UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF INDIANA FORT WAYNE DIVISION Plaintiff(s), j v. j Defendant(s). ) ) ) ) ) ) ) ) CAUSE NO. j ATTORNEY CERTIFICATION I hereby certify that I have disclosed to my client(s) the anticipated fees and expenses that are likely to be incurred during each phase of these proceedings through final disposition. I have also separately estimated the fees and expenses reasonably expected to be incurred through an early successful mediation. To the extent that I anticipate seeking fees and/or costs from the other side based on the outcome of this litigation, I have communicated my fee and cost estimates to opposing counsel. I further certify that I have read the court's ADR Pamphlet, have discussed the available ADR options with my client, and have considered how this case might benefit from them. j j ___________________________ ____________________________ Date Signature j ______________________________ Print Name j ___________________________ Attorney for (Plaintiff(s))((Defendant(s)) j CLIENT CERTIFICATION I hereby certify that I have read the Court's ADR Pamphlet and have discussed the ADR options presented with my attorney. I further certify that my attorney has given me an estimate of the costs of mediation as well as those other forms of ADR which interest me. j j _________________________________________________________ Date Signature j ________________________________ Print name/Title American LegalNet, Inc. www.USCourtForms.com