SETTLEMENT CONFERENCE INFORMATION SHEET JUSTICE LARRY S. SCHACHNER, PRESIDING TITLE OF PROCEEDINGS INDEX # __________________ ____________________________ NOTE OF ISSUE DATE_____________ TYPE OF TORT____________________ vs. ____________________________ DESCRIPTION OF ACTION AND DAMAGES OCCURRENCE: DATE:__________ TIME:__________ LOCATION:______________ DESCRIBE OCCURRENCE:____________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ DESCRIBE INJURY & TREATMENT:___________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ LIENS:_______________________________________________________________________ DEMAND:__________________ OFFER: ____________________ PLAINTIFF: D.O.B. __________ OCCUPATION:___________________________ PLAINTIFF: D.O.B. __________ OCCUPATION:___________________________ 1 American LegalNet, Inc. www.FormsWorkflow.com ATTORNEYS OF RECORD & TRIAL COUNSEL COUNSEL FOR PLAINTIFF(S) COUNSEL FOR DEFENDANT(S) 1. 1. _____________________________________________________ _____________________________________________________ ATTORNEY OF RECORD FOR ___________________________ ATTORNEY OF RECORD FOR ___________________________ OFFICE ADDRESS AND PHONE NUMBER OFFICE ADDRESS AND PHONE NUMBER ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ TRIAL COUNSEL FOR PLAINTIFF NO. 1 TRIAL COUNSEL FOR DEFENDANT NO. 1 ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ 2. 2. _____________________________________________________ _____________________________________________________ ATTORNEY OF RECORD FOR ___________________________ ATTORNEY OF RECORD FOR ___________________________ OFFICE ADDRESS AND PHONE NUMBER OFFICE ADDRESS AND PHONE NUMBER ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ TRIAL COUNSEL FOR DEFENDANT NO. 2 TRIAL COUNSEL FOR PLAINTIFF NO. 2 ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ 3. 3. _____________________________________________________ _____________________________________________________ ATTORNEY OF RECORD FOR ___________________________ ATTORNEY OF RECORD FOR ___________________________ OFFICE ADDRESS AND PHONE NUMBER OFFICE ADDRESS AND PHONE NUMBER ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ TRIAL COUNSEL FOR DEFENDANT NO. 3 TRIAL COUNSEL FOR PLAINTIFF NO. 3 __________________________________________________________ __________________________________________________________ _________________________________________________________ _________________________________________________________ 2 American LegalNet, Inc. www.FormsWorkflow.com