SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF PART ------------------------------------------------------------------------ -X Plaintiff, Index No.: - against - STIPULATION FOR REFERRAL TO Defendant. FAMILY CASE ANALYST ------------------------------------------------------------------------ -X J.: It is hereby stipulated and agreed by and between the parties in consultation with their respective attorneys, and by their attorneys, as follows: 1. The parties shall meet with the Courts Family Case Analyst, C.S.W., for the purpose of mediating and resolving their outstanding differences with regard to custody/visitation of their child(ren). Such meetings, in the Family Case Analysts discretion, may be together or separate, with or without co unsel. 2. All statements made by the parties in context of the meeting(s) contemplated herein shall be deemed to be made solely for the purpose of settlement and shall not be admissible at any hearing or trial in this or any other court or tribunal. The trial court will not ask the Family Case Analyst for either a written or oral report with regard to this matter and the Family Case Analyst shall not be called as a witness by either party or the court. OR 3. This/These issue(s) is/are hereby referred to the Family Case Analyst for possible resolution. If the issue(s) is/are not resolved, the court may call upo n the Family Case Analyst to render a written or oral report concerning his/her findings or recommendations. If the Family Case Analyst issues a written report, he/she may be subpoe naed by either party with regard to his/her expert opinion or statements made by the parties. Any oral report issued by the Family Case Analyst to the Court in reporting the s tatus of his/her efforts and the relative positions of the parties shall not subject the Family Case Analyst to being called as a witness. Attorney/Witness Plaintiff Attorney/Witness Defendant Law Guardian SO ORDERED: Dated: , New York Justice Supreme Court FCA#1 September 2004 American LegalNet, Inc. www.USCourtForms.com