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NEW JERSEY JUDICIARY CIVIL PRACTICE DIVISION RESOLUTION OF ARBITRATED CASES QUESTIONNAIRE

This questionnaire was created and will be used by the Supreme Court Arbitration Advisory Committee to better understand and improve the arbitration process. Information provided on this form may be subject to public review.

REGARDING THE CASE YOU HAVE JUST SETTLED, PLEASE PROVIDE THE FOLLOWING INFORMATION:

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* Docket Number (e.g. L-000067-08)

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* Arbitrator Name

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* County

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* 1. The demand for trial de novo was filed by?

Plaintiff

Defendant

Third Party Defendant

Not Applicable

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* 2. Your role and if applicable, your client's insurance status: (check all that apply)

Attorney for Plaintiff

Self-Insured

Attorney for Defendant

No Insurance Carrier

Attorney for Third Party Defendant

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* Docket Number (e.g. L-000067-08)

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* Arbitrator Name

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* County

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* 1. The demand for trial de novo was filed by?

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* 2. Your role and if applicable, your client's insurance status: (check all that apply)

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* 3. If representing a defendant, please indicate name of insurance carrier: