IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT, LAKE COUNTY, ILLINOIS IN RE THE MARRIAGE OF ) ) ) ) ) ) ) Petitioner, Respondent. Gen. No. ORDER FOR MEDIATION/CONCILIATION/COUNSELING ON MOTION OF, IT IS HEREBY ORDERED that the following persons are referred to (name of professional) for (check one) 9 mediation Party A 9 conciliation 9 counseling on the issue of Name: Telephone: ( ) Attorney: Telephone: ( ) Name: Telephone: ( ) Attorney: Telephone: ( ) Attorney’s Address: (Street/City/State/ZIP) Party B Attorney’s Address: (Street/City/State/ZIP) Fee Allocation: The prorated shares of the professional’s fee are as follows: Party A= % Party B= % *County of Lake= % *Limit on amount County will pay. $ Stipulation: THE PARTIES STIPULATE that the Court may consider the report of the counseling agency, which may be part of the Court record. (No written report will be prepared unless the parties have executed this Stipulation.) T h i s stipulation is optional with the parties. Party A In C- Party B IT IS FURTHER ORDERED that the matter be continued before Judge on for the purpose of reviewing the progress on the matters addressed herein. ENTER: Dated at Waukegan, Illinois this day of , 20 . JUDGE 171-245 4/98 2000 © American LegalNet, Inc.