encumber, conceal, or dispose of your property or the other party's 
property unless:  

a.  you have the written consent of the other party or  

b.  you have a court order  

except in the usual course of business or to provide for the necessities of life. 

3. 

If the petition involves minor children, the parties must not: 

a.  Take the children on non-routine travel unless: 

i.  you have the written consent of the other party or  

ii.  you have a court order, or 

iii.  the following information has been provided to the other party:  

•  an itinerary of travel dates and destinations; 

•  how to contact the children or traveling party; and 

• 

the name and telephone number of an available third person who will 
know the children's location. 

b.  In the presence or hearing of the children:  

i.  demean or disparage (talk badly about) the other party;  

ii.  attempt to influence the children’s preference regarding custody or parent 

time; or 

iii.  say or do anything that would negatively affect the love and affection of 

the children for the other party, or involve the children in the issues of the 
petition. 

c.  Make parent time arrangements through the children. 

4. 

When the children are under a party’s care, that party must use best efforts to 
prevent others from doing anything described above, and if necessary remove 
the children from the situation. 

5. 

This domestic relations injunction is effective:  

• 

for the petitioner when the petition is filed.  

1501FAJ Approved April 22, 2019 / 
Revised May 1, 2022 
 

Domestic Relations Injunction 

Page 2 of 4 

• 

• 

• 

• 

• 

• 

for the respondent when they receive a copy of the injunction entered by the 
court. 

6. 

The domestic relations injunction is in effect until:  

the final decree is entered,  

the petition is dismissed,  

the court orders otherwise. 

the parties otherwise agree in a writing signed by all parties, or  

7. 

A party may ask to modify or dissolve the domestic relations injunction by filing a 
motion.  

•  The motion will be decided as quickly as possible if it is filed before an 

answer to the petition or other responsive pleading is filed. The moving party 
must serve the nonmoving party at least 48 hours before a hearing.   

If the motion is filed after a responsive pleading is filed, Utah Rule of Civil 
Procedure 7 or Rule 101 apply. 

If there is another order with conflicting provisions governing the parties or their 
minor children, the parties must comply with the provisions of the other order.  

This domestic relations injunction does not apply to the Office of Recovery 
Services.    

8. 

9. 

 

1501FAJ Approved April 22, 2019 / 
Revised May 1, 2022 
 

Domestic Relations Injunction 

Page 3 of 4 

I certify that I filed with the court and am serving a copy of this Domestic Relations Injunction on the 
following people. 

Certificate of Service 

Person’s Name 

Service Method 

Service Address 

Service 
Date 

 

 

 

 

 

 

[  ]  Mail 
[  ]  Hand Delivery 
[  ]  E-filed 
[  ]  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 
[  ]  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  
[  ]  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 ► 

Printed Name 

 

 

 

 

 

 

 
Date 

 

1501FAJ Approved April 22, 2019 / 
Revised May 1, 2022 
 

Domestic Relations Injunction 

Page 4 of 4