Mediation Referral Or Request
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Mediation Referral Or Request Form. This is a Michigan form and can be use in Monroe Local County.
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Tags: Mediation Referral Or Request, Michigan Local County, Monroe
MEDIATION REFERRAL/REQUEST
DATE ______________
CASE # _________________
JUDGE _________________
We, the undersigned parties, agree (BOTH PARTIES MUST SIGN) to
have the following disagreements mediated by the Monroe County Friend
of the Court:
1.
2.
3.
4.
5.
We further understand that any agreement reached by us will be
filed with the court and is binding and enforceable. Both parties
must appear at the time and place of the scheduled mediation before it
will be heard. All mediations will be held either at 9:00 a.m. or
2:30 p.m on Tuesdays only. Please call the Enforcement Aide to
coordinate date and time at 734-240-7180. The notice below will be
returned to you with the confirmation date.
_________________________________
Name of Requesting Party
_______________________________
Name of Other Party
_________________________________
Address
_______________________________
Address
_________________________________
City, State, Zip
_______________________________
City, State, Zip
____________________________________
Referred by
CONFIRMATION OF MEDIATION:
MEDIATION IS SCHEDULED FOR ___________________________(CASEWORKER) ON
TUESDAY, ________________ AT ________________. I CERTIFY THAT THIS
NOTICE WAS MAILED TO THE PARTIES AT THEIR ABOVE ADDRESSES ON
_____________________.
______________________________________
Enforcement Aide
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