ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 939 W. Main Street El Centro, CA 92243 PETITIONER: RESPONDENT: CASE NUMBER: STIPULATION TO USE OF ALTERNATIVE DISPUTE RESOLUTION PROCESS (California Rules of Court 3.221) The parties and/or their attorneys stipulate that the matter is at issue and that this action shall be submitted to the following alternative dispute resolution process. Selection of any of these options will not delay any case management timelines. _____ Court Ordered Non-Binding Arbitration (Cases valued at $50,000 or less) _____ Private Mediation _____ Private Binding Arbitration _____ Other (specify):______________________________________________________________ It is also stipulated that the following shall serve as arbitrator, mediator or other neutral: ________________________________________________________________________________. Date:_______________________________ Date:_______________________________ ___________________________________ Name of Plaintiff/Petitioner ___________________________________ Name of Defendant/Respondent ___________________________________ Signature of Plaintiff/Petitioner ___________________________________ Signature of Defendant/Respondent ___________________________________ Name of Plaintiff's Attorney ___________________________________ Name of Defendant's Attorney ___________________________________ Signature of Attorney ___________________________________ Signature of Attorney GN-03 (Adopted 01/01/11 Revised 01/01/13) STIPULATION TO USE OF ALTERNATIVE DISPUTE RESOLUTION PROCESS (CA Rules of Court 3.221) American LegalNet, Inc. www.FormsWorkFlow.com