Form 24.1C

Courts of Justice Act

(General heading)

STATEMENT OF ISSUES

(To be provided to mediator and parties at least seven days before the mediation session)

1. Factual and legal issues in dispute

The plaintiff (or defendant) states that the following factual and legal issues are in dispute and remain to be resolved.

(Issues should be stated briefly and numbered consecutively.)

2. Party’s position and interests (what the party hopes to achieve)

(Brief summary.)

3. Attached documents

Attached to this form are the following documents that the plaintiff (or defendant) considers of central importance in the action: (list)

(date)	(party’s signature)
	(Name, address, telephone number and fax number of lawyer of party filing statement of issues, or of party)

NOTE:  When the plaintiff provides a copy of this form to the mediator, a copy of the pleadings shall also be included.

NOTE:  Rule 24.1.14 provides as follows:

All communications at a mediation session and the mediator’s notes and records shall be deemed to be without prejudice settlement discussions.

RCP-E 24.1C (November 1, 2005)