Probate Rule 5-Proof Of ADR {481ES}

STATE OF SOUTH CAROLINA ) ) COUNTY OF ____________________ ) ) IN THE MATTER OF: ) _______________________________, ) (Decedent) ) 1. 2. 3. IN THE PROBATE COURT PROOF OF MEDIATION CASE NUMBER: _______________________ A mediation conference was conducted on ________________________, 20___. The mediator was: _________________________________________________. As a result of mediation, this case should be considered (please check one): Fully Settled Partially Settled At an Impasse In need of further mediation. I am am not willing to serve. 4. The following persons were present at the mediation conference: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 5. Choice of mediator was by: Stipulation Court Order 6. 7. The total number of hours spent in mediation was: ______________________________ Further comments of the mediator:___________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ ______________________________________ Mediator's Signature Date: ___________________________ FORM 481ES (1/2014) Probate Court Rule 5 www.FormsWorkFlow.com