ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME, ADDRESS, PHONE) FOR COURT USE ONLY Attorney for: SUPERIOR COURT OF CALIFORNIA, COUNTY OF STANISLAUS Court Location: 801 10 Street, 4 Floor, Modesto, CA 95354 th th Civil Clerk's Office: 801 10 Street, 4 Floor, Modesto, CA 95354 Petitioner/Plaintiff: th th Respondent/Defendant: SETTLEMENT CONFERENCE STATEMENT Case Number: Hearing Date: Time: Trial Date: 1. Identify Plaintiff(s) and attorney(s) of record: Plaintiff: ___________________________________________________________ Attorney: __________________________________________________________ Plaintiff: ___________________________________________________________ Attorney: __________________________________________________________ Plaintiff: ___________________________________________________________ Attorney: __________________________________________________________ Identify Defendant(s), attorney(s) of record and Insurance Carrier: Defendant: ________________________________________________________ Attorney: __________________________________________________________ Insurance Carrier: ___________________________________________________ Defendant: _________________________________________________________ Attorney: __________________________________________________________ Insurance Carrier: ___________________________________________________ Defendant: _________________________________________________________ Attorney: __________________________________________________________ Insurance Carrier: ___________________________________________________ 2. 3. Provide a short statement of what this case is all about: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ CV004 Optional Form Rev 05/08 American LegalNet, Inc. www.FormsWorkFlow.com ________________________________________________________________________________ 4. List all economic damages claimed in this case: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 5. Identify Plaintiff(s)' position in this case: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 6. Identify Defendant(s)' position in this case: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 7. Identify major disputed legal issues: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 8. Identify major disputed factual issues: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 9. What is the last best offer to settle made by both parties? Plaintiff(s): _______________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Defendant(s): _____________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 10. Please state your current, best offer of settlement: ________________________________________________________________________________ ________________________________________________________________________________ 11. Provide as exhibits any attachments which will aid settlement (such as medical reports, compilations of damages, contracts, etc.): Dated: ______________________ _______________________________ Attorney for CV004 Optional Form Rev 05/08 American LegalNet, Inc. www.FormsWorkFlow.com