Utah Code § 78B-7-105.5

Forms for motions, criminal protective orders, and criminal stalking
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injunctions.
(1)
(a) The offices of the court clerk shall provide forms to an individual seeking any of the following
under this chapter:
(i) a criminal protective order; or
(ii) a criminal stalking injunction.
(b) The Administrative Office of the Courts shall:
(i) develop and adopt uniform forms for motions and protective orders and stalking injunctions
described in Subsection (1)(a) in accordance with the provisions of this chapter; and
(ii) provide the forms to the clerk of each court authorized to issue the protective orders and
stalking injunctions described in Subsection (1)(a).
(2) The forms described in Subsection (1)(b) shall include:
(a) language indicating the criminal penalty for a violation of a criminal protective order or criminal
stalking injunction under this chapter;
(b) language indicating that a criminal protective order that is a continuous protective order may
be modified or dismissed under this chapter; and
(c) a space to indicate whether the party to be protected is an intimate partner to the defendant or
a child of an intimate partner to the defendant.
(3) A criminal protective order and criminal stalking injunction shall be issued in the form adopted
by the Administrative Office of the Courts under Subsection (1)(b).
(4) Except for a jail release agreement and jail release court order, a criminal protective order that
is issued shall, if applicable, include the following language:
 "Respondent was afforded both notice and opportunity to be heard in the hearing that
gave rise to this order. Pursuant to the Violence Against Women Act of 1994, P.L. 103-322,
108 Stat. 1796, 18 U.S.C. Sec. 2265, this order is valid in all the United States, the District
of Columbia, tribal lands, and United States territories. This order complies with the Uniform
Interstate Enforcement of Domestic Violence Protection Orders Act."

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