STIPULATION FOR DISMISSAL IN THE DISTRICT COURT OF THE THIRD CIRCUIT ______________________________ DIVISION STATE OF HAWAII Plaintiff(s) Form# 3DC21 Reserved for Court Use Civil No. Defendant(s) Filing Party/Attorney Name, Attorney Number (if applicable), Address, Telephone and Fax Numbers Next Court Date and Time (if any): _________________________________________________________________________________ G None G Return G Pre-Trial G Trial G Answer G Disposition/Other (Specify): ____________________________________________ STIPULATION FOR DISM ISSAL Plaintiff and Defendant agree to the Entry of Dismissal in this case (select one) G W ITH or G W ITHOUT prejudice pursuant to District Court Rules of Civil Procedure, Rule 41(a)(1)(ii). This Stipulation for Dismissal is signed by all parties who have appeared in this action. (Select one) G Partial Dismissal as to Defendant ________________________________________________________________________________ _______________________________________________________________________________________________________________. (Certificate of Service required as to other Defendants). OR G DISM ISSAL OF ALL CLAIM S. Signature of Plaintiff/Attorney: Date: Print/Type Name: Signature of Defendant/Attorney: Date: Print/Type Name: In accordance with the Americans with Disabilities Act if you require an accommodation for your disability, please contact the ADA Coordinator at PHONE NO. (808) 961-7424, FAX (808) 961-7411, or TTY (808) 961-7422 at least ten (10) working days in advance of your hearing appointment date. For Civil related matters, please call or visit the District Court Civil Section at Hilo Division, 777 Kilauea Avenue, Hilo, Ph. (808) 961-7515 · Kohala Division, 67-5187 Kamamalu St., Kamuela, Ph. (808) 443-2030 · Kona Division, 79-1020 Haukapila St., Kealakekua, Ph. (808) 322-8700. DISMSTIP CommonLook® 508 Certified Reprographics (09/09) 3D Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com Stipulation for Dismissal 3D-P-272