Cause No. __
IN THE MATTER OF § IN THE DISTRICT COURT
THE MARRIAGE OF §
§
__ § __TH JUDICIAL DISTRICT
AND §
__ § __COUNTY, TEXAS
Cause No. __
IN THE MATTER OF § IN THE DISTRICT COURT
THE MARRIAGE OF §
§
__ §
AND § __TH JUDICIAL DISTRICT
__ §
§
AND IN THE INTEREST OF §
__, A CHILD § __COUNTY, TEXAS
Report of the Mediator
On __date__, both parties appeared along with their legal counsel and
commenced mediation.
__Mediator’s name__, mediator, was appointed Mediator in this case by (choose)
Order of the Court OR agreement of the parties.
CHOOSE The parties were unable to reach a settlement. I have declared an impasse.
OR I am pleased to report that the lawsuit was resolved as a result of mediation. The parties
will submit the appropriate settlement documents to the Court in the near future.
OR I was unable to conduct the mediation because __ did not appear even after notice and
confirmation of the mediation date, time and location.
Thank you for the opportunity to be of service.
Respectfully submitted,
______________________
__Mediator’s Name__, Mediator
Address
Phone Number
Email Address