Oregon > Statewide > Circuit Court > Family Law > Miscellaneous
Request For Mediation And Order (6H) - Oregon
| Request For Mediation And Order (6H) Form. This is a Oregon form and can be used in Miscellaneous Family Law Circuit Court Statewide . |
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IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of the Marriage of: ________________________________, Petitioner, and ________________________________, Respondent. ) ) ) ) ) ) ) ) Case No. ______________________ REQUEST FOR MEDIATION and ORDER The parties to this case do not agree upon custody and/or parenting time. I, mother father, request that the court send us to a mediator. The contact address and contact telephone for each parent is: Mother: Father: Dated: Petitioner Respondent, Signature ORDER Allowed. Denied. The parents are hereby ordered to contact and schedule a mediation with by the following time/date : . DATED this ______ day of ___________________, 20_______. Circuit Court Judge Print Name REQUEST FOR MEDIATION and ORDER - Page 1 of 2 6D-Z.MiscForms: 6H-Med-ReqVer02.doc (2/08) American LegalNet, Inc. www.FormsWorkflow.com I certify that I mailed a true copy of this Request for Mediation to the other parent by placing a copy in a stamped envelope in the US Mail on_________________(insert date of mailing) addressed to mother father at the address listed above. Certificate of Document Preparation. You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks that apply: I selected this document for myself and I completed it without paid assistance. I paid or will pay money to for assistance in preparing this form. Petitioner Respondent, Signature Submitted by: Petitioner Respondent, Print Name Address or Contact Address City, State, Zip Telephone or Contact Telephone REQUEST FOR MEDIATION and ORDER - Page 2 of 2 6D-Z.MiscForms: 6H-Med-ReqVer02.doc (2/08) American LegalNet, Inc. www.FormsWorkflow.com
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