Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: ATLAS Number: Lawyer222s Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case No. Petitioner / Party A ATLAS No. Respondent / Party B ALTERNATIVE DISPUTE RESOLUTION STATEMENT TO THE COURT A.R.F.L.P. 66(E) Check appropriate box below: Party A222s Statement Party B222s Statement Joint Statement (signed by both parties) Pursuant to the Arizona Rules of Family Law Procedure, we hereby state the following, under penalty of perjury: 1. The parties agree to participate in the following Alternative Dispute Resolution (ADR) process and: a. have selected the following ADR process: Arbitration Mediation Settlement Conference Other: b. The parties will use a private provider OR The parties request a program provided through the court. c. The person or company providing the ADR service is: d. The parties expect to complete the ADR process by . 2. The parties have been unable to agree on an ADR process. Party A Party B believe(s) that the following ADR process would be appropriate: Party A Party B request(s) a conference to discuss ADR. Party A Party B believe(s) that an ADR process would not be appropriate for the following reason: Date Party A Date Party B FOR CLERK222S USE ONLY 251Superior Court of Arizona in Maricopa County Page 1 of 1 DRAD10f - 061917 ALL RIGHTS RESERVED Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com