San Mateo — Stipulation for Appointment or Removal of Mediator

Source: https://sanmateo.courts.ca.gov/system/files/local-forms/fl-18.pdf

FOR COURT USE ONLY ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number, Address)

TELEPHONE NO: FAX NO.(Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SanMateo SuperiorCourt, Hall of Justice 400 County Center RedwoodCity, CA 94063

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT: CASE NUMBER: STIPULATION FOR APPOINTMENT OR REMOVAL OF MEDIATOR (FAMILY LAW)

We, the undersigned, have elected to participate in collaborative law, or mediation, to resolve our case and grant remote access of the case file to the mediator.

We hereby stipulate to ________________________, as mediator.

Mediator Name ______________________
Address ______________________
______________________
______________________
Phone Number ______________________
Bar Number ______________________

I, the undersigned, have elected to no longer participate in collaborative law, or mediation, to resolve our case.

I hereby remove ________________________ as mediator.

I, the undersigned, am no longer providing services as Mediator in this matter.

I hereby remove myself as mediator.

Dated:

TYPE OR PRINT NAME SIGNATURE

Dated:

TYPE OR PRINT NAME SIGNATURE

Form adoptedfor MandatoryUse STIPULATION FOR APPOINTMENT OR REMOVAL www.sanmateo.courts.ca.gov FL-18 …Adopted3/5/21 OF MEDIATOR