Baker Supp. L. R. 16 app C
See SLR 12.015(3)
__________________________________, Petitioner, | CASE No: ____________________ DOMESTIC RELATIONS |
and | MEDIATOR REPORT |
__________________________________, Respondent. | [] AMENDED REPORT |
TOTAL TIME SPENT ON MEDIATION:Enter in minutes __________
This includes time spent on mediation activities (scheduling, party contact, case management, individual orientation), as well as time spent in mediation sessions and drafting the mediation agreement.
MEDIATION OUTCOMES:
[] FAILURE TO APPEAR FOR MEDIATION
(Filing Code: FTAM) At least one party failed to appear for mediation.
CUSTODY AND PARENTING TIME
Select one of the below if custody and parenting time mediation was provided
[] FULL AGREEMENT (Filing Code: AGME)
Parties reached agreement on all custody and parenting time issues.
[] PARTIAL AGREEMENT (Filing Code: MEPA)
Parties reached partial agreement on custody and parenting time issues.
[] NO AGREEMENT (FILING CODE: MENA)
Both parties appeared for mediation but either they were unable to reach agreement on any custody or parenting time issues, and/or the case was inappropriate for mediation and mediation was not continued or completed.
FINANCIAL MEDIATIONwas provided for the following issues:
[] property division [] spousal support [] child support [] other:__________________ Select one of the below if financial mediation was provided
[] FULL AGREEMENT (Filing Code: MEFA)
Parties reached agreement on the selected financial issues.
[] PARTIAL AGREEMENT (Filing Code: MEFP)
Parties reached partial agreement on the selected financial issues.
[] NO AGREEMENT (Filing Code: MEFN)
Both parties appeared for mediation but either they were unable to reach agreement on the selected financial issues, and/or the case was inappropriate for mediation and mediation was not continued or completed.
Date: __________________Mediator:___________________
Revised 12/1/23
Baker Supp. L. R. 16 app C