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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 939 W. Main Street El Centro, CA 92243

PETITIONER: RESPONDENT: CASE NUMBER: STIPULATION TO USE OF ALTERNATIVE DISPUTE RESOLUTION PROCESS (California Rules of Court 3.221)

The parties and/or their attorneys stipulate that the matter is at issue and that this action shall be submitted to the following alternative dispute resolution process. Selection of any of these options will not delay any case management timelines.

_____ Court Ordered Non-Binding Arbitration (Cases valued at $50,000 or less)

_____ Private Mediation

_____ Private Binding Arbitration

_____ Other (specify):______________________________________________________________

It is also stipulated that the following shall serve as arbitrator, mediator or other neutral:

________________________________________________________________________________.

Date:_______________________________ Date:_______________________________

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Name of Plaintiff/Petitioner Name of Defendant/Respondent

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Signature of Plaintiff/Petitioner Signature of Defendant/Respondent

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Name of Plaintiff’s Attorney Name of Defendant’s Attorney

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Signature of Attorney Signature of Attorney

GN-03 (Adopted 01/01/11 STIPULATION TO USE OF ALTERNATIVE DISPUTE Revised 01/01/13) RESOLUTION PROCESS (CA Rules of Court 3.221)