STATE OF NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE COUNTY OF MECKLENBURG DI STRICT COURT DIVISION CASE NUMBER_______________________ ______________________________ ______________________________ PLAINTIFF VS. NOTICE OF SELECTION OF MEDIATOR OR FAMILY COURT ______________________________ JUDGE BY AGREEMENT IN FAMILY FINANCIAL CASES ______________________________ DEFENDANT The parties in the above-captioned case have selected the mediator or Family Court Judge indicated below to conduct a Mediated Settlement Conference or Judicial Settlement conference in their Family Financial case. ____________________________________________________________________________________ Name and address of mediator or Family Court Judge conducting ADR: Telephone Number NOTE: THE FILING PARTY in this case shall file this notice with the court within 60 days of the courts order to participate in ADR. *ATTENTION* If the parties choose to participate in a Judicial Settlement Conference and do not select a Family Court Judge to conduct it, the Family Court Administrator shall appoint a settlement judge. Notice submitted by: ________________________________ ___________________ Plaintiff/Attorney for Plaintiff Date CCF-69 August 2000 >>>> 2 Certificate of Service I certify that I served the above Notice by: ____ delivering a copy personally to: Name and Address Name and Address ____ depositing a copy in the United States mail in an envelope bearing proper postage and addressed as follows: Name and Address Name and Address ____ leaving a copy at the office of the attorney named below, with a partner or employee: Name of Attorney Name of Attorney Party Represented Party Represented Person With Whom Copies Left Person With Whom Copies Left Name Address and Phone Number of Person Serving Date of Service Notice CCF-69 August 2000