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ATTY NAME & BAR NO Attorney for [PLAINTIFF/DEFENDANT] ADDRESS PHONE NO. IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF UTAH - [CENTRAL/NORTHERN] DIVISION ______________________________________________________________________________ : : : Plaintiff, : MOTION TO REFER CASE TO ADR : FOR [MEDIATION/ARBITRATION] vs. : : Case No. [CASE NO.] : [DEFENDANT] : : Defendant. : : ______________________________________________________________________________ [PLAINTIFF]

The [PLAINTIFF/DEFENDANT], by and through counsel, hereby move the Court to refer the above-captioned matter to the court-annexed Alternative Dispute Resolution Program for [MEDIATION/ARBITRATION], pursuant to DUCivR 16-2 and the Court's ADR Plan.

DATED this _______ of [MONTH], [YEAR].

By ______________________________ [ATTORNEY] Attorney for [PLAINTIFF/DEFENDANT]