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INITIAL STATUS REPORT OF MEDIATOR Case Name: County: Docket Number: Mediator Name:
Mediator Telephone Number:
Mediator Fax Number: To: Civil CDR Point Person (please check appropriate fax number) Atlantic (609) 343-2326 Bergen (201) 371-1131 Burlington (609) 518-2826 Camden (856) 379-2253 Cape May (609) 463-6465 Cumberland (856) 453-4349 Essex (973) 648-7789 Gloucester (856) 853-3429 Hudson (201) 217-5091 Hunterdon (908) 237-5821 Mercer (609) 571-4473 Middlesex (732) 519-3725 Monmouth (732) 677-4369 Morris (973) 656-4104 Ocean (732) 435-8384 Passaic (973) 247-8185 Salem (856) 935-6551 Somerset (908) 231-7167 Sussex (973) 579-0736 Union (908) 659-3273 Warren (908) 475-6142
1. 2. 3.
The organizational telephonic conference was held on The parties must complete their informal information exchange by An initial mediation session has been scheduled for
Revised 04/29/2009, CN 10527-English
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Initial Status Report of Mediator
4.
If any of the above questions have not been answered, please provide details.
5.
Please complete if applicable: The mediator requires assistance from the court
Dated:
Mediator: (print or type name)
Note: This form must be faxed to the court at the appropriate county fax number listed above no later than 35 days after the referral of the case to you even if the telephone conference has not been held.
Revised 04/29/2009, CN 10527-English
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