Fillable Form 5 Rev 4/2021: MEDIATION An alternative dispute (Fifth Judicial District of Pennsylvania)

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Form 5 Rev 4/2021: MEDIATION An alternative dispute (Fifth Judicial District of Pennsylvania)

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LANDLORD/TENANT MEDIATION INFORMATION
MEDIATION – An alternative dispute resolution process, and an alternative to litigation.
All parties must agree to mediate. The Mediator does not have the authority or power to enter an
award, to terminate the dispute, or to employ equitable relief. Mediation is not punitive.
What are the benefits of Mediation?
• Achieves finality – brings the case to conclusion.
• Eliminates uncertainty and further risks associated with litigation.
• Allows for self-determination.
• Allows litigants to see and understand benefits to resolution.
Disputes are resolved through mutual agreement of the parties ONLY.
Mediation involves no evidentiary submissions, swearing in of witnesses, or testimony taken.
No public record of the mediation is created, and break-out sessions are conducted separately
with each party.
These discussions are confidential.
No notes are preserved relating to negotiations.
AGREEING TO MEDIATE WILL NOT DELAY YOUR
ARBITRATION HEARING
Form 5 Rev 4/2021
MEDIATION REQUEST FORM
1. My name is _____________________________. I have an Arbitration hearing
scheduled for ________________________, 20_____; in case docket number
LT_______-_________________.
2. I have read the Landlord/Tenant Mediation Information sheet, and I am interested in
proceeding with mediation.
3. I understand mediation is voluntary and confidential.
4. I understand if mediation is unsuccessful, my case will be heard before a panel of
arbitrators on the above date.
5. This form may be completed and submitted to the Housing Court Help Desk located at
City-County Building, 414 Grant Street, Pittsburgh, PA 15219, or it may be taken to
the City-County Building, Courtroom 702, on the day of your scheduled Arbitration
hearing.
IF YOU HAVE ANY QUESTIONS ABOUT THIS FORM OR THE
MEDIATION PROCESS, YOU MAY CONTACT THE HOUSING
COURT HELP DESK AT 412-350-4462.
Respectfully Submitted,
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Form 5 Rev 42021: MEDIATION An alternative dispute (Fifth Judicial District of Pennsylvania)

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Completed 16 May 2021

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