(Form 9) IN THE SUPREME COURT OF ALABAMA or ALABAMA COURT OF CIVIL APPEALS Case Number: Style: MOTION FOR WAIVER OF MEDIATOR'S FEES _____________________________________, through undersigned counsel, hereby moves for a waiver of the mediator's fees and, as grounds therefor, would state that this party has been granted leave to appeal in forma pauperis. (See attached order from the trial court or the appellate court.) _____________________________ Appellant/Appellee ___________________________________ Counsel for:_________________________ _____________________________ Date NOTE: Signatures by both the party and counsel are required. This form is to be filed with the Appellate Mediation Office, 300 Dexter Avenue, Montgomery, Alabama 36014, within14 days after the issuance of the Order of Referral to Mediation. American LegalNet, Inc. www.USCourtForms.com