Uniform Counsel Certification {CCF}

Commonwealth of Massachusetts __________ Division The Trial Court Probate and Family Court Department Docket No. UNIFORM COUNSEL CERTIFICATION FORM Case Caption: I am attorney-of-record for: plaintiff/defendant/petitioner in the above-entitled matter. In accordance with Rule 5 of the Supreme Judicial Court Uniform Rules on Dispute Resolution (SJC Rule 1:18) which states in part: . ''...Attorneys shall provide their clients with this information about court-connected dispute resolution services; discuss with their clients the advantages and disadvantages of the various methods of dispute resolution; and certify their compliance with this requirement on the civil cover sheet or its equivalent.'' I hereby certify that I have complied with this requirement. Signature of Attorney-of-Record Print Name B.B.O.# Date: INSTRUCTIONS: Plaintiff 's/Petitioner's counsel shall file this document at the time his/her initial pleading is filed. All other counsel shall file it within thirty (30) days of his/her initial entry into the case whether by answer, motion, appearance slip or other pleading. CCF (3/00) mcpfc-c.g.f. American LegalNet, Inc. www.FormsWorkflow.com