PATHWAYS MEDIATION CENTER
239 Wall Street · Kingston, NY · (845) 331-0100 · E-mail

AGREEMENT TO MEDIATE

This agreement is entered into this ____ day of ___________, 2006, between the HUSBAND, ______________________, and the WIFE, ______________________, (hereinafter referred to as "the parties"); and JOSHUA N. KOPLOVITZ and MYRA SCHWARTZ, of Pathways Mediation Center, MEDIATORS.

RECITALS

The parties are now living separately or have reached a decision to do so as a result of irreconcilable differences; and

In connection with living separately, and the possible dissolution of their marriage, they wish to reach settlement through mediation of one or more of the following matters: division of property, custody and visitation of minor children, child support and spousal support.

This agreement is made in consideration of the parties' desire to reach settlement of existing controversies between them which might otherwise be the subject of litigation; and

The signing of this agreement shall be evidence of each party's sincere intention to avoid for himself or herself, for the other party, and for their children, if any, the anxiety, frustration, and bitterness that often arises between parties in connection with the above controversies.

In consideration of the above, the parties further contract and agree:

1. To participate in good faith in the mediation, until such time as the parties either reach agreement or the mediator declares an impasse.

2. To make full and accurate disclosure of all assets, liabilities, and income of every kind that each has.

3. To assume responsibility for the payment of the fees of the mediation as outlined in the FEE POLICY.

4. Neither of the parties will take any action to subpoena the Mediator or request his or her records of any materials given to him or her by the other party and marked "CONFIDENTIAL", for the purpose of any court action.

5. No offer or information coming out of this mediation will be used in any court action by either of the parties against the other.

IT IS FURTHER understood that the mediator is not a legal advisor to either or both of the parties. The parties acknowledge that they have each been advised to consult legal counsel if they wish legal advice, and that they understand that they are free to do so at any time during the course of the mediation.



Dated: ________________________



Dated: ________________________




Accepted:

____________________________
MEDIATOR




_____________________________
MEDIATOR


(THIS IS A CONFIDENTIAL FORM NOT SUBJECT TO COURT SUBPOENA)


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PATHWAYS MEDIATION CENTER
239 Wall Street · Kingston, NY · (845) 331-0100 · Fax (845) 246-1967 · E-mail