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Form ADR-100, Statement of Agreement or Nonagreement, page 1
Basic · 42/100Form Complexity Index

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What this form asks for

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This is Form ADR-100, a mandatory legal document for the Superior Court of California used by a court-appointed mediator to officially report the status and outcome of a mediation. The mediator must indicate whether the mediation resulted in a full agreement, partial agreement, or nonagreement, and file it with the court within a specified timeframe. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
Fillable fields71
Pages2
Form Complexity IndexBasic, 42/100

The AI checks your answers before you download

14 checks built for this form, so a wrong date or a missing answer is caught before anyone else sees it.

Ensures Case Number is Provided

This check verifies that the 'CASE NUMBER' field is not empty. The case number is a critical identifier for associating the document with the correct legal proceeding in the court's system. Failure to provide it will result in the form being rejected by the court clerk, as it cannot be filed correctly.

Mutually Exclusive Mediation Status Selection

Validates that exactly one option is selected in Section 2 for the mediation status ('was not scheduled', 'was scheduled but not held', or 'was held'). Selecting none or more than one of these options creates an ambiguous and contradictory statement about the mediation's progress. The form must be corrected to reflect a single, clear status.

Conditional Requirement for Session Details

This check ensures that if 'was held' (Section 2c) is selected, the fields for 'Session dates', 'Number of sessions', and 'Total length of sessions' are all filled. These details are mandatory to document the mediation activities when a session has occurred. If this information is missing, the statement is incomplete and does not provide the court with required information.

Logical Date Chronology for Mediation

Verifies that the 'mediation ended on' date (Section 3) is on or after the 'mediator was appointed on' date (Section 1). This ensures a logical sequence of events, as the mediation cannot end before the mediator is appointed. An illogical date sequence would invalidate the timeline of the report.

Mutually Exclusive Mediation Outcome Sections

This validation ensures that information is provided in either Section 3 (mediation ended) or Section 4 (mediation has not yet ended), but not both. These sections are mutually exclusive, as the mediation cannot be both finished and ongoing simultaneously. Filling both sections would create a logical contradiction requiring user correction.

Future Date for Anticipated Completion

If Section 4 ('The mediation has not yet ended') is completed, this check validates that the 'anticipated completion date' is a future date. This is important for court scheduling and oversight, as it provides a timeline for when to expect a final resolution. An invalid or past date would be nonsensical and unhelpful for case management.

And 8 more checks
  • Valid Mediator Email Address Format
  • Proof of Service Row Completeness
  • Service Manner Consistency Check
  • Conditional Requirement for Mailing Location
  • Required Mediator and Declarant Information
  • Logical Service Date
  • Numeric Validation for Session Count and Length
  • Court and Case Information Completeness

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How to Fill Out ADR-100 Online for Free in 2026

What the AI walks you through.

  1. Navigate to Instafill.ai and upload or select Form ADR-100, Statement of Agreement or Nonagreement.
  2. Use the AI assistant to automatically populate the header with the mediator's contact information and the details of the Superior Court of California handling the case.
  3. Enter the specific case name and case number in the designated fields.
  4. Complete the main statement by checking the appropriate boxes to indicate if the mediation was held, the session dates, and whether it concluded in a full agreement, partial agreement, or nonagreement.
  5. If the mediation has not concluded, provide the anticipated completion date or the date of the next scheduled session.
  6. The mediator must digitally or manually sign and date the first page to certify the statement's accuracy.
  7. Fill out the 'Proof of Service' on the second page, detailing how, when, and to whom the document was sent, then sign the declaration.

Common Mistakes in Completing ADR-100

The ones the AI is built to catch.

Incomplete or Incorrect Case Information
Users often enter an incorrect case number or fail to specify the exact court branch name. This typically happens due to a typo or not having the correct case documents on hand. An incorrect case number can lead to the form being rejected or misfiled, causing significant delays in the legal process. Always double-check the case number and court details against official court notices or filings to ensure accuracy.
Forgetting to Select 'First' or 'Supplemental' Statement
At the top of the form, the filer must check a box to indicate if this is the 'First' or a 'Supplemental' statement. This small detail is easily overlooked but is crucial for the court to track the mediation's progress. Forgetting to check a box can cause confusion for the court clerk and may require clarification or refiling. To avoid this, start filling out the form from the very top and review all checkboxes before submission.
Contradictory Selections for Mediation Status
A common logical error is selecting conflicting options, such as checking both 'was held' (Item 2c) and 'has not yet ended' (Item 4). These sections are mutually exclusive; the mediation has either concluded or it is ongoing. This mistake signals confusion and will likely result in the court rejecting the form for being ambiguous. Carefully read each section and select only the one option that accurately describes the current status of the mediation.
Omitting Required Details for Completed Mediations
When selecting that the mediation 'was held' (Item 2c), filers must provide all session dates, the total number of sessions, and the total length in hours. People frequently miss one of these three required data points, rendering the submission incomplete. This can lead to the form being returned for correction. To prevent this, gather all session records before filling out the form and ensure all three sub-fields are completed.
Confusing the Mediator and Declarant Signatures
This two-page form requires two different signatures: the mediator signs Page 1, and the 'Declarant' (the person who served the form) signs the Proof of Service on Page 2. A frequent error is having the mediator sign both pages, even if they did not personally serve the document. This invalidates the Proof of Service. Ensure the person who actually performed the service completes and signs the declaration on Page 2.
Incomplete Proof of Service Table
The table in Item 4 on the Proof of Service page has five columns for each person served, including name, manner of service, address, date, and time. Filers often leave columns blank, especially the 'Time of service' column. An incomplete Proof of Service is defective and can be challenged, potentially nullifying the service. To avoid this, methodically fill in every required field for each party served.
Mismatch Between Service Manner and Declaration
On Page 2, the 'Manner of service' listed in the table (Item 4b) must match the detailed declaration checked in Item 5. For example, a user might write 'Mail' in the table but then check the box for 'Personal Service' in Item 5a. This inconsistency makes the Proof of Service invalid. Always cross-reference your selection in Item 4b with the corresponding detailed checkbox in Item 5.
Forgetting to Specify City and State for Service by Mail
When indicating service by mail (Item 5b), the form requires the filer to specify the city and state where the mailing occurred. This detail is a required part of the declaration but is often missed. Omitting this information creates an incomplete and potentially challengeable Proof of Service. Carefully read the entire text of the selected service option and fill in all blanks.
Leaving the Declarant's Address Blank
Item 2 on the Proof of Service page requires the residence or business address of the person who served the form. This information is essential for identifying the declarant and is often left blank. An anonymous or unidentified declarant makes the Proof of Service invalid. The person signing the declaration on page 2 must provide their full address in this section.
Failing to Attach Fax Transmission Record
If service is completed by fax (Item 5c), the form explicitly states that a copy of the fax transmission record must be attached. Mediators or their staff often forget to print and attach this confirmation page. Without the attached record, there is no proof the fax was successfully sent, and the service can be deemed invalid. Always remember to attach the machine-printed confirmation sheet when serving by fax.

Frequently Asked Questions About ADR-100

 

Is it really free for 7 days?
Yes. You pay $0 today. Cancel before Nov 20 and you are never charged. Keep it, and it is $19.99 a month for 5 fills of your ADR-100.
Can I fill other forms too?
This plan is for your ADR-100: your own AI agent fills it as often as 5 times a month. To fill other forms and upload your own, choose a Professional plan from your account.
How do I cancel?
From your account, in two clicks, any time. No email, no call.
How does the AI fill out ADR-100?
You answer a few questions in plain words, or upload a document you already have. The AI reads what you give it and puts each answer into the right field of ADR-100, on every page, in seconds. It checks the answers against the form's own rules, and you review and change anything before you download, print or sign.
What happens to my information?
It is encrypted in transit and at rest, and it is never used to train AI.
How complex is ADR-100 to fill out?
ADR-100 has a Form Complexity Index of 42 out of 100, in the basic tier: 71 fillable fields across 2 pages. Instafill.ai's AI fills it in under a minute, with every field there for you to review before you download.
What is the purpose of Form ADR-100, the Statement of Agreement or Nonagreement?
This form is used by the mediator to officially report the status and outcome of a court-ordered mediation to the Superior Court of California. It indicates whether the mediation resulted in a full agreement, partial agreement, or no agreement.
Who is responsible for filling out and filing this form?
The mediator who was appointed, assigned, or retained for the case is responsible for completing, serving, and filing Form ADR-100.
When is the deadline to submit Form ADR-100?
The mediator must file this form within 10 days after the mediation concludes, or by an alternative date if one has been set by the court.
Can I include details about the settlement terms on this form?
No, you are strictly prohibited from disclosing any settlement terms, confidential communications, or your impressions of the mediation. The form should only contain the information specifically requested.
What should I do if the mediation is still ongoing but I have a deadline to file this form?
You should complete section 4 of the form, indicating that the mediation has not yet ended and providing an anticipated completion date. You will be required to file a supplemental statement once the mediation is complete.
Does filing Form ADR-100 extend the court's deadline for completing the mediation?
No, the form explicitly states that it does not extend any mediation completion deadline set by the court. You must request any necessary extensions directly from the court.
What is the 'Proof of Service' section on page 2 for?
The Proof of Service is a mandatory section where the person serving the document declares under penalty of perjury that they have sent a copy of the completed form to all other parties in the case.
What information do I need to have ready to complete this form?
You will need the court and case information, the date you were appointed as mediator, the dates and total length of the mediation sessions, and the final outcome of the mediation.
What is the difference between checking 'First' and 'Supplemental' at the top of the form?
Check 'First' for the initial statement you file about the mediation. Check 'Supplemental' for any follow-up statement you file, such as after reporting that a mediation was still in progress.
Can I use an AI tool to help me fill out Form ADR-100?
Yes, services like Instafill.ai use AI to accurately auto-fill form fields with your case and contact information, which can save time and help prevent errors.
How can I fill out this form online using a service like Instafill.ai?
Simply upload the ADR-100 PDF to the Instafill.ai platform. Its AI will make the document interactive, allowing you to fill in all the required fields, sign, and download it easily.
The PDF of Form ADR-100 that I downloaded is not fillable. What can I do?
If you have a non-fillable or 'flat' PDF, you can use a service like Instafill.ai. It can convert the document into an interactive, fillable form that you can complete on your computer.
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