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Here is the text we could read:

TENANT'S NOTICE TO PROVIDE DEPOSIT DISPOSITION 

   

_____________________________________________________________________ 
(owner or owner's agent's name) 
             
RE: 

______________________________________________________________________  
(address of rental property) 
             

OTICE IS HEREBY GIVEN THAT WITHIN FIVE (5) CALENDAR DAYS pursuant to 
Utah Code Sections 57-17-3 et seq., the owner or the owner's agent must provide the 
tenant, at the address below, a refund of the balance of any security deposit, the 
balance of any prepaid rent, and a notice of any deductions from the security deposit or 
prepaid rent as allowed by law. 
            

OTICE IS FURTHER GIVEN that the tenant vacated the property on 

___________________________ (date).      

OTICE IS FURTHER GIVEN that failure to comply with this notice will require the 
owner to refund the entire security deposit, the full amount of any prepaid rent, and a 
penalty of $100. If the entire security deposit, the full amount of any prepaid rent, and 
the penalty of $100 is not tendered to the tenant, and the tenant is required to initiate 
litigation to enforce the provisions of the statute, the owner may be liable for the tenant's 
court costs and attorney fees. 

______________________________________________________________________ 

enant's Name(s): 

Mailing Address 

ity, State, Zip 

his is a legal document. Please read and comply with the document's terms. 

ate: ___________________________. 

June 2018 

Tenant’s Notice to Provide Deposit Disposition  
(Utah Code §57-17-3) 

Page 1 

 

TO: 

  N

  N

    N

  T

   

  C

  T

  D

 

Return of Service 

n ___________________________ (date)  I swear and attest that I served this notice 

in compliance with Utah Code Section 57-17-3 by:  (check all that apply) 
 

____  Delivering a copy to the owner or the owner's agent personally at the address 

provided in the lease agreement; 

___   Leaving a copy with a person of suitable age and discretion at the address 

provided in the lease agreement because the owner or the owner's agent was 
absent from the address provided in the lease agreement; 

___   Affixing a copy in a conspicuous place at the address provided in the lease 

agreement because a person of suitable age or discretion could not be found 
at the address provided in the lease agreement; or 

____  Sending a copy through registered or certified mail to the owner or the 
owner's agent at the address provided in the lease agreement. 

  _

  _

   

he owner's address to which the service was effected is: 

ity, State, Zip 

  C

Address 

ursuant to Utah Code Title 78B, Chapter 18a, Uniform Unsworn Declarations Act, I 

declare under criminal penalty of the State of Utah that the foregoing is true and correct. 

xecuted this _____ day of _____________, 20____. 

_______________________________________________ 

(server’s name printed) 

_______________________________________________  

(server's signature) 

June 2018 

Tenant’s Notice to Provide Deposit Disposition  
(Utah Code §57-17-3) 

Page 2 

 

   

Self-Authentication Declaration 

_______________________________________________ 

(server’s name printed) 

_______________________________________________  

(server's signature) 

  O

  T

   

    _

  _

  P

  E

  _

  _

Tenants Notice to Provide Deposit Disposition

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): 2
Fields(s): 98
Average fields per page: 49
Reading Level: Grade 9
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.

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

Tenants Notice to Provide Deposit Disposition

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Identified Data Fields:

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