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Mediator Report CCL 0132 - Illinois
| Mediator Report Form. This is a Illinois form and can be used in Law Cook Local County . |
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Mediator Report (Form 6) (3/09/04) CCL 0132 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION 3488____________________________________________________ Plaintiff(s) No. ________________________________ v. ___________________________________________________________________________________} Defendant(s) Judge Judges No. MEDIATOR REPORT (To be completed at the end of each mediation and filed with the Court, with a courtesy copy delivered to the Court- Annexed Civil Mediation Supervisor, pursuant to Illinois Supreme Court Rule 99 as a mechanism for reporting to the Supreme Court on the mediation program.) Mediator Name: _____________________________________Case Number: ____________________________ Case Type: Personal Injury Medical Malpractice Products Liability General Tort Commercial Construction Real Property Disputes Employment/Wrongful Termination Probate Chancery Other (list below) ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ The undersigned mediator, selected by the attorney/s appointed by the Court pursuant to the Order entered on the________ day of ____________________________, _________ reports to the Court as follows: A. A settlement of this matter has been reached has been reached in part has not been reached B. (If a settlement was reached) The party designated to prepare the settlement agreement and stipulation to dismiss is ______________________ _______________________________; to be submitted to the court by __________________________, ________ (Date) C. Date mediation began:______/______/______ Date ended:______/______/______Number of sessions: _______ D. Hours in mediation:__________ Hours of preparation:__________ E. How many from each category attended? _______ Lawyers _______ Clients _______ Non-Parties (please list, e.g., witnesses, spouse) ____________________ __________________________________________________________________________________ __________________________________________________Dated: ____________________________, _________ Signature of Mediator DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
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