STATE OF SOUTH CAROLINA
IN THE FAMILY COURT
I certify that this action is exempt from mediation based on the following:
An agreement has been reached among all parties on every issue.
This is a contempt action.
This is a family court case initiated by South Carolina Department of Social Services
All contested issues have been previously subjected to an ADR conference meeting
the requirements of the ADR Rules (Proof of ADR must be attached).
Submitting Party Signature: _____________________________________ Date: _________________
Print Name: ___________________________________
Self Represented Litigant
SC Bar # (if applicable): _______________