Superior Court of California , County of Los Angeles SETTLEMENT CONFERENCE PROGRAM INTAKE FORM (Return via email to SSCMSC@lacourt.org ) Case Number: Case Name: Name of Referring IC/Complex/Writs Judge: Department: Date of Minute Order Ordering Parties to an MSC: Joint Preferred MSC Dates (must offer 3 dates): , or , or Unavailable Dates: , or, or Preferred MSC Judge* (optional): (1) , (2) *Please note that the assignment of a settlement judge is at the court222s discretion and subject to availability. Plaintiff 222 s Counsel Name Telephone Number Email Address 1. ( ) - 2. ( ) - Defendant 222 s Counsel Name 1. ( ) - 2. ( ) - Other Counsel 1. ( ) - 2. ( ) - Plaintiff222s Causes of Action Cross - Complaint222s Causes of Action (if any) 1. 1. 2. 2. 3. 3. Previous Mediation Date: Previous MSC Date and Judge: Trial Date: Trial Time Estimate: Remaining Discovery: Remaining Law and Motion: Plaintiff222s Last Demand: Defendant222s Last Offer: Brief Description of Case: DO NOT WRITE BELOW THIS LINE. FOR SUPERIOR COURT USE ONLY Date submitted: Date processed: Clerk: LASC CIV 270 Rev. 3/19 For Optional Use SETTLEMENT CONFERENCE PROGRAM INTAKE FORM American LegalNet, Inc. www.FormsWorkFlow.com