Utah Code § 78B-18a-106: Form of unsworn declaration.

An unsworn declaration under this chapter must be in substantially the following form:

I declare under criminal penalty under the law of Utah that the foregoing is true and correct.

Signed on the ___ day of ______, _____, at ________________________________.

Date

Month Year City or other location, and state or country

________________________

Printed name

________________________

Signature