ile this form with the clerk of the district court in Utah where the adoption was ordered.  

1) 

Check one of the following: 

[  ] 

[  ] 

I am the adoptive parent in this case.  

I am the adult adoptee in this case 

(2) 

As far as I know, the adoption order was entered by this court in  

___________ (year) and the court case number is _____________________.  

I present the following identification to prove my identity (list the government-issued 
identification you are presenting to the court): 

I ask the court to give me a certified copy of the adoption order in my case. 

I understand that I will be charged a fee for the certified copy of the order and 
that I must pay the fee to the court before the court will give me the copy. 

Sign here ►

Typed or Printed Name

Request for Certified Copy of Adoption Decree 

Approved Board of District Court Judges November 21, 2014 
Revised May 14, 2015 

Page 1 of 1 

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(3) 

 

(4) 

(5) 

 
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Request for Certified Copy of Adoption Decree Pursuant to URCP 107(a) 



Microsoft Word - 01_Request_for_Certified_Copy_of_Adoption_Decree.doc

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.

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About This Form:

• Sourced from legacy.utcourts.gov (2023-03)
• Page(s): 1
• Fields(s): 16
• Average fields per page: 16
• Reading Level: Grade 8
• LIST Grouping(s): Unknown

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