Sample Form UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY In re: Case No. Chapter Debtor. Use adversary caption if applicable. Plaintiff, v. Adversary No. Defendant. JOINT APPLICATION REQUESTING REFERRAL OF MATTER TO MEDIATION Applicants, (identify attorneys and the parties each represent), hereby submit this joint application for approval of a consent order to refer this contested matter (identify contested matter) to mediation. 1. The parties have resolved all matters relating to the manner in which the mediation shall proceed as reflected in the proposed consent order submitted herewith [if applicable, “ with the exception of the following matters:”]. 2. 2. mediator. Also submitted herewith is the acceptance form executed by the selected mediator. -orThe parties are unable to agree upon a mediator and request the court to select a C:\publishing\APPLICA.WPD/Feb.1998 Joint Application Requesting Referral of Matter to Mediation - Sample Form American LegalNet, Inc. www.FormsWorkflow.com WHEREFORE, the undersigned counsel and parties respectfully request this court enter the consent order for referral to mediation submitted herewith. Adam, Adam & Adam Attorneys for Smith, Smith & Smith Attorneys for ________________________ By: __________________________ By: ________________________ Party/Litigant __________________________ Party/Litigant C:\publishing\APPLICA.WPD/Feb.1998 Joint Application Requesting Referral of Matter to Mediation - Sample Form American LegalNet, Inc. www.FormsWorkflow.com UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY In re: Case No. Chapter Debtor. Plaintiff, v. Adversary No. Defendant. JOINT APPLICATION REQUESTING REFERRAL OF MATTER TO MEDIATION Applicants, , hereby submit this joint application for approval of a consent order to refer this contested matter to mediation. 1. The parties have resolved all matters relating to the manner in which the mediation shall proceed as reflected in the proposed consent order submitted herewith, with the exception of the following matters: 2. Feb.1998 The parties are unable to agree upon a mediator and request the court to select a mediator. Joint Application Requesting Referral of Matter to Mediation American LegalNet, Inc. www.FormsWorkflow.com WHEREFORE, the undersigned counsel and parties respectfully request this court enter the consent order for referral to mediation submitted herewith. Attorneys for Attorneys for ________________________ By: __________________________ By: ________________________ Party/Litigant __________________________ Party/Litigant Feb.1998 Joint Application Requesting Referral of Matter to Mediation American LegalNet, Inc. www.FormsWorkflow.com