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.):

[ ] the petitioner.
[ ] the co-petitioner.
[ ] the respondent.
[ ] deceased (Attach a photocopy of the death certificate.).
(5)

The man in the relationship is named

______________________________, and he is (Choose x one.):
[ ] the petitioner.
[ ] the co-petitioner.
[ ] the respondent.
[ ] deceased (Attach a photocopy of the death certificate.).

(6)

The partners agreed to live together as husband and wife. At the time of
the agreement, the partners were of legal age and capable of giving
consent and were legally capable of entering a solemnized marriage
according to Utah law.

(7)

As a result of the agreement to live together as husband and wife, the

partners:

(8)

cohabitated;

mutually assumed marital rights, duties, and obligations;

held themselves out as husband and wife; and

acquired a uniform and general reputation as husband and wife.

(Choose x one.)

[ ] The partners are living together, and have been living together since
________________________ (date).
[ ] The relationship has ended, but the partners lived together between
________________________ (date) and ________________________
(date).
(9)

This petition was filed: (Choose x one.)

[ ] during the relationship.
[ ] within one year following the end of the relationship.

(10)

[___] The Respondent has stipulated to the entry of an order establishing

a marriage between the partners. (If the Respondent is not a co-petitioner, but
agrees with this petition, attach the Stipulation to Enter Judgment.)

(11)

I/We ask the court for an order establishing the date of the partners
marriage as ________________________________ (date).

_______________________________
Sign here
Date
Typed or Printed Name (Petitioner)

_______________________________
_______________________________

I certify that _____________________, who is known to me or who presented satisfactory identification,

has, while in my presence and while under oath or affirmation, voluntarily signed this document and
declared that it is true.
_______________________________
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, has, while in my presence and while under oath or affirmation, voluntarily signed this
document and declared that it is true.
_______________________________
Sign here
Date
Typed or printed name (Court Clerk or Notary Public)
Notary Seal

_______________________________
_______________________________