AAA� Judicial Settlement Conference Service (JSCS) Required items are indicated with an asterisk (*) After completing and saving the form, send it to the AAA and the opposing party/parties by email at casefiling@adr.org; by fax at 1.877.304.8457, or by mail to American Arbitration Association, Case Filing Services, 1101 Laurel Oak Road, Suite 100, Voorhees, NY 08043. Questions: Email AAAJudicialSettlement@adr.org. * Name of Party 1 (Company, Organization, or Person's Name if an individual.) * Name of Party 2 (Company, Organization, or Person's Name if an individual.) * Email Address: * Confirm Email Address: * Address Line 1: Address Line 2: Address Line 3: * City: * State: * Telephone: Representative Information (if applicable) Select "YES" if Self-Represented: Name: Firm (if applicable): Email Address: Confirm Email Address: Address Line 1: Address Line 2: Address Line 3: City: State: Telephone: * Name of Person Filing: * Please indicate the category that best describes the nature of the dispute: Commercial Construction Yes Employment No Zip Code: Fax: Yes * Zip Code: Fax: * Email Address: * Confirm Email Address: * Address Line 1: Address Line 2: Address Line 3: * City: * State: * Telephone: * Zip Code: Fax: Representative Information (if applicable) Select "YES" if Self-Represented: Name: Firm (if applicable): Email Address: Confirm Email Address: Address Line 1: Address Line 2: Address Line 3: City: State: Telephone: Zip Code: Fax: Yes Other (Specify) * Requested JSCS Locale (City & State) * Does this matter involve more than two parties? (If "Yes", the AAA will contact you to obtain the additional party's/parties' information.) * Have parties mutually agreed to a JSCS Judge? * Summary of Dispute: Yes No If "Yes" enter name of JSCS Judge: Claim of Relief Sought: (amount, if any) Amount Enclosed $________. There is a $250.00 fee to initiate a Judicial Settlement Conference or to request the AAA to invite parties to participate in a Judicial Settlement Conference. * Allocation of Costs: % Party 1 % Party 2 If you are using Acrobat Reader 8.0 or higher, you should be able to save the form once completed. Please save the form BEFORE navigating away from it or your data will be lost. American LegalNet, Inc. www.FormsWorkFlow.com