STATE OF MICHIGAN MEDIATION STATUS REPORT CASE NO. 17 TH CIRCUIT COURT JUDGE: Court address ADR OFFICE, 180 OTTAWA AVE NW, SUITE 3100, GRAND RAPIDS MI 49503 C ourt telephone no. 616 - 632 - 5052 Plaintiff name(s), address(es) Defendant name(s), address(es) V Plaintiff' s attorney, bar no., address, and telephone no. Defendant222s attorney, bar no., address, and telephone no. The Mediator must submit this report every 60 d ays until the mediation process is complete. Once mediation is completed, this report must be filed within 7 days and evaluation forms must be provided to all the parties and the attorneys who participated in the mediation. Please mark the appropriate boxes. The mediation was: Held Not Held If held, INDICATE the number of sessions: 1 2 3 4 5 The Status Report is (check one): Interim Final filing to the ADR Clerk Domestic Violence Screening was completed on: (Domestic Relations Cases Only) The participants were: on behalf of Plaintiff on behalf of Plaintiff on behalf of Defendant on behalf of Defendant on behalf of on behalf of on behalf of on behalf of OUTCOME OF MEDIATION : Parties did not settle Further ADR contemplated Further ADR not contemplated Parties settled in part Further ADR contemplated Further ADR not contemplated Parties settled: Agreement signed on . Other: Mediation to resume on . NOT HELD BECAUSE : Inappropriate to mediate (ie, domestic violence, uncooperative party, etc) Unnecessary to mediate due to prior settlement Due to no response Other Date Signature Mediator name (type or print) Kent County Mediation Status Report (8/18) American LegalNet, Inc. www.FormsWorkFlow.com