Mediation Questionnaire Form. This is a Florida form and can be use in District Courts Of Appeal Appellate Courts.
Tags: Mediation Questionnaire, Florida Appellate Courts, District Courts Of Appeal
IN THE DISTRICT COURT OF APPEAL OF THE STATE OF FLORIDA FIFTH DISTRICT , Appellant(s), v. , Appellate Case No. 5D County Case No: Appellee(s). _____________________________/ DATE: MEDIATION QUESTIONNAIRE* This questionnaire is sent to obtain information for the Court’s use in determining whether this case is appropriate for appellate mediation. Pursuant to administrative order, copy enclosed, each party is ordered to file a completed questionnaire with Penny H. Cooper, Court Mediation Coordinator, Fifth District Court of Appeal, 300 S. Beach St., Daytona Beach, FL 32114, within ten (10) days of the date of the Court’s acknowledgment of the notice of appeal with a copy served on opposing counsel (except for the Confidential Statement Regarding Appropriateness of Appellate Mediation, which is only to be filed with the Mediation Coordinator of the court). FAILURE TO RETURN QUESTIONNAIRE AND CONFIDENTIAL STATEMENT MAY RESULT IN SANCTIONS * Download Mediation forms at: www.5dca.org American LegalNet, Inc. www.FormsWorkflow.com Appellant(s) Attorney (Lead Counsel): Appellee(s) Attorney (Lead Counsel): (Name) (Address) (Name) (Address) (City/State/Zip) (City/State/Zip) (Telephone) (Fax) (Telephone) (Fax) (E-Mail) (Florida Bar No.) (E-Mail) (Florida Bar No.) NATURE OF THE CASE Business Tort Employment Insurance Real Estate Other (please describe) Contract Family matter (with children issues) Family matter (without children issues) Personal injury/wrongful death ISSUES ON APPEAL (To be completed by Appellants/Cross-Appellants only): Describe each expected issue on appeal as now known and the standard of review which will be applicable to each issue (completion of the questionnaire will not limit issues which may be raised in the briefs). MEDIATION Was the case mediated at the trial level? Yes Has the case been mediated since entry of the order appealed? Yes No No 2 American LegalNet, Inc. www.FormsWorkflow.com - NOTICE You are hereby given an extension to file your directions to the clerk and court reporter, upon your receipt of this form. If appellate mediation is ordered in this case, you will be given an automatic extension of the deadlines for preparation of the transcript, preparation of the record and filing of briefs, said time to run from the date of the notification from the Court that mediation is ordered until 10 days after mediation has concluded. [Mediation session has concluded with either an impasse or full or partial settlement]. The court will send an Order Declining Referral To Mediation if mediation is not ordered in this case. (It is the intention of the Court that the mediation process will not substantially slow down the appellate process. However, the above extensions will give the parties the opportunity to save the costs of the record and brief preparation, if mediation is successful. Accordingly, additional extensions of deadlines pending mediation will normally not be granted absent stipulation of the parties and court order). Lead Counsel: Date: For: Appellant(s) (Counsel’s Certificate of Service that complies with Florida Rule of Appellate Procedure 9.420(d)(1) must be attached to this Questionnaire) CERTIFICATE OF SERVICE 3 American LegalNet, Inc. www.FormsWorkflow.com