Print Form Clear Form Mediator Report (Form 5) (03/28/14) CCCH 0132 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, CHANCERY DIVISION 3488 ____________________________________________________ Plaintiff(s), v. No. ______________________________________ ____________________________________________________ Defendant(s). ___________________________________________ 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 Number: ___________________ Case Type: Administrative Rview Class Actions Commerical Litigation Condominium Disputes Construction Law Corportations/Partnerships Employment Employment (Wrongful Termination) General Tort Insurance Coverage Mechanics Liens Medical Malpractice Mortgage Foreclosures Municipal Public Sector Law Neighbour Disputes Personal Injury Products Liability Probate Real property Disputes 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 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) has been reached in part has not been reached 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) ___________________ ______________________________________________________________________________________________ ______________________________________________ Signature of Mediator Dated: ______________________________, _______ DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 1 of 1