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Stipulation For Referral To Family Law Mediation Center YOCV 0220 - California
| Stipulation For Referral To Family Law Mediation Center Form. This is a California form and can be used in Family Yolo Local County . |
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Name, Address, Telephone # State Bar # FOR the USE of the ALONE COURT Attorney for: SUPERIOR COURT OF CALIFORNIA, COUNTY OF YOLO Plaintiff(s): Case Number: Defendant(s): STIPULATION FOR REFERRAL TO FAMILY LAW MEDIATION COUNSELOR IT IS HEREBY STIPULATED by the parties hereto: 1. The matter is referred to a Court appointed mediation counselor to undertake a mediation counseling program. Areas of dispute: 2. The Court and the parties waive their right to confidentiality as to any communication made to the counselor during this mediation. All mediation is at the expense of the parties. Signature of Petitioner Petitioner (Print) Address, City, Zip Code Telephone Attorney for the Petitioner Address, City, Zip Code Telephone Preferred Counseling Agency It is ordered that the matter be set for mediation and that the counselor's report shall be filed and a copy provided to each attorney on or before: Date: JUDGE Distribution: Court file - original Petitioner/Attorney - 1 copy Respondent/Attorney - 1 copy Mediator - 1 copy Rev. 9/99 Signature of Respondent Respondent (Print) Address, City, Zip Code Telephone Attorney for Respondent Address, City, Zip Code Telephone YOCV 0220 Stipulation for Referral to Family Law Mediation Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com
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