Colorado > Statewide > Domestic Relations
Certificate Of Mediation Or Alternative Dispute Resolution Compliance JDF 1119 - Colorado
| Certificate Of Mediation Or Alternative Dispute Resolution Compliance Form. This is a Colorado form and can be used in Domestic Relations Statewide . |
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District Court Denver Juvenile Court ________________________________ County, Colorado Court Address: In re: The Marriage of: Parental Responsibilities concerning: ______________________________________________________ Petitioner/Plaintiff(s): and Co-Petitioner/Respondent/Defendant(s): Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number: Phone Number: FAX Number: E-mail: Atty. Reg. #: Division Courtroom CERTIFICATE OF MEDIATION/ALTERNATIVE DISPUTE RESOLUTION COMPLIANCE This certificate certifies that the parties to this case have complied with the court's order to engage in Mediation/Alternative Dispute Resolution (ADR). Please list all parties who participated in the Mediation/ADR. 1. _________________________________________ 3. _________________________________________ 5. _________________________________________ 7. _________________________________________ 2.___________________________________________ 4. ___________________________________________ 6. ___________________________________________ 8. ___________________________________________ The parties listed above met with _______________________________ (name of Mediator/Arbitrator/Special Master) on _____________________________ (date(s)) for the Mediation/ADR process checked below. Mediation (ADRM) Med-arb (ADRB) ADR Settlement Conference (ADRC) Special Master (ADRR) Parenting Coordination (ADRG) Settlement Week (ADRS) Early Neutral Evaluation (ADRE) Child Support Worksheet Conference (ADRW) ADR other please describe (ADRO) ________________________________________________________ The following results occurred as a result of this Mediation/ADR process: Case Fully Resolved (ADRF) Case Partially Resolved (ADRP) No Issues Resolved (ADRN) ADR Inappropriate (ADRI) (ADR determined inappropriate by the Mediator/Arbitrator/Special Master; reasons may include the existence of domestic violence, incapacity of a party, or other specified reasons.) Date: ______________________________ ______________________________________ Signature of Party or Attorney CERTIFICATE OF SERVICE I certify that on _________________________ (date) the original was filed with the Court and a true and accurate copy of the Certificate of Mediation/ADR Compliance was served on the other party by Hand Delivery E-filed Faxed to this number ___________________ or by placing it in the United States mail, postage pre-paid, and addressed to the following: To: ______________________________________ ______________________________________ ______________________________________ JDF 1119 1/06 CERTIFICATE OF MEDIATION/ADR COMPLIANCE ______________________________________ (Your Signature) American LegalNet, Inc. www.FormsWorkflow.com
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