Free Stipulation for Mediation - Michigan

Approved, SCAO

Original - Court 1st copy - Plaintiff

2nd copy - Defendant 3rd copy - Mediator

STATE OF MICHIGAN JUDICIAL DISTRICT JUDICIAL CIRCUIT COUNTY PROBATE
Court address

CASE NO. STIPULATION FOR MEDIATION

Court telephone no.

Plaintiff name(s), address(es), and telephone no(s).

Defendant name(s), address(es), and telephone no(s).

v

Plaintiff attorney, bar no., address, and telephone no.

Defendant attorney, bar no., address, and telephone no.

Probate

In the matter of

1. The parties agree that this matter shall be submitted to mediation under MCR 2.411(B). mediation under MCR 3.216(A)(1). evaluative mediation under MCR 3.216(A)(2). 2. At the request of the parties,
Name

has agreed to serve as mediator.

Date

Plaintiff/Attorney signature

Date

Defendant/Attorney signature

USE NOTES: · Item 2 must be checked in general civil matters if parties stipulate to mediation. · If item 2 is not completed in a domestic relations matter and evaluative mediation is not requested, mediation will be nonevaluative and a mediator will be assigned from the court roster of domestic relations mediators. · After this form is filed with the court, an order for mediation will be prepared for the judge's signature.

MC 279 (8/00)

STIPULATION FOR MEDIATION

MCR 2.411(B), MCR 3.216(A)