Adjusters Supply
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Utah Citation & Complaint

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UTAH CITATION AND COMPLAINT (Form UT-17-5) is a five-part citation. (Price Group 16) The face of all five copies is shown at right.

The back of the first copy ("Traffic Court Copy") contains a waiver of formal information. The back of the second copy ("Court Copy") has information for the Driver License Services. The back of the third copy ("Defendant Copy") contains a notice to violator and instructions. The back of the fourth copy ("Department Copy") is blank. The back of the fifth copy ("Officer Copy") has space for notes and diagrams.

The citation is approximately 9 inches by 5 inches before being torn at the perforation and is booked in sets of twenty-five. Each book is numbered on the outside to aid your record-keeping. As with all our tickets, there is no extra charge for consecutive numbering and up to five lines of crash imprinting. Stock tickets are shipped within seven business days from time the order is received.

To obtain a free sample call 1-800-527-0340 or email

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