Free Microsoft Word - SCADR 104 - South Carolina

STATE OF SOUTH CAROLINA COUNTY OF

Plaintiff, vs.

Defendant.

) ) ) ) ) ) ) ) ) ) ) )

IN THE COURT OF COMMON PLEAS

PROOF OF ADR OR EXEMPTION

FILE NO.:

(An original and copy of this form is to be completed and filed with the Office of the Clerk of Court and a copy forwarded to the attorneys for the parties within 10 days of the conclusion of ADR, or within 300 days of the filing date of the action, whichever is earlier.) PURSUANT to the Court's Standing Order for Alternative Dispute Resolution dated A. I certify that this case is exempt from ADR for the following reason and the parties wish to exercise that exemption:

Plaintiff/Attorney for Plaintiff

Defendant/Attorney for Defendant

Print Name

Print Name

Phone/Fax Date: B.

Phone/Fax

1. Alternative Dispute Resolution (ADR) was conducted in the form of: (Note: If binding arbitration has been chosen by the parties but not yet completed, an appropriate order of dismissal must be attached hereto.) 2. The neutral(s) was/were: (Name of arbitrator/mediator):

3.

The ADR was conducted on

, 200

SCADR 104A (5/2007)

4.

As a result of ADR, this case should be considered (please check one); ( ) Fully Settled. ( or ( ) ( ) ( ) ( ) by Consent Judgment, to be filed by ) Voluntary Dismissal to be filed by

Partially Settled. At an Impasse. In need of further ADR I am am not willing to continue as a neutral. I recommend that ADR resume as of . was present was present was not present was not present

5.

Plaintiff Defendant

6.

Other partcipants were: Lawyer for Defendant Lawyer for Plaintiff Representative for Insurance Carrier Guardian ad Litem Experts Others

7.

Choice of the neutral was by: Stipulation Court Order

8. 9.

The total number of hours spent in ADR was: Further comments of the neutral:

hours.

Neutral's Signature Date:

SCADR 104B (5/2007)