Fillable ATTACHMENT FM-1191 (The Superior Court of California, County of Santa Clara)

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ATTACHMENT FM-1191 (The Superior Court of California, County of Santa Clara)

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ATTACHMENT FM-1191
NEW 07/01/20 FM-1191
For Mandatory Use
REFERRAL TO POST-MEDIATION HEARING (PMH)
Page 1 of 1
ATTORNEY OR PARTY WITHOUT AN ATTORNEY (NAME AND ADDRESS): TELEPHONE NO.:
FOR COURT USE ONLY
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
201 North First Street, San José, CA 95113
MAILING ADDRESS:
191 North First Street
CITY AND ZIP CODE:
San José, California 95113
BRANCH NAME:
Family Justice Center
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
REFERRAL TO POST-MEDIATION HEARING (PMH)
CASE NUMBER:
FCS NUMBER:
1. The parents and other party/parties (list names):_________________________________________________
participated in mediation with Family Court Services (FCS) or a private provider
on (date): ______________________. The mediation process is complete.
2. The parties: reached a partial agreement, which is submitted to the court as a separate document; or
were unable to reach an agreement.
3. The parties are referred to a Post-Mediation Hearing (PMH).
4. The parties are referred to a PMH for the following issues: Legal Custody
Physical Custody
Timeshare/Parenting Time
Holiday Schedule
Miscellaneous Unresolved Parenting Issues
5. The court will send notice of the hearing date and time to the parties.
Dated:
Signature of FCS Mediator Party Attorney for Party
Type or Print Name
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ATTACHMENT FM-1191 (The Superior Court of California, County of Santa Clara)

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Completed 29 June 2021

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