Confidential Mediation Background Information FOR MEDIATION OFFICE REVIEW ONLY - Do Not File Case Name: Case Number: Office of the Circuit Mediators United States Court of Appeals for the Sixth Circuit 331 Potter Stewart U.S. Courthouse 100 East Fifth Street Cincinnati, Ohio 45202-3988 Phone: 513-564-7330 Fax: 513-564-7349 CA06-Mediation@ca6.uscourts.gov Please provide names, addresses and phone numbers (including the fax nos.) of all counsel who will be participating on behalf of your client and the name of the client(s) you are representing. Please indicate who is lead counsel: Appellant Appellee Other Name(s) and position(s) of client(s), or client representatives, (along with the necessary phone numbers) who will be participating in the conference with you: Return by email or fax (513/564-7349), at least five working days prior to the mediation date, to the attention of Teresa Mack, 331 Potter Stewart U.S. Courthouse, 100 E. Fifth Street, Cincinnati, Ohio 45202. This form can be downloaded from the Mediation Website at http/ca6.uscourts.gov. Rev 06/08 Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com Confidential Mediation Background Information Case Name: Case Number: Confidential Information This information will be not shared with other parties or their counsel. It is intended to help the mediator more efficiently assist you: first, in assessing prospects for settlement generally, and then, if warranted, by steering negotiations toward solutions that might satisfy the parties’ interests. Please be as thorough and candid as possible. 1. Do you or your client have specific interests or concerns other than money that you would like to see addressed in this mediation? 2. What, in your opinion, have been the primary obstacles to settlement to date? 3. Is there anything else you can tell the mediator in advance that might enable him/her to be more helpful or efficient? Return by email or fax (513/564-7349), at least five working days prior to the mediation date, to the attention of Teresa Mack, 331 Potter Stewart U.S. Courthouse, 100 E. Fifth Street, Cincinnati, Ohio 45202. This form can be downloaded from the Mediation Website at http/ca6.uscourts.gov. Rev 06/08 Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com