California > Local County > Contra Costa > Alternative Dispute Resolution
Mediation Statement (To Inform Panel Member) ADR-304 - California
| Mediation Statement (To Inform Panel Member) Form. This is a California form and can be used in Alternative Dispute Resolution Contra Costa Local County . |
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PARTY: (Name and Address): TELEPHONE NO: E-MAIL ADDRESS (Optional): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF CONTRA COSTA MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NAME: P.O. BOX 911 MARTINEZ, CA 94553 MARTINEZ DO NOT SEND THIS FORM TO THE COURT CASE NUMBER: MEDIATION STATEMENT PARTIES MUST PREPARE AND GIVE INFORMATION ABOUT THEIR CASE TO THE MEDIATOR AND THE OTHER PARTIES AT LEAST FIVE COURT DAYS BEFORE THE MEDIATION CONFERENCE. YOU MAY USE THIS FORM OR WRITE THE INFORMATION ON YOUR OWN PAPER. MEDIATION STATEMENTS MUST BE 5 PAGES OR LESS. 1. The name and title (or relationship to the case) of all people who will attend mediation are as follows: _______________________________________________ _______________________________________________ (NAME) _______________________________________________ (NAME) _______________________________________________ (NAME) _______________________________________________ (NAME) (TITLE) _______________________________________________ (TITLE) _______________________________________________ (TITLE) _______________________________________________ (TITLE) More information attached to this form. 2. People who are connected with this case or who, if present at mediation, might improve the chances of settlement are: _______________________________________________ _______________________________________________ (NAME) _______________________________________________ (NAME) _______________________________________________ (NAME) (TITLE) _______________________________________________ (TITLE) _______________________________________________ (TITLE) More information attached to this form. 3. The important issues in this case are as follows: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ More information attached to this form. ADR-304 Rev. 10/4/12 American LegalNet, Inc. www.FormsWorkFlow.com 4. I believe that the liability and damages in this case are as follows: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ More information attached to this form. 5. Narrowing or resolving these issues early would make it easier to settle this case: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ More information attached to this form. 6. Summary of the history of this case and any settlement discussions: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ More information attached to this form. 7. I have attached the following documents to help the mediator better understand the issues in dispute: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ More information attached to this form. 8. Other comments: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ More information attached to this form. Date: _______________________________________________ (TYPE OR PRINT NAME OF PARTY SUBMITTING THIS MEDIATION STATEMENT) _______________________________________________ (SIGNATURE OF PARTY SUBMITTING THIS MEDIATION STATEMENT) American LegalNet, Inc. www.FormsWorkFlow.com ADR-304 Rev. 10/4/12
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