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Name,Address and Telephone Number of Attorney(s): <br /> UNITED STATES DISTRICT COURT <br /> CENTRAL;DISTRICT OF CALIFORNIA <br /> CASE NUMBER <br /> V. Plaintiff(s) <br /> REQUEST: <br /> ADR PROCEDURE SELECTION <br /> Defendant(s). <br /> Pursuant to Civil L.R.16-15, the parties request that the Court approve the following ADR <br /> procedure: <br /> ❑ ADR PROCEDURE NO. 1 - The parties shall appear before the <br /> ❑ district)edge or ❑ magistrate judge assigned to the case for such settlement <br /> proceedings as the judge may conduct or direct. <br /> ❑ ADR PROCEDURE NO. 2 - The parties shall appear before a neutral selected <br /> from the Court's Mediation Panel for mediation. <br /> ❑ ADR PROCEDURE NO. 3 - The parties shall participate in a private dispute <br /> resolution proceeding. <br /> Dated: <br /> Attorney for Plaintiff <br /> Dated: <br /> Attorney for Plaintiff <br /> Dated: <br /> Attorney for Defendant <br /> Dated: <br /> Attorney for Defendant <br /> NOTE: If additional signatures are required,attach an additional page to this request. <br /> ADR-01 (01/12) REQUEST:ADR PROCEDURE SELECTION __ page 1 of 1 <br />