COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : : Plaintiff(s) -against- Calendar No. JUDICIAL SUBPOENA : UNITED STATES DISTRICT COURT : CENTRAL DISTRICT OF CALIFORNIA CASE NUMBER : Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .PLAINTIFF(S). . . . . . . . . ......... v. ADR PILOT PROGRAM QUESTIONNAIRE THE PEOPLE OF THE STATE OF NEW YORK DEFENDANT(S). TO (1) What, if any, discovery do the parties believe is essential in order to prepare adequately for a settlement conference or mediation? Please outline with specificity the type(s) of discovery and proposed completion date(s). Please outline any areas of disagreement in this regard. Your designations do not limit the discovery GREETINGS: that you will be COMMAND in the event this case doesexcuses being laid aside, you and each of you attend before WE able to take YOU, that all business and not settle. , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (2) What are the damage amounts being claimed by each plaintiff? Identify the categories of damage claimed [e.g., lost profits, medical expenses (past and future), (Attorney must (past and future), emotional distress, lost wages sign above and type name below) damage to reputation, etc.] and the portion of the total damages claimed attributed to each category. Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: ADR-9 (02/04) ADR PILOT PROGRAM QUESTIONNAIRE American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. (3) Do the parties agree to utilize a private mediator in lieu of the court’s ADR Pilot Program? : Yes G Calendar No. : JUDICIAL SUBPOENA No G Plaintiff(s) -against- : (4) If this case is in category civil rights - employment (442), check all boxes that describe the legal bases of plaintiff claim(s). : G Title VII G Age Discrimination : G 42 U.S.C. §1983 Defendant(s) G California Fair Employment and Housing Act : ...................................................... G Americans with Disabilities Act of 1990 G Rehabilitation Act G Other THE PEOPLE OF THE STATE OF NEW YORK TO I hereby certify that all parties have discussed and agree that the above-mentioned responses are true and GREETINGS: correct. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed Date adjourned date, to testify and give evidence as a witness Plaintiff (Signature) of the Attorney for in this action on the part or Attorney for Plaintiff (Please print full name) Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Date Witness, Honorable Court in County, Attorney for Defendant (Signature) the Justices of the , one of day of , 20 Attorney for Defendant (Please print full name) (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: ADR-9 (02/04) ADR PILOT PROGRAM QUESTIONNAIRE American LegalNet, Inc. www.USCourtForms.com