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Mediator Report Form. This is a Illinois form and can be use in Cook Local County.
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Tags: Mediator Report, CCCH 0132, Illinois Local County, Cook
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Mediator Report (Form 6)
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(12/22/06) CCCH 0132
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
COUNTY DEPARTMENT, CHANCERY DIVISION
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____________________________________________________
Plaintiff(s)
v.
____________________________________________________
Defendant(s)
3488
No. ________________________________
_______________________________
Judge
Judge’s No.
MEDIATOR REPORT
(To be completed at the end of each mediation and filed with the Court, with a courtesy copy delivered to the Chancery
Division Court-Annexed Mediation Supervisor, pursuant to Illinois Supreme Court Rule 99 as a mechanism for reporting
to the Supreme Court on the mediation program.)
Mediator Name: ______________________________________
Case Type:
Case Number: ___________________________
Administrative Review
Employment (Wrongful Termination)
Class Actions
General Tort
Neighbor Disputes
Commercial Litigation
Insurance Coverage
Personal Injury
Condominium Disputes
Mechanics Liens
Products Liability
Construction Law
Medical Malpractice
Probate
Corporations/Partnerships
Mortgage Foreclosures
Real Property Disputes
Employment Agreements
Municipal/Public Sector Law
Other (list below)
______________________________________________________________________________________
The undersigned mediator,
selected by the attorney/s
appointed by the Court pursuant to the Order entered on
the________ day of ____________________________, _________, reports to the Court as follows:
A. A settlement of this matter
has been reached
has been reached in part
has not been reached
B. (If a settlement was reached)
The party designated to prepare the settlement agreement and stipulation to dismiss is ______________________
_______________________________; to be submitted to the court by __________________________, ________
(Date)
C. Date mediation began:______/______/______ Date ended:______/______/______
Number of sessions: _______
D. Hours in mediation:__________ Hours of preparation:__________
E. How many from each category attended?
_______ Lawyers _______ Clients _______
Non-Parties (please list, e.g., witnesses, spouse)
____________________
__________________________________________________________________________________
__________________________________________________
Dated: ____________________________, _________
Signature of Mediator
DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS