File No. STATE OF NORTH CAROLINA COUNTY OF WAYNE In The General Court Of Justice Superior Court Division Name Plaintiff MOTION TO DISPENSE WITH Name Of Defendant Mediated Settlement Conference Wayne County ADR Rule 5 NOTICE TO JUDICIAL ASSISTANT The undersigned party requests this case be exempt from the Mediated Settlement Conference This request is based upon the following reason(s): Trial Date NOTE: Indicate with particularity the reason for request. All opposing counsel/party(ies) consent to the motion Date Name Of Movant Address And Telephone Number Attorney For Plaintiff Attorney For Defendant Unrepresented Party Copy of this Notice distributed to: Indicate method of service to opposing parties (Provide Name and Address of all parties) US MAIL FACSIMILE HAND DELIVERY NOTICE: All counsel/parties have a continuing obligation to notify this office of any correction/addition/deletion of counsel. PART B [For Official Use Only] Objection(s) received no yes (attach written objections) DO NOT WRITE IN THIS SPACE Date Motion Received: Ruling Denied Granted Date Judicial Assistant WCLF-CV-005