ALA ADR-003 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS: ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, ALAMEDA COUNTY STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME PLAINTIFF or PETITIONER: DEFENDANT or RESPONDENT: CASE NUMBER: NOTICE OF DISCOVERY FACILITATOR SELECTION FORM INSTRUCTIONS: Prior to filing this notice, one of the parties or their attorney must contact a discovery facilitator to verify that the facilitator has no conflicts and agrees to facilitate the matter by the discovery facilitation deadline. Parties or their attorneys must identify the case to the facilitator as a Superior Court of California, County of Alameda, Discovery Facilitation Program referral in order to qualify for program rates. All applicable boxes must be completed, and the specified information must be provided. E-mail completed and signed form to the Alternative Dispute Resolution program at the following address: adrprogram@alameda.courts.ca.gov Name of discovery facilitator selected: E-mail address of discovery facilitator selected: Parties or attorneys state that: a. They have contacted the above-mentioned discovery facilitator; b. They have identified the matter to the facilitator as a Superior Court of California, County of Alameda, Discovery Facilitation Program referral; and c. The facilitator has agreed to accept the case, serve according to the rules of the court's Discovery Facilitation Program, and complete the facilitation before (the completion deadline). I, , certify that all counsel and parties to this matter have complied with the above-listed instructions and agree with the selection of this facilitator. Date: (SIGNATURE) (TYPE OR PRINT NAME) Form Approved for Mandatory Use Superior Court of California, County of Alameda ALA ADR-003 [New July 1, 2015] American LegalNet, Inc. www.FormsWorkFlow.com