You are on page 1of 3

This is a private record.

My Name

This is a Tier 2 case.
Address
City, State, Zip
Phone
Email

In the District Court of ________________ County, Utah
Court Address ______________________________________________________

In re marriage of

Verified Petition to Recognize a
Relationship as a Marriage

___________________________________

_______________________________
Case Number

_______________________________

And

Judge

___________________________________

_______________________________
Commissioner

(1)

The district court has jurisdiction under Utah Code Section 30-1-4.5. and
Section 78A-5-102.

(2)

The court of this county has venue because (Choose x all that apply.):
[ ] at least one of the partners resides in this county.
[ ] at least one of the elements giving rise to the cause of action occurred
in this county.

(3)

My/Our interest in this relationship is as:
[ ] a partner.
[ ] another interested person
________________________________________. (describe your interest in
the relationship sought to be recognized as a marriage)

(4)

The woman in the relationship is named
____________________________, and she is (Choose x one.):

and 4 acquired a uniform and general reputation as husband and wife. but agrees with this petition. [ ] the co-petitioner. attach the Stipulation to Enter Judgment. the partners were of legal age and capable of giving consent and were legally capable of entering a solemnized marriage according to Utah law. At the time of the agreement. and obligations.) (11) I/We ask the court for an order establishing the date of the partners’ marriage as ________________________________ (date). [ ] the co-petitioner. (10) [___] The Respondent has stipulated to the entry of an order establishing a marriage between the partners. the partners: (8) 1 cohabitated.) [ ] The partners are living together. but the partners lived together between ________________________ (date) and ________________________ (date). 2 mutually assumed marital rights. [ ] the respondent.). . (9) This petition was filed: (Choose x one. [ ] The relationship has ended.[ ] the petitioner.). (If the Respondent is not a co-petitioner. 3 held themselves out as husband and wife. (7) As a result of the agreement to live together as husband and wife. (Choose x one. duties.) [ ] during the relationship. (5) The man in the relationship is named ______________________________. (6) The partners agreed to live together as husband and wife. [ ] deceased (Attach a photocopy of the death certificate. and he is (Choose x one. [ ] the respondent.): [ ] the petitioner. and have been living together since ________________________ (date). [ ] deceased (Attach a photocopy of the death certificate. [ ] within one year following the end of the relationship.

voluntarily signed this document and declared that it is true. _______________________________ Sign here ► Date Typed or printed name (Court Clerk or Notary Public) Notary Seal _______________________________ _______________________________ . who is known to me or who presented satisfactory identification. has. has. while in my presence and while under oath or affirmation. _______________________________ Sign here ► Date Typed or printed name (Court Clerk or Notary Public) _______________________________ _______________________________ Notary Seal _______________________________ Date Sign here ► _______________________________ Typed or Printed Name Co-Petitioner _______________________________ I certify that ___________________________. who is known to me or who presented satisfactory identification._______________________________ Sign here ► Date Typed or Printed Name (Petitioner) _______________________________ _______________________________ I certify that _____________________. voluntarily signed this document and declared that it is true. while in my presence and while under oath or affirmation.