JUSTICE COURT, LAS VEGAS TOWNSHIP
Clark County, Nevada
Case No.
Department No.
SMALL CLAIMS -
MOTION TO ENTER
MEDIATED AGREEMENT
AS JUDGMENT
Name of Plaintiff(s)
Name of Defendant(s)
This Motion is being brought by Plaintiff Defendant, who hereby requests that the Agreement reached during the
mediation on
(insert mediation date) ___________________, be entered as a Judgment, based upon the following:
AMOUNT AGREED TO AT MEDIATION: $
minus -
PAYMENTS RECEIVED $________
TOTAL OUTSTANDING AMOUNT
TO BE ENTERED AS JUDGMENT $________
(Attach a copy of the receipts for money received.)
This original Motion to Enter Mediated Agreement as Judgment must be E-Filed with the Justice Court Clerk’s Office
and a copy mailed by First Class postage to the opposing Party(s).
A party has the right to file an Opposition to Motion to Enter Mediated Agreement as Judgment. The form is available at
the court’s website: http://www.clarkcountycourts.us/lvjc/small-claims.html#SmallClaimsForms.
Any Opposition must be filed no
later than three (3) business days after receipt of the Motion to Enter Mediated Agreement as Judgment form.
CERTIFICATION OF
MAILING
The Undersigned certifies on the day of , 20 , a copy of the foregoing Motion to Enter Mediated
Agreement as Judgment was mailed to at
by depositing a copy in the United States Mail in an addressed sealed envelope, postage prepaid.
DATE: NAME:
Per NRS 53.045, "I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct."
(Signature):
(Type or print name):
(Date):
LVJCVL Form-127 Revised 1/17
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