NO. ____________________ __________________ Vs. § § § __________________ § § IN THE _________________ _____________________ ___________ County, Texas ORDER OF REFERRAL TO MEDIATION This case is appropriate for mediation pursuant to Tex. Civ. Prac. & Rem. Code Ann., Section 154.001, et seq. IT IS ORDERED that SMU Plano Mediation & Conflict Resolution Services (“SMU”), 5228 Tennyson Parkway, Suite 213, Plano, Texas 75024-3547, (972) 4733486, is appointed Mediator in the above case and all parties are directed to contact SMU through their counsel, or personally if they are unrepresented by counsel, within seven business days to arrange the logistics of mediation and a date for mediation. If no agreed date can be scheduled, then SMU shall select a date for the mediation and all parties shall appear as directed by SMU. The date scheduled by SMU is incorporated in this Order as the date upon which the mediation shall occur. The date scheduled for mediation, can not be changed or cancelled except upon agreement of the parties, and only so long as the mediation can be rescheduled before the mediation deadline, unless otherwise ordered by the Court. The mediation deadline, before when mediation shall occur, is no later than 15 days prior to the date this matter is set for trial. IT IS FURTHER ORDERED that the administration fees for the mediation charged by SMU are to be divided and borne equally by the parties unless agreed otherwise, shall be paid by the parties directly to SMU, and shall be taxed as costs. IT IS FURTHER ORDERED that, upon completion of the Mediation, SMU is directed to advise this Court when the process was completed, whether the parties and their counsel appeared as ordered, and whether a settlement resulted. As provided by Tex. Civ. Prac & Rem. Code Ann., Section 154.053 and Section 154.073, all matters, including the conduct and demeanor of the parties and their counsel during the mediation process, are to remain confidential and will not be disclosed to anyone, including this Court. Except as may be permitted by Tex. Civ. Prac. & Rem. Code Ann., Section 154.073, neither the Mediator nor the Mediator’s files shall be subject to a subpoena or to a request for production filed by any person. SIGNED this ___ day of ____________, 20__. ________________________________ JUDGE PRESIDING American LegalNet, Inc. www.FormsWorkFlow.com