JDF 1337 Certificate of Mediation/ADR Compliance Rev. 02/2017 Page 1 of 2 District Court Denver Juvenile Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petitioner/Plaintiff(s): and Co - Petitioner/Respondent/Defendant(s): COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom CERTIFICATE OF MEDIATION/A DR COMPLIANCE (CADR) The Mediator/ Petitioner / Co-Petitioner / Respondent respectfully submits the following report on the status of the mediation held on (date) with . The mediation session was: ordered by the Court or attended voluntarily. After mediation, the party submitting this report informs the Court of the following: Mediation occurred and agreements were fully resolved and signed a written agreement (ADRF) Mediation occurred and agreements were partially resolved and have signed a written agreement on resolved issues and unresolved issues have been identified (ADRP) Mediation occurred and no issues were resolved (ADRN) Mediation did not occur because the mediator determined that the case was inappropriate for mediation. (ADRI) Mediation occurred and an additional mediation session is scheduled for (CADR) Mediation occurred and the parties fully resolved modifications on post-decree issues. (ADRF) Mediation occurred and the parties partially resolved modifications on post-decree issues. (ADRP) Mediation occurred and no issues were resolved modifications on post-decree issues. (ADRN) Other THIS REPORT IS NOT A SUBSTITUTE FOR ANY REPORTS, FILINGS, OR REQUIREMENTS THAT THE COURT MAY HAVE ORDERED OR REQUESTED FROM THE PARTIES TO BE COMPLETED. Date: Signature of Party or Attorney American LegalNet, Inc. www.FormsWorkFlow.com JDF 1337 Certificate of Mediation/ADR Compliance Rev. 02/2017 Page 2 of 2 CERTIFICATE OF SERVICE I certify that on (date) the original was filed with the Court and a true and accurate copy of the Certificate of Mediation/ADR Compliance was served on the other party by Hand Delivery E-filed Faxed to this number or by placing it in the United States mail, postage pre-paid, and addressed to the following: To: Your Signature American LegalNet, Inc. www.FormsWorkFlow.com