Report On Status Of Selection Of Mediator
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Report On Status Of Selection Of Mediator Form. This is a Alabama form and can be use in Appellate Mediation Program Appellate.
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Tags: Report On Status Of Selection Of Mediator, 6, Alabama Appellate, Appellate Mediation Program
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INSERT COURT
INSERT CASE #
INSERT STYLE
REPORT ON STATUS OF SELECTION OF MEDIATOR
I,
, attorney for the appellant,
have consulted with the attorney(s) for the appellee(s) and am advising
the Appellate Mediation Office of the following:
1. The parties have jointly selected the following person
to serve as the mediator for this case:
Name
Address
Telephone
I have confirmed with the mediator that he/she
can and will mediate this dispute.
AND
And, if applicable:
I have confirmed that the selected mediator
will serve pro bono for the appellant/appellee
2. The parties are unable to stipulate to the appointment of
a mediator.
By signing this agreement, I confirm that the information provided to the
Appellate Mediation Office is true.
Dated this
day of
,20
Signature
Counsel for Appellant
cc:
Mediator (if number 1 above is checked)
Counsel
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CERTIFICATE OF SERVICE
I hereby certify that a copy of the foregoing document has been served on
this
day of
, 20
, to the following:
Served by:
U.S. Mail to their regular mailing addresses or by
Email to their regular email addresses:
Signature
NOTE: This form is to be filed with the Appellate Mediation Office by U.S.
Mail to 300 Dexter Avenue, Montgomery, Alabama, 36104, or by email to
mediation@appellate.state.al.us, within 14 days from the date of issuance of
the Order of Referral to Mediation.
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