ATTACHMENT CV-5017
ATTORNEY OR PARTY WITHOUT AN ATTORNEY (NAME AND ADDRESS) TELEPHONE NUMBER:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PLAINTIFF:
DEFENDANT:
FOR COURT USE ONLY
JUDGES ADR PROGRAM
STIPULATION AND ORDER FORM
CASE NUMBER:
The parties and their attorneys stipulate that the claims in this action be submitted to the Judges ADR
Program as a
Mediation
Settlement Conference.
It is further stipulated that the matter be submitted to the following Judge(s), in the following order:
1. The Hon. , Judge, Superior Court of California, County of Santa Clara; or
2. The Hon. , Judge, Superior Court of California, County of Santa Clara; or
3. A Judge of the Superior Court of California, County of Santa Clara assigned by the Civil Supervising
Judge.
We estimate the trial will take
days.
Parties and counsel have read and agree to be bound by the Rules of the Judges ADR Program, and the
Rules Court of the Superior Court of California, County of Santa Clara.
Date:
(Attorney for Plaintiff, or Self-Represented Plaintiff) (Signature)
(Attorney for Defendant or Self-Represented Defendant) (Signature)
(Attach Additional Signature Pages if Necessary)
ORDER ON REVERSE SIDE
CV-5017 REV 1/1/08 JUDGES ADR PROGRAM Page 1 of 2
STIPULATION AND ORDER FORM
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