§ Form 3 Joint Alternative Dispute Resolution Statement to the Court

Form 3. Joint Alternative Dispute Resolution Statement to the Court

Name:

Address:

City:

State:

Phone:

IN THE SUPERIOR COURT OF THE STATE OF ARIZONA

IN AND FOR THE COUNTY OF __________

__________ ) Case No.:

Plaintiff ) Joint Alternative Dispute Resolution

vs ) Statement to the Court

__________ )

Defendant )

Pursuant to the Arizona Rules of Civil Procedure, I hereby state the following, under penalty of perjury:

1. The parties have conferred as required by Rule 16(g)(2). [ Yes [ No ] ]

2. Is this case subject to compulsory arbitration under Rule 72(b)? [ Yes [ No ] ]

[Note: Pursuant to Rule 72(d), the court shall waive the compulsory arbitration requirement if the parties agree to
participate in a different ADR process approved by the court.]

3. If the case is subject to compulsory arbitration have the parties [ Yes [ No agreed to participate in an ADR process other than compulsory arbitration? ] ]

4. If the case is not subject to compulsory arbitration have the [ Yes [ No parties agreed to participate in an ADR process? ] ]

5. If the answer to three or four is yes, the parties agree to participate in the following ADR process:

        A.         [        mediation        [        binding arbitration        [        early neutral evaluation
                     ]                               ]                                            ]
                     [        short trial        [        summary jury trial        [         judge pro tem                                                ]    ]                                             ]
                    [ ]      other __________

B. [ ] The parties will use a private provider

[ ] The parties request a program provided through the court [Note: not all programs are available through the
court.]

C. If known, the name and address of the person or company providing the ADR service is:

D. The parties expect to complete the ADR process by: / /

6. The parties have been unable to agree on an ADR process. The [ ] plaintiff / [ ] defendant believes that the following ADR process would be appropriate:

7. The [ ] plaintiff / [ ] defendant requests a conference to discuss ADR.

8. The [ ] plaintiff / [ ] defendant believes that an ADR process would not be appropriate for the following reason:

______________________________________ ______________________________________

Date Plaintiff

______________________________________ ______________________________________

Date Defendant