CENTRO DE CONCILIAO E MEDIAO

TRIBUNAL DE JUSTIA DA PARAIBA

UNIVERSIDADE FEDERAL DE CAMPINA GRANDE

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FICHA DE MEDIAO PR-PROCESSUAL

REQUERENTE_______________________________________________________
REQUERIDO_________________________________________________________
TEMPO DE RECLAMAO MEDIAO_________________________________
ORIGEM DA PROVOCAO____________________________________________
MEIO DE INTIMAO_________________________________________________
MEDIADORES_______________________________________________________
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TIPO DE CASO_______________________________________________________
DATA DA MEDIAO__________/_________________/______________________
RESULTADO
(

) Acordo

) No Acordo

) Mediao Prejudicada

) Ausncia do reclamado

) Ausncia do reclamante

) Ausncia de ambos

) Mediao redesignada para_________________________________________

OBS________________________________________________________________
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Rua Sinfrnio Nazar, n 38, Centro, Sousa PB.