ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Address, Telephone Number, State Bar membership number): For Court Use Only ATTORNEY FOR: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SONOMA Civil & Family Law Courthouse, Family Law Division 3055 Cleveland Avenue Santa Rosa, CA 95403 Plaintiff/Petitioner: Defendant/Respondent: STIPULATION AND ORDER APPOINTING PRIVATE CHILD CUSTODY RECOMMENDING COUNSELOR (CCRC) Sonoma County Rule 9.15(B) Case Number: Submitted with: Request for Order NOTICE: If you have a Family Court Services appointment, it will be dropped upon the filing of this form. THE PARTIES HEREBY STIPULATE AS FOLLOWS: 1. ___________________________________________ is appointed Private Child Custody Recommending Counselor ("CCRC") under Family Code §§ 1815 and 3164. 2. Private child custody recommending counseling shall satisfy the requirement for mandatory mediation pursuant to Family Code § 3160 in this proceeding and be subject to each provision affecting mediation proceedings as set forth in Family Code § 3160 through Family Code § 3186. 3. Private Child Custody Recommending Counseling is subject to all Sonoma County Local Rules affecting custody proceedings. 4. By signing this Stipulation and Order, the Private CCRC verifies that he or she meets the minimum qualifications to conduct child custody recommending counseling as set forth in Family Code § 3164(b). 5. 6. The Private CCRC shall not serve in any other capacity in this case. Quasi-Judicial Immunity: The Private CCRC is an Officer of the Court. The Private CCRC has quasi- judicial immunity. The Private CCRC cannot be sued based on his or her actions in this matter. Writings or testimony by the Private CCRC shall not constitute a waiver of the Private CCRC's quasi-judicial immunity. 7. By signature of the parties and counsel to this proceeding, each affirms that as of the date of signature each of the following has occurred: a. each party in writing. b. Each party has the ability to meet his or her obligation to compensate Private CCRC according to The terms of compensation to the Private CCRC have been confirmed between the CCRC and the terms set forth by the Private CCRC. Local Form FL-035 Form Adopted for Mandatory Use (New 3/08; Rev. 4/09; 1/10; 7/10; 7/11; 5/13, 2/14, 1/16) STIPULATION AND ORDER APPOINTING PRIVATE CHILD CUSTODY RECOMMENDING COUNSELOR Sonoma County Local Rule 9.14(B) American LegalNet, Inc. www.FormsWorkFlow.com Case Name: ______________________________________________ Case Number: _____________________ c. CCRC. d. Each party is aware of the office location, telephone number and hours of operation of the Private Each party has resolved any potential conflicts of interest between the Private CCRC and the parties to the action or between the Private CCRC and the attorneys of record in the action. e. Each party has confirmed with the Private CCRC that the private Child Custody Recommending Counseling proceeding, including the service of any resulting written recommendations to the all parties, counsel and the Court, will be completed no later than five court days prior to the scheduled hearing of the proceeding. 8. Check all that apply: Petitioner shall pay for ______% of the cost and Respondent shall pay for ______% of the cost. Petitioner shall pay $_____ and Respondent shall pay $____. The Court shall reserve jurisdiction to determine if either or both parties shall ultimately be responsible for any portions or all of said Private CCRC's time and costs incurred in this proceeding. 9. All relevant materials to be considered by the Private CCRC shall be personally delivered to the Private CCRC and opposing party (or counsel if the party is represented) no less than five court days before the appointment with the Private CCRC. If delivery is by US Mail, documents must be mailed to the opposing party (or counsel) five court days plus five calendar days before the Private CCRC date. 10. Absent written stipulation of the parties, there shall be no ex parte communication between the Private CCRC and any party or between the Private CCRC and any attorney of record in this action, except to schedule appointments, coordinate collateral contacts, participate in a joint conference with a party or attorney from both sides present, or as required or permitted by law. 11. Upon request by the Private CCRC, the parties shall promptly sign all documents required to allow access by the Private CCRC to documents and information in the possession of therapists, counselors, physicians, psychiatrists, psychologists, evaluators, educators, educational institutions, police and other law enforcement authorities, hospitals, social workers and child protection entities and staff. No release provided to the Private CCRC pursuant to this Order, nor the disclosure or production of any documents or information to the Private CCRC pursuant to this Order shall constitute a waiver of any valid privilege. 12. Upon filing this order, the Family Law Clerk shall notify Family Court Services ("FCS") that the FCS appointment shall be dropped. A copy of this Order shall be provided to FCS by the moving party. DATED: ______________________ ___________________________________________ Petitioner ___________________________________________ Attorney for Petitioner ____________________________________________ Respondent ____________________________________________ DATED: ______________________ DATED: _______________________ DATED: _______________________ Local Form FL-035 Form Adopted for Mandatory Use (New 3/08; Rev. 4/09; 1/10; 7/10; 7/11; 10/13, 2/14, 1/16) STIPULATION AND ORDER APPOINTING PRIVATE CHILD CUSTODY RECOMMENDING COUNSELOR Sonoma County Local Rule 9.14(B) American LegalNet, Inc. www.FormsWorkFlow.com Case Name: ______________________________________________ Case Number: _____________________ Attorney for Respondent AGREEMENT TO SERVE: I, ________________________________________, agree to serve as Private CCRC and affirm my qualifications in the above- entitled case. My business address is _______________________________________________________. DATED: __________________________ __________________________________________ Private Child Custody Recommending Counselor IT IS SO ORDERED. DATED: ___________________________ __________________________________________ Judge of the Superior Court Local Form FL-035 Form Adopted for Mandatory Use (New 3/08; Rev. 4/09; 1/10; 7/10; 7/11; 10/13, 2/14, 1/16) STIPULATION AND ORDER APPOINTING PRIVATE