COURT OF APPEAL
PROVINCE OF QUÉBEC
REGISTRY OF __________
File number: 500-09- __________
First instance
File number: __________
___________________________________________________
APPELLANT
v.
___________________________________________________
RESPONDENT
JOINT REQUEST FOR JUDICIAL MEDIATION
We, the undersigned, jointly request to proceed by judicial mediation in order
to attempt to resolve the present litigation by way of a transaction.
We undertake jointly to prepare and file at the Office of the Court, a copy of
all relevant documents within seven (7) days prior to the date set for mediation.
The documents will include the inscription in appeal, the judgment appealed from
and all other proceedings and exhibits which we deem to be useful.
Upon the filing of our joint request, we understand that the delays determined
in accordance with Title II of the Code of Civil Procedure (chapter C-25) are
suspended.
Furthermore, we undertake to respect the confidential nature of all matters
discussed throughout the mediation procedure, including telephone conferences,
videoconferences, individual and plenary meetings.
Date:___________________________________
_____________________________________ ________________________________________
Appellant Respondent
(Attorney) (Attorney)
Name ................................ Name ...................................
Law firm: ........................... Law firm: ..............................
Address: ............................ Address: ...............................
..................................... ........................................
..................................... ........................................
Telephone: .......................... Telephone: .............................
Fax: ................................ Fax: ...................................
Please return a duly signed copy of this form to the Office of the Court of
Appeal, clearly indicating on the envelope:
“REQUEST FOR MEDIATION”