Form Adr 110 PDF Details

An Adr 110 form, also known as a "Statement of Claim" is a legal document used to commence a civil action in court. The form is used to identify the parties involved in the action, state the nature of the claim and list out the damages or other relief being sought by the claimant. It must be filed with the court before any legal proceedings can take place. If you are considering filing a civil lawsuit, it is important to understand how an Adr 110 form works and what information needs to be included. Speak with an attorney for more information.

QuestionAnswer
Form NameForm Adr 110
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesca referee resolution, adr appointing resolution, santa clara county adr cm 110, referee alternative dispute resolution

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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

TELEPHONE NO.:

FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

 

ATTORNEY FOR (Name):

 

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

ORDER APPOINTING REFEREE

ADR-110

FOR COURT USE ONLY

CASE NUMBER:

THE COURT FINDS:

1.

2.

Section 638 appointment. A referee is properly appointed under Code of Civil Procedure section 638 because (check one):

a. all parties to the action have agreed to the appointment of a referee under section 638.

b. the parties entered into a written contract or lease that provides that any controversy arising therefrom shall be heard by a referee.

Section 639 appointment. A referee is properly appointed under Code of Civil Procedure section 639 because (check and complete a or b):

a. Discovery reference. It is necessary for the court to appoint a referee to hear and determine any and all discovery motions and disputes relevant to discovery in the action and to report findings and make a recommendation. (Code Civ. Proc., § 639(a)(5). State the exceptional circumstances specific to the particular case that require the discovery reference, below or in Attachment 2a.)

b.

Other reference. (Check one or more of the following statutory grounds and state the reason for the appointment below or in Attachment 2b.)

The trial of an issue of fact requires the examination of a long account. (Code Civ. Proc., § 639(a)(1).)

The taking of an account is necessary for the information of the court before judgment, or for carrying a judgment or order into effect. (Code Civ. Proc,. § 639(a)(2).)

A question of fact, other than on the pleadings, has arisen by motion or otherwise. (Code Civ. Proc., § 639(a)(3).)

It is necessary for the information of the court in a special proceeding. (Code Civ. Proc., § 639(a)(4).)

c.Economic inability to pay. (Check one.)

(1)

 

No party has established an economic inability to pay a pro rata share of the referee's fees.

(2)

(3)

Form Approved for Optional Use

Judicial Council of California ADR-110 [Rev. July 1, 2011]

One or more parties has established an economic inability to pay a pro rata share of the referee's fees and another party has agreed voluntarily to pay that additional share of the referee's fees. (Complete item 5c(3)(b).)

(a)The following party has established an economic inability to pay a pro rata share of the referee's fee (name each):

(b)The following party has agreed voluntarily to pay an additional share of the referee's fee (name each):

The referee is being appointed at no cost to the parties.

 

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ORDER APPOINTING REFEREE

Code of Civil Procedure, § 638 et seq.;

Cal. Rules of Court, rules 3.900–3.910,

(Alternative Dispute Resolution)

3.920–3.927

 

www.courts.ca.gov

ADR-110

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

THE COURT ORDERS:

CASE NUMBER:

3.Referee. The following person is appointed as referee. (The referee's signature indicating consent to serve and certification that he or she is aware of and will comply with the applicable provisions of canon 6 of the Code of Judicial Ethics and the California Rules of Court must be included in the proposed order appointing a referee under Code of Civil Procedure section 638 or attached to the order appointing a referee under section 639. See item 9.)

a.Name:

b.Business address:

c.Telephone number:

d. The referee is a member of the State Bar of California. (Rules 3.903 and 3.923 of the California Rules of Court provide that a referee who is a former judicial officer must be an active or inactive member of the State Bar.)

(1)

 

The referee's State Bar number is:

(2)

 

The referee's State Bar membership status is (check one):

 

(a) Active

(b) Inactive

(c)

 

Other (specify):

4.Scope and subject matter of reference. The referee is appointed as follows (check and complete a or b):

a. Section 638 appointment. The referee is appointed under Code of Civil Procedure section 638 (check and complete one):

(1)

 

to hear and determine any or all of the issues in the action or proceeding, whether of fact or of law, and to

 

 

report a statement of decision.

(2)

 

to ascertain the following facts necessary to enable the court to determine the action or proceeding (state

 

 

 

facts to be ascertained by referee below or in Attachment 4a):

b. Section 639 appointment.

(1)

The following subject matter or matters are included in the reference (describe the matter or matters the referee is ordered to consider below or in Attachment 4b):

(2)

Section 639 discovery reference.

 

(a)

 

The discovery referee is appointed for (check one):

 

 

(i)

 

The discovery matters identified in (1) above.

 

 

 

 

 

 

 

 

 

 

(ii)

 

All discovery purposes in the action.

(b)The referee is authorized to set the date, time, and place for all hearings determined by the referee to be necessary; direct the issuance of subpoenas; preside over hearings; take evidence; and rule on objections, motions, and other requests made during the course of the hearing.

5.Referee's compensation. (Check and complete one of the following.)

a.

 

Uncompensated referee. The referee will not be privately compensated by the parties.

 

 

 

b.

 

Compensation of section 638 referee.

(1)

(2)

The referee's fees will be paid as agreed by the parties.

The parties have not agreed on the payment of the referee's fees and have requested that the matter be resolved by the court. The court orders that the referee's fees be paid as follows (state the manner of payment determined by the court to be fair and reasonable below or in Attachment 5b):

ADR-110 [Rev. July 1, 2011]

ORDER APPOINTING REFEREE (Alternative Dispute Resolution)

Page 2 of 3

Section 638 referees. The referee must report in the following manner agreed to by the parties and approved by the court (describe):

ADR-110

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

CASE NUMBER:

5.c. Compensation of section 639 referee.

(1)The maximum hourly rate that the referee may charge is (specify):

(2)

 

The maximum number of hours for which the referee may charge is (at the request of any party, state the

 

 

maximum number of hours for which referee may charge):

(3)

 

The court orders that the referee's fees be paid or apportioned as follows and reserves jurisdiction to modify

 

 

this order (state fair and reasonable apportionment of reference costs below or in Attachment 5c):

 

 

(a)

 

 

All parties shall pay equal shares of the referee's fees.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(b)

 

 

The parties shall pay equal shares of the referee's fees except that, based on the finding of

 

 

 

 

 

economic inability set forth in item 2c(2):

 

 

 

 

 

(i)

The following party is not required to pay any portion of the referee's fees (name of each

 

 

 

 

 

 

party excused from paying referee's fees):

 

 

 

 

 

(ii)

The following party shall pay the pro rata share of the referee's of the party identified in (i), in

 

 

 

 

 

 

addition to his or her own share of the referee's fees (name of each party who has agreed to

 

 

 

 

 

 

pay an additional share of the referee's fees):

 

(c)

The referee's fees shall be paid as set forth in Attachment 5c.

 

 

(4)

The court will subsequently determine how the referee's fees will be paid, under Code of Civil Procedure

 

section 645.1(b). (If the issue of economic hardship is raised before the services of a referee appointed under section 639 begin, the court must make a fair and reasonable apportionment of reference costs.)

6.Use of court facilities and court personnel. Court facilities and court personnel (check and complete one):

 

a.

 

 

 

may not be used without an order of the presiding judge. (Court facilities and personnel may be used in proceedings

 

 

 

 

 

 

 

 

before a privately compensated section 638 referee only upon a finding of the presiding judge that the use would further

 

 

 

 

 

the interest of justice.)

 

 

 

 

 

 

 

b.

 

 

 

may be used as follows (describe any authorized use of court facilities or court personnel if referee will not be

 

 

 

 

 

privately compensated or is appointed under section 639):

7.

 

 

The reference will be conducted in a private facility. The clerk must post notice that the following person may be

 

 

 

 

 

contacted to arrange attendance at any proceeding that is open to the public (complete all of the following):

a.Name:

b.Address:

c.Telephone:

8.Referee's report.

a.Time of report. The referee must report (check and complete one):

(1)

 

in writing to the court within 20 days after the hearing, if any, has been concluded and the matter submitted.

(2)

 

as follows (specify other time and manner of reporting directed by the court):

 

b.Manner and contents of report.

(1)

(2)

 

 

Section 639 referees. The referee must file with the court a report that includes a recommendation on the

 

 

 

 

 

merits of any disputed issue, a statement of the hours spent and the total fees charged by the referee, and the

 

 

 

referee's recommended allocation of payment. The referee must serve the report on all parties.

9.Certification of referee. The undersigned consents to serve as referee as provided above and certifies that he or she is aware of and will comply with the applicable provisions of canon 6 of the Code of Judicial Ethics and the California Rules of Court.

(TYPE OR PRINT NAME OF PROPOSED REFEREE)

(SIGNATURE OF PROPOSED REFEREE)

Date:

JUDICIAL OFFICER

ADR-110 [Rev. July 1, 2011]

ORDER APPOINTING REFEREE (Alternative Dispute Resolution)

Page 3 of 3

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Simple tips to complete referee alternative dispute resolution portion 1

2. Once this part is filled out, go on to type in the relevant information in all these: Other reference Check one or more, The trial of an issue of fact, A question of fact other than on, Economic inability to pay Check, No party has established an, One or more parties has, The following party has, The following party has agreed, The referee is being appointed at, Form Approved for Optional Use, Judicial Council of California ADR, ORDER APPOINTING REFEREE, Page of, and Code of Civil Procedure et seq.

referee alternative dispute resolution completion process explained (portion 2)

3. This next section focuses on PETITIONERPLAINTIFF, RESPONDENTDEFENDANT, CASE NUMBER, ADR, THE COURT ORDERS Referee The, he or she is aware of and will, The referee is a member of the, The referees State Bar number is, The referees State Bar membership, Active Inactive, Other specify, Scope and subject matter of, and Section appointment The referee - fill in these blank fields.

The right way to fill out referee alternative dispute resolution portion 3

4. Completing Section appointment, The following subject matter or, Section discovery reference a, The discovery referee is appointed, The discovery matters identified, All discovery purposes in the, The referee is authorized to set, Referees compensation Check and, a b, Uncompensated referee The referee, The referees fees will be paid as, and The parties have not agreed on the is key in the fourth stage - always take the time and take a close look at each blank area!

Uncompensated referee The referee, Section discovery reference a, and The discovery matters identified inside referee alternative dispute resolution

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5. This final notch to finalize this document is critical. Be certain to fill in the required blanks, and this includes PETITIONERPLAINTIFF, RESPONDENTDEFENDANT, Compensation of section referee, The maximum hourly rate that the, CASE NUMBER, ADR, The maximum number of hours for, All parties shall pay equal shares, The following party is not, The following party shall pay the, The referees fees shall be paid as, and The court will subsequently, prior to submitting. Failing to do so can end up in a flawed and potentially incorrect paper!

Filling in part 5 of referee alternative dispute resolution

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