Information and Application Documents
Please type your answers. The application and agreement are fillable forms. Fill them out, print and sign them. UPC is not equipped to accept on-line applications and will not accept faxed or e-mailed applications. No handwritten application will be considered.
Please Note: If you click on a link in the document while filling it out online, it will take you to the page referenced by the link and you will LOSE everything you have typed into the form up to that time (unless you have saved it before clicking on the link). There are 3 ways to avoid this problem:
- Save your data before clicking on any link.
- Download the form first, then open it in your PDF reader. If you click on links at this point, it will take you to them without affecting the form or the data entered in it.
- If you fill it out online, then right-click on the link and then click on Open in New Tab or Open in New Window. That will open the link in a new tab or window and will leave your data intact.
Utah JRJ Benefit Application
Service Agreement Requirement
All persons receiving repayment assistance will be required to sign and submit ONE of the following:
- 1st Year Service Agreement - New Applicant
- 2nd Year Service Agreement
- 3rd Year Service Agreement
- 4th or Subsequent
The completed and signed JRJ Benefits Application Form, the signed service agreement and all other supporting documents, must be received by Utah Prosecution Council no later than 5:00 pm on Friday, February 18, 2022. No application received after that date will be considered.