Free mediation - New Jersey

Sample Form

UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY

In re: Case No.

Chapter Debtor. Use adversary caption if applicable. Plaintiff, v. Defendant. Adversary No.

JOINT APPLICATION REQUESTING REFERRAL OF MATTER TO MEDIATION Applicants, (identify attorneys and the parties each represent), hereby submit this joint application for approval of a consent order to refer this contested matter (identify contested matter) to mediation.

1.

The parties have resolved all matters relating to the manner in which the mediation

shall proceed as reflected in the proposed consent order submitted herewith [if applicable, " with the exception of the following matters:"].

2. 2. mediator.

Also submitted herewith is the acceptance form executed by the selected mediator. -orThe parties are unable to agree upon a mediator and request the court to select a

C:\publishing\APPLICA.WPD/Feb.1998

Joint Application Requesting Referral of Matter to Mediation - Sample Form

WHEREFORE, the undersigned counsel and parties respectfully request this court enter the consent order for referral to mediation submitted herewith.

Adam, Adam & Adam Attorneys for

Smith, Smith & Smith Attorneys for

________________________ By:

__________________________ By:

________________________ Party/Litigant

__________________________ Party/Litigant

C:\publishing\APPLICA.WPD/Feb.1998

Joint Application Requesting Referral of Matter to Mediation - Sample Form