Form Ri-Adr02 - Response To Notice Of Court-Ordered Mediation (Local Rule 3273) Page 2

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PROOF OF SERVICE BY MAIL
(Must be attached to the original document at time of filing)
Case No.
I, the undersigned, say: I am over the age of eighteen years and not a party to the within action or proceeding; that my
residence or business address is:
That on the
day of
, I served a copy of the paper to which this proof of service by mail
is attached, RESPONSE TO NOTICE OF COURT-ORDERED MEDIATION, by depositing said copy enclosed in a
sealed envelope with postage hereon fully prepaid, in the United States Postal Service mail box at the city of
California, addressed as follows:
Mediator named in 1
Name:
I certify (or declare) under penalty of perjury that the foregoing is true and correct.
Executed on
, at
, California
(SIGNATURE)
Page 2 of 2
Adopted for Mandatory Use
Local Rule 3273
RESPONSE TO NOTICE OF COURT-ORDERED
Riverside Superior Court
riverside.courts.ca.gov/localfrms/localfrms.shtml
MEDIATION
RI-ADR02 [Rev. 07/01/15]
(Local Rule 3273)

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