Consent To Serve And Certification Of

Cal. Form FL-002

California Superior Local Rules

Form Adopted for Mandatory Use Superior Court of California, County of Alameda ALA FL-002 – Attachment [New January 1, 2008] CONSENT TO SERVE AND CERTIFICATION OF PRIVATE CHILD CUSTODY RECOMMENDING MEDIATOR Fam.

Code § 3164 ALA FL-002 - Attachment ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, ALAMEDA COUNTY STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER: CONSENT TO SERVE AND CERTIFICATION OF PRIVATE CHILD CUSTODY RECOMMENDING MEDIATOR CASE NUMBER: 1. My name is 2.

Pursuant to the order of court rendered on (date) , I hereby consent to serve as the private child custody recommending mediator in the above entitled action. 3. I agree to conduct the mediation in accordance with and shall comply with Family Code §§216, 1815 and through 3188, and the applicable provisions of California Rules of Court. I shall submit to the Court a written report and recommendations as to custody and/or visitation, and may submit such other recommendations as are authorized by Family Code §3183.

I will be impartial, maintain appropriate levels of confidentiality, and shall function at the request of the Court and pursuant to court order. CERTIFICATION I certify that I meet the minimum qualifications required of a counselor of conciliation as provided in Family Code § 1815 and that I meet the continuing education requirements specified in Family Code § 1816. Date: _________________________________________________________ (SIGNATURE OF PRIVATE CHILD CUSTODY RECOMMENDING MEDIATOR)

Document details

Collection	California Superior Local Rules
Citation	Cal. Form FL-002
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	5634810c0ad8ead295583d50e5eb9da764d0f3e1

Source file is stored in the law ingest library (pdf).