ATTORNEY OF PARTY WITHOUT ATTORNEY (Name and Address) FOR COURT USE ONLY Telephone Number ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA 800 SOUTH VICTORIA AVE. VENTURA, CA 93009 3855 – F ALAMO ST. SIMI VALLEY, CA 93063-2210 PLAINTIFF: DEFENDANT: CASE NUMBER: VOLUNTARY EARLY CIVIL MEDIATION QUESTIONNAIRE (Local Rule No. 24.00) The parties are required to meet and confer re: selection of ADR procedure and must jointly submit this ADR Questionnaire on the date that the responsive pleading is required. Extensions of time granted by the parties for filing of responsive pleading will not extend the time deadline for filing of this questionnaire. (Local Rule No.24.04) If the parties elect to participate in the Ventura Superior Court Voluntary Early Civil Mediation Program, normal discovery procedures and deadlines will be suspended for 150 days and limited discovery shall be conducted pursuant to C.C.P. §94. Suspension of discovery deadlines applies only when the parties elect to participate in the Ventura Superior Court Voluntary Early Civil Mediation Program. The parties elect as follows: A. Pursuant to Local Rule No. 24.00, the parties elect to participate in the Voluntary Early Civil Mediation Program, with the following type of mediator. Pro-bono mediator Party-pay neutral The mediator to be selected as follows: Mediator selected by the parties from Court Web site Private mediator (not on Court panel) B. The parties decline to participate in the Voluntary Early Civil Mediation Program. The Court will assign the parties to mediation, early settlement conference, or arbitration. Normal discovery rules and deadlines shall apply, as per Local Rules. Dated: ____________________ _______________________________________ Attorney for Dated: ____________________ _______________________________________ Attorney for Dated: ____________________ _______________________________________ Attorney for Note: Whether or not the parties decide to participate in the Voluntary Early Civil Mediation Program, this form must be executed by all parties or their counsel and filed at the time of the last defendant’s first appearance (Ventura County Local Rule 24.04). Failure to file this form may result in your required appearance at a Case Management hearing and sanctions being imposed. VN 183 Rev 7/01/06 VOLUNTARY EARLY CIVIL MEDIATION QUESTIONNAIRE American LegalNet, Inc. www.USCourtForms.com