Madera Superior Court Form Adopted for Optional Use MAD - 0067 FAMILY LAW SETTLEMENT CONFERENCE STATEMENT Page 1 of 2 Revised 6/04/2018 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) : TELEPHONE NO: FAX NO. (Optional): E - MAIL ADDRESS (Optional) : ATTORNEY FOR (Name) : FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF MADERA STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: 200 South G Street 200 South G Street Madera, CA 93637 Civil Division PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: FAMILY LAW SETTLEMENT CONFERENCE STATEMENT CASE NUMBER: 1. Parties: Petitioner: Attorney for Petitioner: Respondent: Attorney for Respondent: Joined Party: Attorney for Joined Party: 2. Nature of Case: Dissolution Legal Separation Nullity Parental Relationship Domestic Partnership 3. General Information: a. Date of Marriage/Partnership: Date of Separation: b. Minor Children and ages: c. Service of Declaration of Disclosure (excluding Parental Relationship case types): Preliminary Final Petitioner: YES NO YES NO Respondent: YES NO YES NO d. Did parties hold joint settlement conference as required by Local Rule 2.8.1? YES If YES, state date of conference: NO If NO, please explain: 4. Issues in Agreement: (Check all applicable boxes) YES a. Child Custody b. Child Support c. Spousal Support d. Attorney Fees e. Paternity f. Property Division American LegalNet, Inc. www.FormsWorkFlow.com Madera Superior Court Form Adopted for Optional Use MAD - 0067 FAMILY LAW SETTLEMENT CONFERENCE STATEMENT Page 2 of 2 Revised 6/04/2018 CASE NAME: CASE NUMBER: If there is a partial property agreement, please specify issues agreed upon (e.g: personal property, residence/real property, debts): 5. Issues in Dispute (check applicable box and briefly state party222s contention.) YES Party222s statement of contention: a. Child Custody b. Child Support c. Spousal Support d. Property Division *If any or all property items are in dispute, forms FL-160 and FL-161 must be fully completed and attached to this statement. e. Attorney Fees f. Paternity of Minor Children 6. Other Issues in Dispute: Specify: 7. Trial Estimate: Hour(s) or Day(s) Date: Signature of Petitioner or Attorney Date: Signature of Respondent or Attorney Date: Signature of Joined Party or Attorney American LegalNet, Inc. www.FormsWorkFlow.com