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Alternative Initial Case Managment Statement FAM-104 - Minnesota

Alternative Initial Case Managment Statement Form. This is a Minnesota form and can be used in Dissolution District Court Statewide .
 Fillable pdf Last Modified 1/3/2014
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State of Minnesota County Judicial District: Court File Number: Case Type: District Court In Re the Marriage of: In Re the Custody of: Petitioner Alternative Initial Case Management Statement (Use if one or both Parties do not have an Attorney) Minn. Gen. R. Prac. 304.02 Respondent 1. This form is being filled out: Jointly (both parties together) Separately Check or complete the following if they apply. A Petition for an Order for Protection has been filed by one party against the other party at some time during the marriage or relationship. An Order for Protection is in effect. is the court file number for the Order for Protection. 2. Please identify any party or witness who will require interpreter services, and describe the services (specifying language and, if known, particular dialect) needed. FAM104 State ENG 05/12 www.mncourts.gov/forms Page 1 of 10 American LegalNet, Inc. www.FormsWorkFlow.com 3. CHILDREN a. Do you have joint children? No Yes If no, skip to Question 4. If yes, how many? List the age of each joint child b. If there are joint children: Do any of the joint children have special needs? If yes, please explain: Yes Yes Yes No No No Do you agree on a parenting time schedule? Do you agree who will have custody? children. c. Please indicate if one or both parties, or any child has an emotional or physical disability, or is addicted to or abuses alcohol and/or drugs and this affects the welfare of the Husband Wife Children d. Please explain what custody and/or parenting time plan is best for the joint children. (If you cannot agree, each person should submit separate plans). 4. CHILD SUPPORT AND SPOUSAL MAINTENANCE a. Do you agree on the amount of child support? If there are no joint children involved in this action, check the box "Not Applicable." FAM104 State ENG 05/12 www.mncourts.gov/forms Page 2 of 10 American LegalNet, Inc. www.FormsWorkFlow.com Yes Yes No No Not Applicable If yes, is the amount agreed upon pursuant to the child support guidelines? If no, please explain why not: b. Do you agree on the amount of spousal maintenance? (applies only to marriage dissolution matters) Yes No Not Applicable If no, please explain why or why not: 5. ASSET AND DEBT INFORMATION (applies only to marriage dissolution matters) a. Are you satisfied that you have sufficient information about your assets and debts to make an informed decision about how they should be divided? Yes Agree Home Business No Disagree Not Applicable If yes, do you agree or disagree about how the assets and debts should be divided? If no, check the following items that still need to be evaluated. Retirement benefits & pensions (including 401K plans, IRA's, deferred compensation) FAM104 State ENG 05/12 www.mncourts.gov/forms Page 3 of 10 American LegalNet, Inc. www.FormsWorkFlow.com Savings and checking accounts Life insurance policies Stock options, bonds, mutual funds, etc. Personal property Automobiles and trucks Boats, motorcycles, snowmobiles, etc. Collectibles Vacation property Other b. Do you agree on how to divide the debts from the marriage? Yes No If no, estimate the total debt: c. Have you filed or do you plan on filing for bankruptcy? Yes Yes No No Not Applicable 6. FINAL HEARING BY DEFAULT (applies only to marriage dissolution matters) The parties are in agreement on all matters and this dissolution will proceed by default. If you answered yes, please check all of the following that apply: Default hearing by General Rules of Practice, Rule 306. Marriage includes joint children Approval without a hearing pursuant to Minn. Stat. § 518.13, subd. 5(2006). The marriage includes joint children, each party is represented by a lawyer and each party has signed a stipulation. The marriage does not include joint children and each party has signed a stipulation. FAM104 State ENG 05/12 www.mncourts.gov/forms Page 4 of 10 American LegalNet, Inc. www.FormsWorkFlow.com The marriage does not include joint children, at least 50 days have passed since service of the Summons and Petition, and the Respondent has not appeared in the action. 7. ALTERNATIVE DISPUTE RESOLUTION (ADR) (NOTE: ATTORNEYS ANSWER QUESTIONS 9 ­ 12) a. Did you and the other party meet with a mediator or other person to help resolve disagreement about your children or property? Yes No Property / Financial problems Custody problems Parenting time problems If yes, what was discussed? b. Is the person you met with on the Supreme Court's roster of qualified neutrals? Yes No to discuss case (date) c. MEETING: The parties (or their attorneys) met on management issues. d. ADR PROCESS: (check one) (descriptions can be obtained from the court administrator) You Both Parties Agree that Alternative Dispute Resolution (ADR) is appropriate and choose the following: Mediation Arbitration (non-binding) Arbitration (binding) Mediation / Arbitration Early Neutral Evaluation Moderated Settlement Conference FAM104 State ENG 05/12 www.mncourts.gov/forms Page 5 of 10 American LegalNet, Inc. www.FormsWorkFlow.com Mini-Trial Summary Jury Trial Consensual Special Magistrate Impartial Fact-Finder Other (describe) You You Both Parties Both Parties Agree that ADR is appropriate but request that the Court select the process. Agree that ADR is NOT appropriate because: the case implicates the federal or state constitution other (explain with particularity) domestic violence has occurred between the parties e. PROVIDER (check one): You Both parties Have selected the following ADR neutral: FAM104 State Cannot agree on an ADR neutral and request the Court to appoint one. Agree to select an ADR neutral on or before (date) f. DEADLINE (check one) ENG 05/12 www.mncourts.gov/forms Page 6 of 10 American LegalNet, Inc. www.FormsWorkFlow.com You Both Parties (date) Recommend that the ADR process be completed by 8. List any other information which may help the court schedule your dissolution, if necessary: Note: both parties must submit this form, together on one form, or separately. Signature of Pro Se Petitioner Signature of Pro Se Respondent Address Address City, State, Zip Code City, State, Zip Code Telephone Date Telephone Date FAM104 State ENG 05/12 www.mncourts.gov/forms Page 7 of 10 American LegalNet, Inc. www.FormsWorkFlow.com THE NEXT THREE PAGES ARE TO BE COMPLETED BY ATTORNEYS ONLY. 9. It is estimated that the discovery specified can be completed within months from the date of this form. (check all that apply and supply estimates where indicated.) a. Inter
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