____________ DISTRICT COURT, ______________________ COUNTY, UTAH 

OURT’S ADDRESS:  _____________________________________________________ 

 

N THE MATTER OF THE   
NAME CHANGE OF: 

_____________________________,. 
(minor’s name) 

 

  
     ORDER TO WAIVE SERVICE 
      

         A minor. 
 

Case No. ____________________ 

Judge  _______________________ 

The Court finds and orders as follows: 

[  ]  Good cause exists to waive service in this matter.  Therefore, the Court waives 

service of the Summons and Petition on the biological [  ] father / [  ] mother. 

[  ]  Good cause does not exist to waive service in this matter.  Therefore, the Court 

denies Petitioner’s Motion to Waive Service.  The Court orders that the Summons and Petition 

be served on the biological [  ] father /  [  ] mother before it will allow this matter to proceed 

further. 

DATED: ________________________ 
 

 

 

 

 

 

 
 

______________________________ 
District Court Judge 

 

  C

 

   I

  _

     

 

 

 

 

_____________________________ 
(Name) 
_____________________________  
(Address) 
_____________________________  
(City) 
_____________________________  
(Telephone) 
 

Minor’s Name Change:  Order to Waive Service                                                          Approved:  November 19, 2004 
 



ORDER TO WAIVE SERVICE

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