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IN THE UNITED STATES DISTRICT COURT DISTRICT OF UTAH - CENTRAL DIVISION ______________________________________________________________________________ : : : Plaintiff, : REFERRAL TO ADR PROGRAM : FOR [MEDIATION/ARBITRATION] vs. : : Case No. [CASE #] [DEFENDANT], : : Defendant. : : ______________________________________________________________________________ [PLAINTIFF]

The above-entitled matter is hereby referred to the court-annexed Alternative Dispute Resolution Program for [MEDIATION/ARBITRATION]. Further proceedings in this matter will be governed by the provisions of DUCivR 16-2 and the Court's ADR Plan. IT IS SO REFERRED, this _____ day of [MONTH], [YEAR].

By _____________________________ [JUDGE] United States [DISTRICT/MAGISTRATE] Judge