APPENDIX A

LOCAL MANDATORY MEDIATION RULES FOR CHILD CUSTODY

AND VISITATION ISSUES

IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON

FOR LEWIS COUNTY

In Re the )

)

Petitioner, ) No.

)

and ) ORDER TO TRANSFER TO

) MANDATORY MEDIATION

) (ORTF)

)

Respondent, )

THIS MATTER having come on regularly for hearing and it appearing that there are custody or visitation issues requiring mandatory mediation pursuant to LMMR 3, Local Rules for Superior Court, now, therefore,

IT IS HEREBY ORDERED as follows:

1.1 This matter shall be transferred to [] Family Court Services [] ______for mandatory mediation.

1.2 The cost of mediation services shall be paid as follows:

By the Petitioner ______%

By the Respondent ______%

At County expense ______%

1.3 The parties shall cooperate and make themselves available in any reasonable manner deemed necessary by the Mediation Provider for the purposes of this Order.

Order to Transfer to Mediation

DATED this ____ of ______, 20____.

______

Judge

Presented by: Approved as to form/

Presentation Waived

______

Attorney for: [] Petitioner Attorney for: [] Respondent

THE FOLLOWING INFORMATION SHALL BE EITHER PRINTED OR TYPED:

Petitioner’s Address: Respondent”s Address:

______

______

Home Telephone: Home Telephone:

______

Work Telephone: Work Telephone:

______

Order to Transfer to Mediation

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