SUPERIOR COURT
OF
CALIFORNIA
COUNTY OF SACRAMENTO 720 9TH STREET ~ ROOM 101 SACRAMENTO, CALIFORNIA, 95814 916-874-5522--WEBSITE WWW.SACCOURT.CA.GOV
COMPLAINT AGAINST NEUTRAL Civil Mediation Program
Date: ___________
Case Name: Neutral Name: Date of Mediation:
_________________________________________________________ _________________________________________________________ _________________________________________________________
Please provide complete details of your complaint (attach additional pages if necessary):
Your Name: Address: City, State, Zip: Telephone: E-mail:
_______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________
Please submit this form to the ADR Administrator, Gordon D. Schaber Sacramento County Courthouse, 720 Ninth Street, Room 101, Sacramento, California, 95814
Complaint Against Neutral CV\EMED169 (Rev 02.13.09) Page 1 of 1