Request for Hearing on 
Protective Order 

Case Number: _______________ District: ____ 

County: ______________________ State: Utah 

Judge:  ________________________________ 

 

Commissioner: __________________________ 

Petitioner 

 

 

 

 

 

 

 

 

This is a private record. 

irst Name 

Middle 

Last 

Respondent 

irst Name 

Middle 

Last 

Notice to Petitioner. Your request for a Temporary Protective Order has been denied. 
However, a hearing where both you and the Respondent can present evidence will be 
scheduled if you request it. The court will notify you of the hearing and have the Respondent 
served with the Petition and notice of the hearing. A Temporary Protective Order will not be in 
place during the time before the hearing, but a Protective Order might be issued at that 
hearing. Please be aware that if you do not request a hearing your case will be dismissed. 

To avoid having your case dismissed, please file this Request for Hearing no later than 
_______________________________ (date). 

Petitioner: I request that a hearing on my Request for a Protective Order be scheduled. 

 

Sign here ► 

Print or type name 

 

 

Request for Hearing on Protective Order 

Approved Board of District Court Judges September 22, 2010 
Revised April 1, 2012 

Page 1 of 1 

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Date 

 

 



Request for Hearing on Protective Order

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