STATE OF MAINE SUPERIOR COURT ______________________________, ss. Docket No. _______________________ ______________________________Plaintiff v. ______________________________Defendant DISTRICT COURT Location________________________ Docket No. _____________________ ATTORNEY: _________________________ Address: _____________________________ _____________________________ ATTORNEY: _________________________ Address: _____________________________ _____________________________ REQUEST FOR MEDIATION Dear __________________________________: Mediation is required on the above mentioned case. Please schedule this case for mediation as soon as a mediator is available. Date: _________________________ ___________________________________ Attorney for Plaintiff / Defendant DO NOT WRITE BELOW THIS LINE Mediator: , phone: Location of Mediation: Date confirmed with mediator: Date confirmed with Court: Comments: CV-063, Rev. 09/97 2000 © American LegalNet, Inc.