Note: If you need to fill out the Domestic Relations Injunction related Certificate of Service, you can use this tool to generate the document.
Before You Start: What This Form Actually Is
A quick but important clarification, because the names get confused often:
Form 1021FA is the "Certificate of Service – Family." It is not the injunction itself. It is the document you file to prove to the court that you delivered (served) court papers to the other party.
So why does it come up in connection with a divorce injunction?
When you file for divorce in Utah, the court automatically enters a Domestic Relations Injunction (DRI) under Utah Rule of Civil Procedure 109. This injunction restricts both spouses from things like harassing each other, hiding or transferring property, canceling insurance, or removing children from the state while the case is pending.
Here's the catch that makes Form 1021FA matter:
The injunction binds you (the Petitioner) the moment you file.
It does not bind your spouse (the Respondent) until they have been served a copy of it.
Form 1021FA (Certificate of Service) is how you document for the court that the Respondent received the injunction (usually along with the Summons, Petition, and other papers). In short: the injunction has no teeth against your spouse until they're served, and this form is your proof of service.
This article is general information, not legal advice. It explains how to complete the fields on the form. It does not tell you whether you should file it or what is best for your case. If you have questions about your specific situation, contact the Utah Courts Self-Help Center or a licensed Utah attorney.
When You Use Form 1021FA
You file a Certificate of Service whenever you deliver a document to the other party in your case and need to prove you did it. In a divorce, common moments include:
After serving the Domestic Relations Injunction, Summons, and Petition for Divorce on your spouse.
After filing and serving any later motion, financial declaration, or other paper.
Important exception: The initial Summons and Petition usually must be served by a neutral adult (a sheriff or professional process server) or accepted in writing by the Respondent — you generally cannot hand them over yourself. The Certificate of Service documents the delivery; it does not replace proper "service of process." See Serving Papers (Service of Process).
Where to Get the Form
From the official Utah Courts page for this form:
PDF version (fill in by hand or type, then print)
Fillable Word version (type directly, then save and print)
Form page: https://www.utcourts.gov/en/forms/forms/court-forms/form-detail.detail.html?formNumber=1021FA
Step-by-Step: Filling Out the Form
The form is three pages. Page 1 is the caption, Page 2 lists the documents you served, and Page 3 certifies that you served the Certificate itself.
Page 1 — Your Information and the Case Caption
Your contact block (top left):
Field | What to enter |
Name | Your full legal name |
Address / City, State, Zip | Your mailing address |
Phone | A number where the court can reach you |
An address you check regularly — the court sends documents here |
"I am" — check the one box that describes you:
Petitioner — you filed the case
Respondent — you are responding to a case filed against you
Petitioner's / Respondent's Attorney — fill in your Utah Bar number
Petitioner's / Respondent's Licensed Paralegal Practitioner — fill in the Bar number
Most people filing on their own check Petitioner or Respondent.
Court information:
Check District Court (divorce cases are filed in District Court, not Justice Court).
Enter the Judicial District number and the County where you filed.
Enter the Court Address.
Not sure which district or county? It must match the court where your divorce was filed. Check your existing case paperwork or look it up at the Utah court directory.
"In the Matter of" — check the box that matches your case:
the Marriage of — for a divorce, annulment, separate maintenance, or temporary separation (this is the box for a divorce)
the Children of — to establish custody, parent-time, or child support
the Parentage of the Children of — for a paternity case
Then fill in:
Name of Petitioner
Name of Respondent
Other parties (only if any)
Case identifiers (must match your existing paperwork exactly):
Case Number
Judge
Commissioner (domestic cases are often assigned a commissioner — copy it from your filings if shown)
The certification line:
"I certify that I served a copy of ____ (document name), which was filed with the court on ____ (date)."
Document name: Write the exact title of what you served. If you served the injunction, write its full name, e.g., "Domestic Relations Injunction." If you served several documents, you can list them or name the lead document and itemize the rest.
Date filed with the court: The date that document was filed (not the date you served it — that goes in the table below).
Page 2 — How and When You Served the Documents
This page has a table. Complete one row per person you served. For each person:
Column | What to enter |
Person's Name | The full name of the person served (usually your spouse, the Respondent — or their attorney if they have one) |
Method of Service | Check the box that matches how you delivered it (see below) |
Served at this Address | The exact address (or email) where you delivered it |
Served on this Date | The actual date of delivery |
Method of Service options:
Mail — mailed to their last known address
Hand Delivery — physically handed to them
E-filed — delivered through the court's electronic filing system
Email — sent by email (allowed in many situations once a case is underway)
Left at business — left with the person in charge or in a delivery receptacle
Left at home — left with someone of suitable age and discretion who lives there
Match the method to what the rules allow. If the other party has filed an answer or is represented by an attorney, email or e-filing is often acceptable. For the first service of the divorce papers, stricter personal-service rules apply (see the service-of-process note above).
Sign the bottom of Page 2:
Signature — sign here
Date — the date you sign
Printed Name — print your name
Page 3 — Certificate of Service for This Certificate
This page certifies that you are also delivering a copy of this Certificate of Service to the other party. The statement reads: "I certify that I filed with the court and am serving a copy of this Certificate of Service on the following people."
Fill in the same kind of table:
Column | What to enter |
Person's Name | Each person getting a copy of this Certificate |
Service Method | Mail / Hand Delivery / E-filed / Email / Left at business / Left at home |
Service Address | Where you sent it |
Service Date | The date you sent it |
Sign the bottom of Page 3 the same way: signature, date, printed name.
After You Complete the Form
Make copies. Keep one for yourself and provide one to each party you listed.
File it with the court in the same case, using the same filing method you've used for your other documents (e-filing, in person, or as your court directs).
Keep your proof. Retain mailing receipts, email confirmations, or process-server affidavits. If service is ever challenged, this is your backup.
Common Mistakes to Avoid
Confusing the "filed" date with the "served" date. Page 1 asks when the document was filed; Page 2 asks when it was served. They are usually different.
Listing the wrong document name. Use the exact title of what you served — vague entries like "court papers" can cause problems.
Using self-service for the initial divorce papers. The first Summons and Petition normally require a neutral server, not you. The Certificate documents delivery; it doesn't override how service must be done.
Case caption mismatches. Case number, county, district, names, and commissioner must match your existing filings exactly.
Forgetting to sign both Page 2 and Page 3. Both signature blocks need to be completed.
Related Resources (Official Utah Courts)
This form's page: Certificate of Service – Family (1021FA)
The injunction: Domestic Relations Injunction
Service rules: Serving Papers (Service of Process)
Help: Utah Courts web navigator / Self-Help Center — (801) 238-7990, Monday–Friday 9:00 a.m.–4:30 p.m.
This article is provided for general informational purposes and is not legal advice. Court rules and forms change; always confirm against the current version on utcourts.gov before filing.