ADR-107 - Attendance Sheet for Court-Program Mediation of Civil Case

Summary

Attendance Sheet for Court-Program Mediation of Civil Case

Text

Form ID: ADR-107
Title: Attendance Sheet for Court-Program Mediation of Civil Case
Effective Date: 2009-07-01
Mandatory Form: no
Info Page: https://selfhelp.courts.ca.gov/jcc-form/ADR-107
Primary Download URL: https://www.courts.ca.gov/documents/adr107.pdf
Form Detail Page:
Attendance Sheet for Court-Program Mediation of Civil Case
(ADR-107)
People in a court mediation give the mediator and the court their contact information.
Get form ADR-107
Effective: July 1, 2009
PDF Text:
ADR-107
ATTENDANCE SHEET FOR COURT-PROGRAM MEDIATION OF CIVIL CASE
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
MEDIATOR:
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
CASE NUMBER: MEDIATION SESSION DATES:
Please provide your name, mailing address, telephone number, and e-mail address and indicate your role in the mediation so that the 
mediator or the court may contact you concerning this mediation if the need arises. This information will not be released or used for 
other purposes. (Multiple attendance sheets may be used to preserve the confidentiality of the participants' contact information.)
NAME AND MAILING ADDRESS
Name
Street
City State Zip Code
TELEPHONE AND E-MAIL
Phone (        )            -
E-mail
ROLE IN MEDIATION
Party Attorney
Insurance Representative
Other:
NAME AND MAILING ADDRESS
Name
Street
City State Zip Code
TELEPHONE AND E-MAIL
Phone (        )            -
E-mail
ROLE IN MEDIATION
Party Attorney
Insurance Representative
Other:
NAME AND MAILING ADDRESS
Name
Street
City State Zip Code
TELEPHONE AND E-MAIL
Phone (        )            -
E-mail
ROLE IN MEDIATION
Party Attorney
Insurance Representative
Other:
NAME AND MAILING ADDRESS
Name
Street
City State Zip Code
TELEPHONE AND E-MAIL
Phone (        )            -
E-mail
ROLE IN MEDIATION
Party Attorney
Insurance Representative
Other:
NAME AND MAILING ADDRESS
Name
Street
City State Zip Code
TELEPHONE AND E-MAIL
Phone (        )            -
E-mail
ROLE IN MEDIATION
Party Attorney
Insurance Representative
Other:
NAME AND MAILING ADDRESS
Name
Street
City State Zip Code
TELEPHONE AND E-MAIL
Phone (        )            -
E-mail
ROLE IN MEDIATION
Party Attorney
Insurance Representative
Other:
Additional page(s) attached.
Form Approved for Optional Use 
Judicial Council of California 
ADR-107 [Rev. July 1, 2009]
ATTENDANCE SHEET FOR COURT-PROGRAM 
MEDIATION OF CIVIL CASE 
(Alternative Dispute Resolution)
Cal. Rules of Court, rule 3.860

Retrieval chunks

• #1

  Form ID: ADR-107 Title: Attendance Sheet for Court-Program Mediation of Civil Case Effective Date: 2009-07-01 Mandatory Form: no Info Page: https://selfhelp.courts.ca.gov/jcc-form/ADR-107 Primary Download URL: https://www.courts.ca.gov/documents/adr107.pdf Form Detail Page: Attendance Sheet for Court-Program Me…