ACCEPTED 05-15-01516-CV FIFTH COURT OF APPEALS DALLAS, TEXAS 12/17/2015 1:54:29 PM LISA MATZ CLERK

FIFTH COURT OF APPEALS CIVIL APPEAL MEDIATION DOCKETING STATEMENT FILED IN RETURN WITHIN 15 DAYS TO: 5th COURT OF APPEALS DALLAS, TEXAS CLERK, FIFTH COURT OF APPEALS; 12/17/2015 1:54:29 PM COMMERCE STREET, SUITE 200, DALLAS, TEXAS 75202-4658 LISA MATZ Clerk

I. General Information: Appellant(s): Appellate Cause No.: JOHN PATMAN 05-15-01516-CV Trial Ct. Cause No.: Appellee(s): CC-14-01094-B STATE FARM LLOYDS County: DALLAS Other: Trial Court: COUNTY COURT 2

II. Timetable: Appeal stayed by bankruptcy. Date bankruptcy filed: NOT APPLICABLE List: name of bankruptcy court: NOT APPLICABLE bankruptcy case number: NOT APPLICABLE style of bankruptcy filing: NOT APPLICABLE

III. Jurisdiction: Will you challenge this court’s jurisdiction? No X Yes 

IV. Indigency Of Party (TRAP 32.1(k)): (Attach file-stamped copy of affidavit)

Event Date N/A Filed Check as appropriate

Affidavit filed No X Yes 

Contest filed No X Yes 

Date ruling on contest due:

Ruling on contest: Sustained  Overruled 

VI. Alternative Dispute Resolution/Mediation (if applicable) Instructions: This information will be used in conjunction with the Rule 32.1 docketing statement to evaluate your case for possible referral to an alternative dispute resolution procedure. See TEX. R. APP. P. 32.1. The court will not consider your answers if the case is submitted on the merits. Each party (except where noted) must complete and file a completed docketing form in the Court of Appeals after the appeal is perfected.

Check Y for yes or N for no. Fill in all blanks or check appropriate boxes.

1. Should this case be referred to mediation? Yes X No  (use additional sheets if necessary) If no, why? (The court makes the final decision regarding referral of a case to mediation) 2. Has this case been through an ADR procedure in the trial court? Yes  No X If you answered yes: a. Who was the mediator? b. What type of ADR procedure? c. At what stage did the case go through ADR?

pre-trial trial post-trial other _______________ 3. Rate the case for complexity. Use 1 for the least complex and 5 for the most complex. Check one:  2 X 3  4  5 

VII. Signature:

Rogelio Garcia/S/ Date: 12/17/2015 Signature of counsel (or pro se party) State Bar No.:07645800

Printed Name: ROGELIO GARCIA Address: 1317 TELEPHONE ROAD, HOUSTON, TEXAS 77023 Email Address: [email protected] Telephone Number: 713-926-8800 Facsimile Number: 713-926-7700 Representing: APPELLANT