COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Case Name: Calendar No. : Case No.: JUDICIAL SUBPOENA Plaintiff(s) -against- Index No. : AGREEMENT TO MEDIATE : This agreement is made between and : , who are referred to as "the parties." Defendant(s) : ...................................................... The mediation will be confidential discussion aimed at resolving the issues in dispute The mediators are neutral. Their purpose is to help the parties come to an agreement. They do not favor either party. They do not and will not give legal advise to either party. THE PEOPLE OF THE STATE OF NEW YORK TO The mediators will not be serving as advocates, lawyers or judges. The parties will honestly attempt to reach an agreement that is acceptable to both parties. GREETINGS: party can end the mediation at any time. Either WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Nothing that is said, written, or done by either party or by a mediator can be used in this , the Honorable at the Court case if an agreement is not reached. at located County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed If mediator has reason evidence as a witness that a child on been abused, or adjournedadate, to testify and give to believe either (a) in this action hasthe part of the abandoned, or neglected, or, (b) that mediation communications must be revealed to prevent a crime that poses a serious risk of bodily injury or death, then, the mediator has a legal duty to report the circumstances to proper authorities. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose READ, UNDERSTAND, AND AGREE WITH ALL THE and all damages sustained as a I HAVE behalf this subpoena was issued for a maximum penalty of $50 TERMS WRITTEN result of your failure to comply. ABOVE. Dated: Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) (Plaintiff) (Defendant) Attorney(s) for Office and P.O. Address Agreement to Mediate - 1 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: SC4-6 American LegalNet, Inc. www.USCourtForms.com