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Mediator Report CCCH 0132 - Illinois
| Mediator Report Form. This is a Illinois form and can be used in Chancery Cook Local County . |
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Print Form Clear Form Mediator Report (Form 6) IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, CHANCERY DIVISION (12/22/06) CCCH 0132 ____________________________________________________ Plaintiff(s) v. ____________________________________________________ Defendant(s) } 3488 No. ________________________________ _______________________________ Judge Judge's No. MEDIATOR REPORT (To be completed at the end of each mediation and filed with the Court, with a courtesy copy delivered to the Chancery Division Court-Annexed 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 Type: Administrative Review Class Actions Commercial Litigation Condominium Disputes Construction Law Corporations/Partnerships Employment Agreements General Tort Insurance Coverage Mechanics Liens Medical Malpractice Mortgage Foreclosures Municipal/Public Sector Law Case Number: ___________________________ Employment (Wrongful Termination) Neighbor Disputes Personal Injury Products Liability Probate Real Property Disputes 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:______/______/______ D. Hours in mediation:__________ Hours of preparation:__________ E. How many from each category attended? Number of sessions: _______ _______ Lawyers _______ Clients _______ Non-Parties (please list, e.g., witnesses, spouse) ____________________ __________________________________________________________________________________ __________________________________________________ Signature of Mediator Dated: ____________________________, _________ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
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