Complaint Against Neutral Civil Mediation Program

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S
C
C
U P E R I O R
O U R T O F
A L I F O R N I A
C
S
OUNTY OF
ACRAMENTO
TH
720 9
S
~ R
101
TREET
OOM
S
, C
, 95814
ACRAMENTO
ALIFORNIA
916-874-5522—
.
.
.
WEBSITE WWW
SACCOURT
CA
GOV
COMPLAINT AGAINST NEUTRAL
Civil Mediation Program
Date: ___________
_________________________________________________________
Case Name:
Neutral Name:
_________________________________________________________
Date of Mediation:
_________________________________________________________
Please provide complete details of your complaint (attach additional pages if necessary):
Your Name:
_______________________________________________________________
Address:
_______________________________________________________________
City, State, Zip:
_______________________________________________________________
Telephone:
_______________________________________________________________
E-mail:
_______________________________________________________________
Please submit this form to the ADR Administrator, Gordon D. Schaber Sacramento
County Courthouse, 720 Ninth Street, Room 101, Sacramento, California, 95814
Complaint Against Neutral
CV\E–MED–169 (Rev 02.13.09)
Page 1 of 1

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