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Borang Mediasi Johor

This document is an agreement form for parties to consent to mediation at the Johor Bahru Mediation Center. The form includes spaces for parties, their solicitors, and contact details to be filled in for reference by the mediation center.

Uploaded by

Aiman Zarith Zahrullail
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231 views2 pages

Borang Mediasi Johor

This document is an agreement form for parties to consent to mediation at the Johor Bahru Mediation Center. The form includes spaces for parties, their solicitors, and contact details to be filled in for reference by the mediation center.

Uploaded by

Aiman Zarith Zahrullail
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PUSAT MEDIASI JOHOR BAHRU

MENARA MSC CYBERPORT


NO.5, JLN BUKIT MELDRUM Tel : 07-2267552
TINGKAT 25
80300 JOHOR BAHRU [email protected]

FORM 1
AGREEMENT TO MEDIATE

Case No. : ………………………………………………………………………………….


Judge / : ………………………………………………………………………………….
Mediator

Parties : Plaintiff : ………………………………………………………………………


: ………………………………………………………………………

: Defendant : ………………………………………………………………………..
: ………………………………………………………………………..

: Third Party : ……………………………………………………………………….


: ……………………………………………………………………….

Mention / Hearing Date : ………………………………………………………………………..

We, the solicitors representing the abovementioned parties hereby consent to refer
this matter for mediation for the purpose to reach an amicable settlement and to the
satisfaction of all parties.

We also agree that all disclosures, admissions and communications made under a
mediation session are strictly “without prejudice”. Such communications do not form part of
any record and the mediator shall not be compelled to divulge such records or testify as a
witness or consultant in any judicial proceeding, unless all parties to both the Court
proceedings and the mediation proceedings consent to its inclusion in the record or to its
other use.

……………………………………………. ………………………………………………….
(Plaintiff’s Solicitor’s Signature) (Defendant’s Solicitor’s Signature)

……..……………………………………
(Third Party’s Solicitor’s Signature)
Dated :
MAKLUMAT TAMBAHAN PIHAK-PIHAK
( untuk rujukan Pusat Mediasi Johor Bahru).

NAMA PEGUAMCARA PLAINTIF

ALAMAT EMEL PEGUAMCARA


PLAINTIF

NO.TELEFON PEGUAMCARA PLAINTIF


( MUDAH DIHUBUNGI)

NAMA PEGUAMCARA DEFENDAN

ALAMAT EMEL PEGUAMCARA


DEFENDAN

NO.TELEFON PEGUAMCARA
DEFENDAN ( MUDAH DIHUBUNGI)

NAMA PEGUAMCARA PIHAK KETIGA

ALAMAT EMEL PEGUAMCARA PIHAK


KETIGA

NO.TELEFON PEGUAMCARA PIHAK


KETIGA (MUDAH DIHUBUNGI)

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