In the Circuit Court of County, Missouri
|In the Circuit Court of ________________ County, Missouri |
| | |
|_____________________________, | |
|Petitioner, | |
| |Case No. _______________________ |
| | |
|_____________________________, | |
|Respondent. | |
Certification at Case Management Conference
The undersigned hereby certify to the court as follows:
1. The status of undersigned’s compliance with Local Rule 68 is:
|Item |( if completed |Enter date to be completed: |
| | |(For Court use only) |
|Statement of Income and Expenses (Rule 68.4(1)) |( | |
|Statement of Assets and Debts (Rule 68.4(2)) |( | |
|Parenting Plan filed with court (Rule 68.7) (( not required) |( | |
|Form 14 exchanged (Rule 68.4(4)) (( not required) |( | |
|Required Document Production (Rule 68.4.1) |( | |
|Parent Education Program (Rule 68.6(1)) (( not required) |( | |
|ADR Education Program (Rule 68.6(2)) |( | |
2. There (( are)/ (( are no) allegations in the pleadings which require the appointment of a Guardian ad Litem for minor child(ren) involved in this case.
3. There (( are)/ (( are no) outstanding Order(s) of Protection involving the parties or a child of the parties.
4. There (( are)/ (( are no) objections to the case being assigned to mediation.
5. The parties have agreed that the case may be mediated by ________________________.
6. The undersigned’s contact information is as follows (Please print legibly):
|Name: |Telephone Number: |
|Mailing Address: |City: |State: |Zip: |
|Alternate Telephone Number: |E-mail Address: |
7. The undersigned’s attorney’s contact information is as follows (Please print legibly):
|Name: |Telephone Number: |
|Mailing Address: |City: |State: |Zip: |
|Alternate Telephone Number: |E-mail Address: |
| | |Party’s Signature: |
| | |Party’s Attorney’s Signature: |
| | |Date: |
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