Orange — Statement of Agreement or Nonagreement

Source: https://www.occourts.org/system/files/statement_of_agreement_or_nonagreement.pdf

ADR NEUTRAL NAME, ADDRESS, TELEPHONE, FAX AND EMAIL: For Court Use Only

For your protection and privacy, please press the Clear This Form button after

you are done printing this form.SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE

JUSTICE CENTER: Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045 Civil Complex Center - 751 W. Santa Ana Blvd., Santa Ana, CA 92701-4512 Harbor – Newport Beach Facility – 4601 Jamboree Rd., Newport Beach, CA 92660-2595 North – 1275 N. Berkeley Ave., P.O. Box 5000, Fullerton, CA 92838-0500

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT:

ALTERNATIVE DISPUTE RESOLUTION (ADR) CASE NUMBER:
COMPLETION REPORT

Mediation Neutral Evaluation
(Attention Neutral: This report must be filed with the Court and a copy mailed to all parties
within 10 days of completing the ADR session.)

1. The ADR session took place on (date(s)): for a total of hours.

2. The ADR process ended or resulted in (check one):

   a. Full Partial settlement. The stipulation or dismissal(s) of the case is attached to this report.

   b. Full agreement as to certain issues.

   c. Non agreement.

3. The session did not take place because:

   A party who was required to appear at the ADR session did not appear.

   A party failed to pay the initial deposit of fees required.

   Other reason (please specify without disclosing any confidential information):

Date: (SIGNATURE OF NEUTRAL)

ALTERNATIVE DISPUTE RESOLUTION (ADR) COMPLETION REPORT

Adopted for Mandatory Use Clear This Form L-2756 (Revised 4-2014) For your protection and privacy, please press the Clear This Form button after you are done printing this form. Print This Form