COMMONWEALTH OF MASSACHUSETTS
________________,SS: HOUSING COURT DEPARTMENT
_______________ DIVISION
_________________________
PLAINTIFF(S)
VS.
________________________
DEFENDANT(S)
REFERRAL TO HOUSING SPECIALIST DEPARTMENT
NOTICE
You are not required, prior to trial to go before the Housing
Specialist. You have the right to refuse referral to a Housing
Specialist.
However, the Housing Specialist Department can sometimes help a
complainant and defendant arrive at an agreement satisfactory to both.
Housing Specialists are Court personnel. Anything said to a Housing
Specialist, and any agreement made before a Housing Specialist prior to
trial is held in strict confidence, and is not admissible as evidence if
a trial is held.
AGREEMENT
I have read the above notice and agree to referral to the Housing
Specialist Department.
Complainant __________________________
Date: ___________ Address ______________________________
City/State ___________________________
Telephone ____________________________
Defendant________________________
Address ______________________________
City/State ___________________________
Form Rev 7/99 Telephone ____________________________
