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JDF 1307 R713 MOTION RE: EXEMPTION FROM MEDIATION/ADR ORDER (DOMESTIC RELATIONS CASE) © 2013 Colorado Judicial Department for use in the Courts of Colorado District Court Denver Juvenile Court ___________________________ County, ColoradoCourt Address:In re:The Marriage of:The Civil Union of:Parental Responsibilities concerning:______________________________________________________Petitioner:andCo-Petitioner/Respondent: COURT USE ONLYAttorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg. #:Case Number:Division CourtroomMOTION RE: EXEMPTION FROM MEDIATION/ADR ORDER (DOMESTIC RELATIONS CASE) The Petitioner and/or Co-Petitioner/Respondent request(s) an exemption from the Mediation/ADR Order in this case, for the following reason(s): The parties attempted mediation or ADR _________________________ (specify ADR process) on __________________________ (date) and believe that additional mediation or ADR would not be useful. The Petitioner or Co-Petitioner/Respondent is unwilling to enter into mediation services or dispute resolution programs because s/he is the victim of physical or psychological abuse by the other party.Mediation or ADR is not appropriate in this case because: ____________________________________________________________________________________ ____________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________ ______________________________________ _____________________________________________PetitionerDateCo-Petitioner/Respondent Date______________________________________ _____________________________________________Petitioner’s Attorney Signature, if any Co-Petitioner’s/Respondent’s Attorney Signature, if any CERTIFICATE OF SERVICE (Required if only one of the parties is filing the Motion.) I certify that on __________________________ (date) the original was filed with the Court; and, a true and accurate copy of the Motion re: Exemption from Mediation/ADR Order (Domestic Relations Case) was served on the other party by:Hand Delivery E-filed Faxed to this number ___________________ or by placing it in the United States mail, postage pre-paid, and addressed to the following:To: ______________________________________ ______________________________________ ______________________________________ ______________________________________ Your Signature