PETITION FOR MEDIATION PACKET NOTICE Sections of the Family

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					  PETITION FOR MEDIATION PACKET




                                    NOTICE

       Sections 3160 - 3186 of the Family Code pertain to Mediation. Family Codes are
available at the Law Library, in the basement of the County Courthouse, at City-County
Libraries and most bookstores.

      This packet contains:
            • Instruction sheet for completing Petition for Mediation form
            • Petition for Mediation form
            • Family Court Services (FCS) Policy Manual
            • FCS return to court after mediation instruction sheet
            • Miscellaneous informational handouts re: Family Law Facilitator and
               Interpreter Services


      Note: When submitting forms for filing, please submit the original and
            three (3) copies.




                                                    C:\WINDOWS\Desktop\forms\Petition for Mediation
                                                                                        Packet.doc
                                PETITION FOR MEDIATION

                             APPLICATION INSTRUCTIONS

Read the following instructions before completing the Petition for Mediation form.

1. “Without further hearing, the Court may:
   • (a) order the parties to reimburse the County of Sacramento pursuant to Sections 3111-3114
      of the Family Code, for all or part of the expense of custody investigation reports; and,
   • (b) divide between the parties such expense in accordance with their respective ability to pay.
             Note: See page 7 in the attached Family Court Services Policy Manual regarding
                 fees.

2. Type or print legibly in blue or black ink only. Please provide all information requested on the
   form. Incomplete forms will be returned for completion.

3. Provide petitioner’s and respondent’s name, mailing address and telephone number in section 6
   & 7 of the petition. Use business addresses only when the home address is unavailable. If
   applicable, provide the name(s) and address(es) of the attorney(s) of record in section 6 & 7 and
   claimants information in Section 8 of the petition.

4. Date and sign section 5 of the petition and make three (3) photocopies.

5. Submit the original and three (3) photocopies to Family Court Services, 3341 Power Inn Road,
                                                                                                 st
   Room 104, Sacramento. Filings may also be placed in the court drop box located on the first (1 )
   floor.

6. Family Court Services will mail copies of the endorsed Petition for Mediation and Notice of
   Orientation/Mediation appointment dates/times to all parties of the action.

7. Mediation appointments cannot be re-set or dropped without the agreement of both parties.
   Both parties must contact Family Court Services, either by telephone or in writing, requesting or
   agreeing to the re-setting or dropping of the mediation appointment.

8. Appointments are set only on weekdays. There are no evening appointments available.

      Note:If you have questions regarding completion of the petition,
           you may contact the Office of the Family Law Facilitator at
           875-2650. (see attached notice)




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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address):          TELEPHONE         For Court Use Only
NO.:




ATTORNEY FOR: (Name)

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SACRAMENTO
STREET ADDRESS: 3341 Power Inn Road
MAILING ADDRESS: Same
CITY AND ZIP CODE: Sacramento, California 95826

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

CLAIMANT:


                                                                                  FL Case No.:___________________________
                           PETITION FOR MEDIATION
                           Family Code §§ 3160-3186                               FCS Case No.:_________________________


1.       Provide any of the following applicable case numbers:
         Family Law:               ____________________        Family Support:          ____________________

         Domestic Violence:        ____________________       Other Family Law#         ____________________

2.       A Controversy exists between the above named parties concerning (check all that apply and provide
         brief explanation):
            Custody           Visitation    Other
         ___________________________________________________________________________________________
         ___________________________________________________________________________________________
         ___________________________________________________________________________________________
         ___________________________________________________________________________________________


3.       Date of last Mediation Report: __________/__________/__________

4.       Do you have a current Domestic Violence Restraining Order?              Yes (If yes, attach a copy)        No


5.     Any information I have provided above and any attachment to this Petition is furnished in good faith in
the hope of settling the controversy. I declare under penalty of perjury that the foregoing information is true
and correct.

Dated:      _______/_______/_______
                                                           SIGNATURE OF DECLARANT

     Mediation of the controversy is ordered:                  Mediation of the controversy is denied: (See Attached form)

Dated:      _______/_______/________
                                                          Judge of the Superior Court of California, County of Sacramento




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                   6.        Petitioner’s Information                                  7.        Respondent’s Information

        Name:                                                               Name:
                 First                 MI               Last                           First                  MI            Last

         DOB:    __________/__________/__________                           DOB:       __________/__________/__________

      Address:                                                          Address:
                 No. Street (Apt.)                                                     No. Street (Suite #)


                 City           State                          Zip                     City           State                        Zip
      Hm. Ph.    (_______)______-_______                                Hm. Ph.        (_______)_______-________

     Work Ph.    (_______)______-_______                               Work Ph.        (_______)_______-________

     Attorney                                                          Attorney
       Name:                                                             Name:
                 First                 MI               Last                           First                  MI            Last

      Address:                                                          Address:
                 No. Street (Apt.)                                                     No. Street (Suite #)


                 City                State                     Zip                     City                State                   Zip

     Work Ph.    (_______)______-_______                              Work Ph.:        (_______)_______-________

8.         Claimant’s Information                                              8a.      Claimant’s Attorney Information

        Name:                                                               Name:
                 First                 MI               Last                           First                  MI            Last

         DOB:    __________/__________/__________

      Address:                                                          Address:
                 No. Street (Apt.)                                                     No. Street (Suite #)


                 City                State                     Zip                     City                State                   Zip

      Hm. Ph.    (_______)______-_______                               Work Ph.        (_______)_______-________
     Work Ph.    (_______)______-_______


9.         CHILDREN AT-ISSUE
           Name                                          DOB                   School                               Resides With

a._________________________________________________________________________________________________________

b._________________________________________________________________________________________________________

c._________________________________________________________________________________________________________

d._________________________________________________________________________________________________________

e._________________________________________________________________________________________________________

10.        Name of Children(s) Attorney: (if applicable)
            Name:                                                                                Work Ph(_____)_____-___________
                     Last                       First                                M.I.
           Address:
                          Number Street (Apt.)                       City                          State            Zip




                                                                             C:\WINDOWS\Desktop\forms\Petition for Mediation Packet.doc
                             Superior Court of California
                               County of Sacramento

                              Office of Family Court Services

                                         NOTICE


                             FAMILY COURT SERVICES
                              ATTORNEY INPUT FORM


Effective July 1, 1997, the Office of Family Court Services (FCS) will no longer provide an attorney
input form at the time the Mediation/Investigation appointment is set.

If an attorney wishes to provide input to the FCS Mediator/Evaluator, they can do so on their own
letterhead. The input MUST be accompanied with a proof of service on the other party of the
action, or it will not be considered by the Mediator/Evaluator. The input should be brief and must not
exceed a single, double spaced, typed page.

Any questions relating to this change, may be addressed to Family Court Services at
875-2600.




                                                           C:\WINDOWS\Desktop\forms\Petition for Mediation Packet.doc
               RETURN TO COURT AFTER MEDIATION

                            INSTRUCTION SHEET




       THE FAMILY COURT SERVICES REPORT IS NOT AN ORDER


1.   For this report to become an order, you need to appear in court. If mediation
     resulted from a filing of an Order to Show Cause or Notice of Motion, you will
     already have a court date set during which this report will be considered.

2.   If mediation occurred as the result of you or the other party filing a Petition for
     Mediation, you or the other party must submit an OSC (Order to Show Cause) or
     Notice of Motion form in room 100 to have the matter calendared for hearing.

3.   If you have any questions concerning the above, you should contact the Family
     Law Facilitator’s Office in the courthouse, room 113, (916) 875-2660.




                                                   C:\WINDOWS\Desktop\forms\Petition for Mediation Packet.doc
                          Superior Court of California
                            County of Sacramento



                                   NOTICE

Regarding Availability of Court Interpreters For Family
         Law / Family Court Services (FCS)

  1. The Court Interpreters Office does not provide interpreter assistance to customers of
     Family Law / Family Court Services.

  2. It is the responsibility of the parties involved to obtain the services of an interpreter. A
     family member or friend may interpret at a court hearing or FCS appointment.

  If you prefer to hire an interpreter, the Court Interpreters Office at 720 9th Street, Room 201,
      may be contacted for referrals, which must be done five days prior to the court hearing or
      FCS appointment. The cost for interpreter services is the responsibility of the party
      requesting the service.

  3. By law, the Court must provide an interpreter to any hearing impaired person, (free of
     charge) requiring services provided by the Court.

  4. Arrangements to have an American Sign Language interpreter present at a court hearing
     or FCS appointment, can be made by one of the following processes:

         ⇒ five (5) days prior to the court hearing or FCS appointment, contact the Court
           Interpreter Office (address noted above),

         ⇒ if you have a TDD machine, call (916) 874-8474,

         ⇒ if you do not have a TDD machine, you can receive assistance by calling the
           California Relay Operator (AT&T) @ 1-800-735-2929.




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