SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE RULES ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): DO NOT SEND THIS FORM TO THE COURT TELEPHONE NO: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE Butte County Courthouse One Court Street Oroville, CA 95965 (530) 538-7002 Chico Courthouse 655 Oleander Chico, CA 95926 (530) 532-7009 PETITIONER/PLAINTIFF(S): RESPONDENT/DEFENDANT(S): MEDIATION STATEMENT CASE NUMBER: PARTIES MUST PREPARE AND GIVE INFORMATION ABOUT THEIR CASE TO THE MEDIATOR AND THE OTHER PARTIES AT LEAST FIVE (5) COURT DAYS BEFORE THE MEDIATION HEARING. YOU MAY USE THIS FORM OR WRITE THE INFORMATION ON YOUR OWN PAPER. MEDIATION STATEMENTS MUST BE FIVE (5) PAGES OR LESS. 1. The name and title (or relationship to the case) of all people who will attend mediation are as follows: ________________________________________ (NAME) ________________________________________ (TITLE) ________________________________________ (NAME) ________________________________________ (TITLE) ________________________________________ (NAME) ________________________________________ (TITLE) ________________________________________ (NAME) ________________________________________ (TITLE) More information attached to this form 2. People who are connected with this case or who, if present at mediation, might improve the chance of settlement are: ________________________________________ (NAME) ________________________________________ (TITLE) ________________________________________ (NAME) ________________________________________ (TITLE) ________________________________________ (NAME) ________________________________________ (TITLE) More information attached to this form 3. The important issues in this case are as follows: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ More information attached to this form (RUL-6-ADR.010 ) Page 1 of 2 (E.D. 7-1-10) Optional MEDIATION STATEMENT American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE RULES 4. I believe that the liability and damages in this case are as follows: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ More information attached to this form 5. Narrowing or resolving these issues early would make it easier to settle this case: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ More information attached to this form 6. Summary of the history of this case and any settlement discussions: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ More information attached to this form 7. I have attached the following documents to help the mediator better understand the issues in dispute: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ More information attached to this form 8. Other comments: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ More information attached to this form Dated: _____________________________________ ___________________________________________ (PRINT NAME OF PARTY SUBMITTING THIS STATEMENT) (RUL-6-ADR.010 ) ►_________________________________________ (SIGNTAURE OF PARTY SUBMITTING THIS STATEMENT) Page 2 of 2 (E.D. 7-1-10) Optional MEDIATION STATEMENT American LegalNet, Inc. www.FormsWorkFlow.com