[Attorney name] [Address] [Telephone number] Attorney for [e.g., Plaintiff], [name] xxx Court, County of xxx [xxx District] xxxxxx ) ) vs. ) ) xxxxxx ) Defendant(s) ) __________________________) Plaintiff(s) No. xxx STIPULATION TO AGREED FACTS
The undersigned agree (1) that this action [or by a commissioner or judge pro tem of this (2) that judgment may be rendered on pleadings the following statement of agreed facts, which evidence of those facts: [State agreed facts]. Date: xxx ______________________ [Typed name]
may be tried by this Court Court] without a jury and filed in this action and on serve as a substitute for
_____________________ [Typed name] Attorney for [name] _____________________ [Typed name] Attorney for [name]
_______________________ [Typed name]