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Here is the text we could read:

 

I am the 

[  ] Petitioner  

[  ] Minor  

[  ] Interested Person  

[  ] Witness 

In the District Court of Utah 

__________ Judicial District ________________ County 

Court Address ______________________________________________________ 

In the Matter of Protection for 

Witness Affidavit 

___________________________________, 
a minor 

_______________________________ 
Case Number 

_______________________________ 
Judge 

Being first sworn and while under oath or affirmation, I say as follows: 

My relationship to the respondent is ___________________________________. 

1. 

2. 

I also say: 

ity, State, Zip 

 
Name 

ddress 

hone 

mail 

  A

  C

  P

  E

             

Witness Affidavit 

 

Approved Board of District Court Judges September 11, 2013 
Revised January 27, 2020 

Page 1 of 3 

Signature ► 

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. 

Printed name (Court Clerk or Notary Public) 

Signature ► 

Notary Seal 

 

 

 

Witness Affidavit 

Approved Board of District Court Judges September 11, 2013 
Revised January 27, 2020 

Page 2 of 3 

                           

       

 

Date 

 
Date 

 

 

 

I certify that I filed with the court and served a copy of this Witness Affidavit on the following people. 

Certificate of Service 

Person’s Name 

Method of Service 

Served at this 
Address 

Served on 
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.) 

[  ]  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 ► 

Printed Name 

 

 

(Petitioner or attorney) 

(Minor or attorney) 

(Interested person or 
attorney) 

(Interested person or 
attorney) 

 
Date 

 

 

 

 

Witness Affidavit 

Approved Board of District Court Judges September 11, 2013 
Revised January 27, 2020 

Page 3 of 3

Witness Affidavit

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Utah state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from legacy.utcourts.gov (2023-03)
Page(s): 3
Fields(s): 115
Average fields per page: 38
Reading Level: Grade 10
LIST Grouping(s): GO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

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users1_phone_number was phone (1.00 conf)
email was email (0.38 conf)
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witness_affidavit was witness_affidavit (0.46 conf)
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matter_protection was in_the_matter_of_protection_for (0.37 conf)
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minor__1 was a_minor (0.38 conf)
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page_field__16 was page_0_field_28 (0.31 conf)
sworn_oath_say_follows was being_first_sworn_and_while_under_oath_or_affirmation__i_say_as_follows (0.39 conf)
page_field__17 was page_0_field_30 (0.31 conf)
judge was judge (0.39 conf)
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page_field__22 was page_0_field_36 (0.31 conf)
page_field__23 was page_0_field_37 (0.37 conf)
page_field__24 was page_0_field_38 (0.37 conf)
relationship_respondent was my_relationship_to_the_respondent_is (0.48 conf)
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page_field__25 was page_0_field_41 (0.37 conf)
page_field__26 was page_0_field_42 (0.37 conf)
page_field__27 was page_0_field_43 (0.37 conf)
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page_field__29 was page_0_field_45 (0.31 conf)
page__1 was page_1_of_3 (0.42 conf)
page_field__30 was page_0_field_47 (0.37 conf)
petitioners1_name was petitioner (1.00 conf)
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page_field__35 was page_1_field_4 (0.36 conf)
page_field__36 was page_1_field_5 (0.36 conf)
page_field__37 was page_1_field_6 (0.36 conf)
page_field__38 was page_1_field_7 (0.36 conf)
page_field__39 was page_1_field_8 (0.36 conf)
page_field__40 was page_1_field_9 (0.36 conf)
page_field__41 was page_1_field_10 (0.36 conf)
page_field__42 was page_1_field_11 (0.36 conf)
page_field__43 was page_1_field_12 (0.36 conf)
page_field__44 was page_1_field_13 (0.36 conf)
page_field__45 was page_1_field_14 (0.36 conf)
users1_signature was signature (1.00 conf)
signature_date was date (1.00 conf)
page_field__46 was page_1_field_17 (0.36 conf)
page_field__47 was page_1_field_18 (0.36 conf)
known_satisfactory_form was who_is_known_to_me_or_who_presented_satisfactory_identification__in_the_form_of (0.32 conf)
form_identification was form_of_identification_has__while_in_my (0.42 conf)
users1_name__2 was printed_name (1.00 conf)
page_field__48 was page_1_field_22 (0.36 conf)
page_field__49 was page_1_field_23 (0.36 conf)
date_certify was on_this_date__i_certify_that (0.39 conf)
page_field__50 was page_1_field_25 (0.36 conf)
page_field__51 was page_1_field_26 (0.36 conf)
page_field__52 was page_1_field_27 (0.36 conf)
page_field__53 was page_1_field_28 (0.36 conf)
page_field__54 was page_1_field_29 (0.36 conf)
page_field__55 was page_1_field_30 (0.36 conf)
page_field__56 was page_1_field_31 (0.36 conf)
page_field__57 was page_1_field_32 (0.36 conf)
notary_seal was notary_seal (0.37 conf)
page__2 was page_2_of_3 (0.42 conf)
page_field__58 was page_2_field_0 (0.31 conf)
page_field__59 was page_2_field_1 (0.36 conf)
page_field__60 was page_2_field_2 (0.36 conf)
page__3 was page_3_of_3 (0.42 conf)
left_home_person_suitable was left_at_home__with_person_of_suitable (0.45 conf)
mail was mail (0.38 conf)
hand_delivery was hand_delivery (0.35 conf)
e_filed was e_filed (0.48 conf)
email_person_agreed_service was email__person_agreed_to_service_by_email (0.42 conf)
left_business_person_charge was left_at_business__with_person_in_charge (0.48 conf)
page_check__1 was page_2_check_6 (0.26 conf)
page_check__2 was page_2_check_7 (0.26 conf)
page_check__3 was page_2_check_8 (0.26 conf)
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page_check__6 was page_2_check_11 (0.26 conf)
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page_check__8 was page_2_check_13 (0.26 conf)
page_check__9 was page_2_check_14 (0.26 conf)
page_check__10 was page_2_check_15 (0.26 conf)
page_check__11 was page_2_check_16 (0.26 conf)
page_check__12 was page_2_check_17 (0.26 conf)
page_check__13 was page_2_check_18 (0.26 conf)
page_check__14 was page_2_check_19 (0.26 conf)
page_check__15 was page_2_check_20 (0.26 conf)
page_check__16 was page_2_check_21 (0.26 conf)
page_check__17 was page_2_check_22 (0.26 conf)
page_check__18 was page_2_check_23 (0.26 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Witness Affidavit

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02