Domestic Violence Screening For Referral To Mediation {MC 282} | Pdf Fpdf Doc Docx | Michigan

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Domestic Violence Screening For Referral To Mediation {MC 282} | Pdf Fpdf Doc Docx | Michigan

Domestic Violence Screening For Referral To Mediation {MC 282}

This is a Michigan form that can be used for Alternative Dispute Resolution within Statewide.

Alternate TextLast updated: 8/16/2006

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Approved, SCAO STATE OF MICHIGAN CASE NO. JUDICIAL DISTRICT DOMESTIC VIOLENCE SCREENING JUDICIAL CIRCUIT FOR REFERRAL TO MEDIATION COUNTY PROBATE Court address Court telephone no.Plaintiff name Defendant name v Plaintiff attorney, bar no., address, and telephone no. Defendant attorney, bar no., address, and telephone no.Note: If you have an attorney, this form should be completed with your attorney. Please return this completed form to the ADR clerk at the above court ad dress within 7 business days. Instructions: If there are any actions involving you or the other party, specify the names of the persons involved, the case number,the name of the court where the action was filed including the county an d state. If there are no actions, write "NONE". 1. I am aware of the following personal protection actions involving myself and/or the other party: 2. I am aware of the following domestic violence criminal actions involving myself and/or the other party: 3. I am aware of the following pending child protective (abuse /neglect) actions involving myself and/or the other party: Date Signature American LegalNet, Inc.MC 282 (3/01) DOMESTIC VIOLENCE SCREENING FOR REFERRAL TO MEDIATION www.USCourtForms.com

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