VN164 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) Telephone Number FOR COURT USE ONLY ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA 800 SOUTH VICTORIA AVE. VENTURA, CA 93009 PLAINTIFF/PETITIONER DEFENDANT/RESPONDENT STIPULATION TO USE OF ALTERNATIVE DISPUTE RESOLUTION PROCESS CASE NUMBER: The parties and their attorneys stipulate that the claim(s) in this action shall proceed to the following alternative dispute resolution process: Private Mediation Mandatory Early Settlement Conference Binding Arbitration Volunteer Mediation _________________________ Assignment to Private Judge Non-Binding Arbitration Other (specify) : ________________________________________________________________________________ It is further stipulated that the deadline for selection of a neutral and completion of the ADR process is: ________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________ Plaintiff (print) Defendant (print) Signature of Plaintiff Signature of Defendant Plaintiff's Attorney (print) Defendant's Attorney (print) Attorney's Signature Attorney's Signature Dated: _________________________ IT IS SO ORDERED. Dated: _________________________ IT IS FURTHER ORDERED THAT: __________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Dated: ________________________________ _______________________________________ Judicial Officer Optional Form VN164 (01/02) STIPULATION TO USE OF ALTERNATIVE DISPUTE RESOLUTION PROCESS American LegalNet, Inc. www.FormsWorkFlow.com