ADR-101 - ADR Information Form

Summary

ADR Information Form

Text

Form ID: ADR-101
Title: ADR Information Form
Effective Date: 1994-03-01
Mandatory Form: yes
Info Page: https://selfhelp.courts.ca.gov/jcc-form/ADR-101
Primary Download URL: https://www.courts.ca.gov/documents/adr101.pdf
Form Detail Page:
ADR Information Form
(ADR-101)
Tell the court about the results of using mediation, arbitration, or another ADR (alternative dispute resolution) process to try to settle your civil case.
Get form ADR-101
Effective: March 1, 1994
PDF Text:
Form Adopted by the  
Judicial Council of California  
ADR-101 [New March 1, 1994]
ADR INFORMATION FORM
 NAME OF COURT:
ADR Information Form
This form should be filled out and returned,  
within 10 days of the resolution of the dispute, to: 
1. Case name: No.
2. Type of civil case:   PI/PD-Auto   PI/PD-Other Contract Other (specify):
3. Date complaint filed Date case resolved
4. Date of ADR conference 5. Number of parties
6. Amount in controversy  $0–$25,000  $25,000–$50,000  $50,000–$100,000  over $100,000 (specify):
7.   Plaintiff's attorney  Cross Complainant's Attorney
NAME
ADDRESS
TELEPHONE NUMBER
8. Defendant's Attorney Cross Defendant's Attorney
NAME
ADDRESS
TELEPHONE NUMBER
9. Please indicate your relationship to the case:
Plaintiff Plaintiff's attorney Defendant Defendant's attorney
3rd party defendant 3rd party defendant's attorney Other (specify):
10. Dispute resolution process:
Mediation Arbitration Neutral case evaluation Other (specify):
11. How was case resolved?
a. As a direct result of the ADR process.
b. As an indirect result of the ADR process. c. Resolution was unrelated to ADR process.
12. Check the closest dollar amount that you estimate you saved (attorneys fees, expert witness fees, and other costs) by using 
this dispute resolution process compared to resolving this case through litigation, whether by settlement or trial.
$0 $250 $500 $750 $1,000 more than $1,000 (specify): $
13. If the dispute resolution process caused a net increase in your costs in this case, check the closest dollar amount of the 
additional cost: 
$0 $250 $500 $750 $1,000 more than $1,000 (specify): $
14. Check the closest number of court days that you estimate the court saved (motions, hearings, conferences, trial, etc.) as a 
result of this case being referred to this dispute resolution process:
0 1 day more than 1 day (specify):
15. If the dispute resolution process caused a net increase in court time for this case, check the closest number of additional 
court days:
0 1 day more than 1 day (specify):
16. Would you be willing to consider using this dispute resolution process again? Yes No

Retrieval chunks

• #1

  Form ID: ADR-101 Title: ADR Information Form Effective Date: 1994-03-01 Mandatory Form: yes Info Page: https://selfhelp.courts.ca.gov/jcc-form/ADR-101 Primary Download URL: https://www.courts.ca.gov/documents/adr101.pdf Form Detail Page: ADR Information Form (ADR-101) Tell the court about the results of using…

• #2

  15. If the dispute resolution process caused a net increase in court time for this case, check the closest number of additional court days: 0 1 day more than 1 day (specify): 16. Would you be willing to consider using this dispute resolution process again? Yes No