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YZ[\]^_`ab(03  *XXD (#X*       _@ 4XXINTHETHIRTEENTHJUDICIALCIRCUITCOURTOFMISSOURI  @ FAMILYCOURTDIVISION t InretheMatterof L __________________________  Petitioner H  and  0 ` 0 ` (#` (#0 (# (#0(#(#0D(#(#CaseNo.: D(#D(# __________________________ X   Respondent  l  @??'XX4 FORM15 #4XX_#Ԉ   Form15mustbecompletedbyPetitionerandfilednolaterthan60daysfromthedateofservice,whenadissolutionor T  motiontomodifyinvolveschildren. h  Checkallthatapply: ,  1.0  ____0` (#(#ThepartieshavecompletedtwohoursofRule68.12mediationasverifiedbytheNoticeofMandatory   MediationCompliance.d` (#` (# 2.0  ____0` (#(#Thepartieshavenodisputesregardingparentingissuesregardingthechildren.(x` (#` (# 3.0  ____0` (#(#TherequiredmediationunderRule68.12hasbeenwaivedbyorderoftheCourt.<` (#` (# <XX D (#XXD X<0  IFYOUHAVESELECTED1,2,OR3ABOVE,YOUNEEDONLYSIGNTHEAFFIDAVITBELOWAND  FILEFORM15.IFYOUCANNOTSELECT1,2OR3ABOVE,PLEASECONTINUE.t(#(# 4.  ____0 ` Thepartieshaveadisputeregardingparentingissuesandhavenotbeentoamediator:8` (#` (#   0 ` a._____0 ` (#` (#PartiesrequestcourtappointedmediatorL (# (#   0 ` b._____0 ` (#` (#Partiesrequest________________________________beappointedmediator (# (#   0 ` 0 ` (#` (#0 (# (#Mediator'sAddress________________________________ (# (#   0 ` 0 ` (#` (#0 (# (#Mediator'sTelephone______________________________H (# (#   0 ` c._____0 ` (#` (#PartiesrequestMARCHmediationservices(paternitycases,familyaccessmotions,and  \ post-dissolutionmotionsqualifyforMARCHmediationservices)  (# (# 5.0  ____0` (#(#TherehasbeenorthereisacurrentRestrainingOrderorProtectionFromAbuseOrderinvolvingthe  partiesorthechild.X ` (#` (# ThePetitioner'smailingaddressis:  0  TheRespondent'smailingaddressis:l!(#(# ___________________________________  _________________________________ 0" ___________________________________  _________________________________ # ___________________________________  _________________________________ h $ AttorneyforthePetitioneris: 0  0(#(#AttorneyfortheRespondentis:,!|%(#(# Name_______________________________  Name______________________________ !@& Address_____________________________  Address____________________________ "' Phone______________Fax______________  Phone_________________Fax__________ x#( @66&AFFIDAVIT %P * IherebycertifythattheaboveResponsetoRule68.12MediationofChildCustodyandVisitationDisputesiscomplete, %!+ trueandaccuratetothebestofmyknowledgeandbelief. &!,   0 ` 0 ` (#` (#0 (# (#0 (# (#0(#(#______________________________________________(`#.(#(#   0 ` 0 ` (#` (#0 (# (#0 (# (#0(#(#_Affiant_-Petitioner/Respondent($$/(#(#  Certificateofmailing: Iherebycertifythatacopyoftheaboveandforegoingwasmailedonthis_____dayof \*%1 _________________________,200___. "+r&2   0 ` 0 ` (#` (#0 (# (#0 (# (#0(#(#Signature:______________________________________n-(5(#(# Ї@NNXX4 XUXXXINTHETHIRTEENTHJUDICIALCIRCUITCOURTOFMISSOURI  @// FAMILYCOURTDIVISION  IntheMatterof b ______________________________ . ~ Petitioner  d and   `        D CaseNo:____________________    ______________________________ x  Respondent ^  @* *  NOTICEOFMANDATORYMEDIATIONCOMPLIANCE  F Pleasecheckallthatapply:  &Thepartiescompliedwiththecourtordertomediate.  &Anagreement&was&wasnotreached&partiescontinueinmediation. ` &ThePetitionerdidnotcomplywiththecourtordertomediate. ,| &TheRespondentdidnotcomplywiththecourtordertomediate. H &Themediatorrequestsleavetowithdrawduetoaconflictofinterest.  &Thedifferencesofthepartieswereresolvedpriortomediation.   &Notappropriateunder_M.A.R.C.H._ԀGuidelinesbasedondirector'sreview. \"! &Other:______________________________________________________ ($x# _________________________  _________________________ '#' Mediator(printname)      D Date (#( _________________________ r*%* Mediator'ssignature X+&+   >,', @NNINTHETHIRTEENTHJUDICIALCIRCUITCOURTOFMISSOURI  @// FAMILYCOURTDIVISION  IntheMatterof b ______________________________ . ~ Petitioner  d and   `        D CaseNo:____________________    ______________________________ x  Respondent ^  @ ORDERFORMEDIATIONANDAPPOINTMENTOFMEDIATOR  `  ITISHEREBYORDERED thatthepartiesinthiscauseshallcompletemediationsetforth 2 inLocalCourtRule68.12andincompliancewithSupremeCourtRule88within30days  ofthisorder.Saidmediationcostsshallbeattheexpenseoftheparties.   ITISFURTHERORDERED thattheappointedmediatorinthiscauseshallbe:    0 ` Mediator'sName:  __________________________________R` (#` (#   0 ` Mediator'sAddress:  __________________________________n` (#` (#   0 ` 0 ` (#` (#0 (# (#0 (# (#0(#(#__________________________________:(#(#   0 ` Mediator'sPhone#:  __________________________________` (#` (#  ITISFURTHERORDERED thatthepartiesshallimmediatelycontactsaidmediatorto !  scheduleatimeandplaceforthemediationtobegin. n"!  ITISFURTHERORDERED thattheclerkforwardacopyofthisOrderandacopyofForm :$# 15tocounselofrecord,toanyunrepresentedpartiesandtoanymediatornamedabove. &%v $ Date:__________________  __________________________________ '(#'   0 ` 0 ` (#` (#0 (# (#0 (# (#0(#(#JUDGE/COMMISSIONER($((#(#    `       13THJUDICIALCIRCUITCOURT )$) Mediatorhereby: p+&+ &AcceptsAppointment V,', &DeclinesAppointment