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Here is the text we could read:

 

 am   [  ]  Intervenor 

[  ]  Attorney for intervenor (Utah Bar #:__________) 

In the Juvenile Court of Utah 

__________ Judicial District ________________ County 

Court Address ______________________________________________________ 

Notice of Designated Tribal 
Representative in a Court 
Proceeding Involving an Indian 
Child 
(Utah Rule of Juvenile Procedure 50(f)(3)) 

_______________________________ 
Case Number(s) 

_______________________________ 
Judge 

State of Utah, in the interest of:  

____________________________________ 

Last name, first name 

_____________________________________ 
Date of birth 

 

[  ] under    [  ] over 18 years of age, and   
[  ] represented    [  ] not represented. 

 minor   

  A

(Choose one) 

[  ]  I have been designated by the ______ (tribe name) as the tribal representative. 

[  ]  __________________ (Name of office) has been designated by the  ____ (tribe 
name) as the tribal representative.  

Here is the contact information: 

Name: 
Title: 
Address: 

1105JUF Approved February 8, 2021 

Notice of Designated Tribal Representative in a Court 
Proceeding Involving an Indian Child – Juvenile Court 

Page 1 of 3 

  I

 

  _

 

 
Name 
 
Address 
 
City, State, Zip 
 
Phone 
 
Email  

 
 
 
 
 
 

 
  

 

City, State & Zip Code 
Telephone: 

Email: 

 declare under criminal penalty under the law of Utah that everything stated in this document is true. 

Signed at ______________________________________________________ (city, and state or country). 

 
Date 

Signature ► 

Printed Name 

 

 

 

1105JUF Approved February 8, 2021 

Notice of Designated Tribal Representative in a Court 
Proceeding Involving an Indian Child – Juvenile Court 

Page 2 of 3 

  I

 

 

Certificate of Service 

I certify that I filed with the court and am serving a copy of this Notice of Designated Tribal Representative 
in a Court Proceeding Involving an Indian Child on the following people. 

Person’s Name 

Service Method 

Service Address 

Service 
Date 

 

 

 

 

 

 

 

 

 

 

[  ]  Mail 
[  ]  Hand Delivery 
[  ]  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 
[  ]  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 
[  ]  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 
[  ]  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 
[  ]  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 

   

 

1105JUF Approved February 8, 2021 

Notice of Designated Tribal Representative in a Court 
Proceeding Involving an Indian Child – Juvenile Court 

Page 3 of 3

Notice of Designated Tribal Representative in a Court Proceeding Involving an Indian Child

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): 96
Average fields per page: 32
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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judge was judge (0.39 conf)
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tribe was tribe (0.33 conf)
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users1_phone_number__2 was telephone (1.00 conf)
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page_check__23 was page_2_check_23 (0.26 conf)
page_check__24 was page_2_check_24 (0.26 conf)

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

Notice of Designated Tribal Representative in a Court Proceeding Involving an Indian Child

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

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