Pre-Suit Mediated Settlement Conference Report {CCF-47}

PRE -SUIT MEDIATED SETTLEMENT CONFERENCE REPORT 1. Date of Pre-Suit Mediated Settlement Conference: ____________________________. 2. Mediator: ___________________________________. 3. Subject of Dispute, Check One: ______ Contract ______ Collection on Accounts ______ Motor Vehicle Negligence ______ Other Negligence ______ Medical Malpractice ______ Real Property ______ Other 4. Settled: Yes or No (please circle one) 5. Please submit this completed form to: Trial Court Administrators Office Civil Courts Building 800 East Fourth Street, Suite 311 Charlotte, North Carolina 28202 Attn: ADR Coordinator Form CCF-47 American LegalNet, Inc. www.USCourtForms.com