COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : FIRST JUDICIAL DISTRICT COURT JUDICIAL SUBPOENA Plaintiff(s) SETTLEMENT CONFERENCE PROGRAM -against- : PARTICIPANT’S QUESTIONNAIRE : CASE NO.________________________ : Defendant(s) Could you please complete the following questionnaire and :forward it to the ADR Office of the ...................................................... First Judicial District Court. All responses will be kept confidential. 1. Your designation THE PEOPLE OF THE STATE OF NEW YORK A. Your role: ____ attorney ____ party ____ insurance co. rep. ____ other: __________ GREETINGS: TO B. Your side: _____ plaintiff _____ defendant _____ third party defendant _____ other: ____________ 2. Did WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before your case: ____ settle _____ reach an impasse at the ____other _________________________ , the Honorable Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or3. Did you receive sufficient information as a witness in this action on the partProgram? adjourned date, to testify and give evidence about the Settlement Conference of the _____ yes _______ No, the information lacked ______________________________ _________________________________________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 4. of you think to Settlement Conference Program was administered well? resultDidyour failure thecomply. _______ yes Honorable ________ No, because __________________________________________ Witness, , one of the Justices of the __________________________________________ Court in County, day of , 20 5. Would you be willing to submit other cases to a Settlement Conference Program? ______ yes (Attorney must sign above and type name below) _______ No, because _________________________________________ _________________________________________ Attorney(s) for 6. Did your Settlement Referee have sufficient expertise for your case? ______ yes _______ No, she/he lacked ____________________________________ ____________________________________ Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : : Plaintiff(s) -against- Calendar No. JUDICIAL SUBPOENA : 7. Please evaluate the role of the Referee in your case: ______ purely neutral : ________ biased against a party : Defendant(s) ________ passive ______ aggressive : ...................................................... ______ facilitated settlement ________ blocked settlement THE PEOPLE(Your referee’s name: ____________________ (Optional). OF THE STATE OF NEW YORK TO Do you have any suggestions regarding the Settlement Conference Program? 8. GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for PLEASE RETURN TO CAROLYN LUMBARD, ESQ., ADR COORDINATOR, FIRST JUDICIAL DISTRICT COURT, P.O. BOX 2268, SANTA FE, NM 87504 Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com