<p>My Name</p><p>Address</p><p>City, State, Zip</p><p>Phone</p><p>Email</p><p>I am the [ ] Plaintiff/Petitioner [ ] Defendant/Respondent [ ] Attorney for the [ ] Plaintiff/Petitioner [ ] Defendant/Respondent and my Utah Bar number is ______</p><p>In the District Court of Utah</p><p>______Judicial District ______County</p><p>Court Address ______</p><p>Stipulation</p><p>______Case Number Plaintiff/Petitioner ______v. Judge</p><p>______Defendant/Respondent</p><p>Instructions:  You must complete this form before you file it. Court staff cannot complete this form for you.  Keep a copy of all documents for your records.</p><p>[ ] By and through my attorney, (Attorney, check here if you are appearing for your client.)</p><p>I say as follows:</p><p>Stipulation Approved Board of District Court Judges May 4, 2011 Page 1 of 3 Revised April 15, 2015 (1) [ ] I have received and read the Motion to Renew Judgment and its supporting documents. I understand the claims and the request that the judgment in this case be renewed for the amount of $______. I understand that, when the judgment is signed, I will owe the creditor that amount.</p><p>(2) [ ] I understand that I have the right to contest the claims and to have a judge decide the issues.</p><p>(3) [ ] Understanding these things, I voluntarily:</p><p>[ ] enter my appearance;</p><p>[ ] admit the claims; and</p><p>[ ] stipulate that the court may enter the attached Findings of Fact, Conclusions of Law and Order at any time and without further notice.</p><p>I have not included any non-public information in this document.</p><p>I declare under penalty of Utah Code Section 78B-5-705 that everything stated in this document is true.</p><p>Sign here ► Date Typed or Printed Name</p><p>Stipulation Approved Board of District Court Judges May 4, 2011 Page 2 of 3 Revised April 15, 2015 Certificate of Service I certify that I served a copy of this document on the following people. Served at this Served on Person’s Name Method of Service Address this Date [ ] Mail [ ] Hand Delivery [ ] Fax (Person agreed to service by fax.) [ ] Email (Person agreed to service by email.) [ ] Left at business (With person in charge or in receptacle for deliveries.) [ ] Left at home (With person of suitable age (Other Party or Attorney) and discretion residing there.) [ ] Mail [ ] Hand Delivery (Clerk of Court) [ ] Electronic File [ ] Mail [ ] Hand Delivery [ ] Fax (Person agreed to service by fax.) [ ] Email (Person agreed to service by 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 [ ] Fax (Person agreed to service by fax.) [ ] Email (Person agreed to service by 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.)</p><p>Sign here ► Date Typed or Printed Name</p><p>Stipulation Approved Board of District Court Judges May 4, 2011 Page 3 of 3 Revised April 15, 2015</p>