The Commonwealth of Massachusetts
S U F F O L K , s s . T R I A L C O U R T O F T H E C O M M O N W E A L T H
B O S T O N M U N I C I P A L C O U R T D E P A R T M E N T
Plaintiff(s)
C i v i l A c t i o n N o .
Defendant(s)
CERTIFICATION OF COMPLIANCE WITH RULE 5 OF THE
SJC UNIFORM RULES ON DISPUTE RESOLUTION.
I am attorney of record for:
G Plaintiff G Defendant G Other (specify) in the above captioned action.
In accordance with Rule 5 of the Supreme Judicial Court Uniform Rules on Dispute Resolution (SJC Rule
1:18) which states in part “...Attorneys shall: provide their clients with this information about court-
connected dispute resolution services; discuss with their clients the advantages and disadvantages of the
various methods of dispute resolution; and certify their compliance with this requirement on the civil
action cover sheet or it’s equivalent...,” I hereby certify that I have complied with this requirement.
Signed
Print or Type Name
B.B.O. Number
Date
Th is ce r tificatio n m a y be file d b y cou nsel as is, o r th is text m ay be inco rp o ra ted in to a form cu rre n tly in u se at th e
initia tio n o f a case (e.g., civil co v er sh e e t, ap pe a r a nce form , e tc.), a s determ ined to be a p prop ria te in e a c h
dep a rtm e n t o f the Trial C o u rt. P la intiff/P etitio n er’s c o un s e l sh a ll file th is d o cu m ent a t th e tim e his/h e r in itia l
p l e a d i n g i s f i l e d . A l l o t h e r c o u n s e l s h a l l f i l e i t w i t h i n t h i r t y ( 30 ) d a y s o f h i s / h e r i n i t i a l e n t r y i n t o t h e c a s e w h e t h e r
by answ er, m otio n , appea ran c e s lip or other plea d in g .
B M C - C V - 0 4 4 C O U N S E L C E R T I F I C A T I O N (Rev. 02/99 s w f)
