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Request For Mediation Under EEO-EDR Plan Form. This is a Nebraska form and can be use in Bankruptcy Court Federal.
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Tags: Request For Mediation Under EEO-EDR Plan, Nebraska Federal, Bankruptcy Court
COURT
COUNTY . .
. . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:
Index No.
:
Calendar No.
REQUEST FOR MEDIATION UNDER EEO/EDR PLAN
:
Plaintiff(s)
JUDICIAL SUBPOENA
Submitted Under the Procedures of the District of Nebraska Equal Employment
-against:
Opportunity and Employment Dispute Resolution Plan (“District of Nebraska
EEO/DER Plan”).
:
*****************************
:
Defendant(s)
:
. . . . . . . . .Prior to completing this .form, .please refer.to.the.District of Nebraska EEO/EDR Plan.
................... .... ......... . .. .....
Please complete this form legibly.
Please attach a copy of the REQUEST FOR COUNSELING FORM filed in
THE PEOPLE OF THE STATE OF NEW YORK
connection with this matter.
TO
1.
Full Name of Person Requesting Mediation
2.
If any of the information supplied in the REQUEST FOR COUNSELING FORM filed in
GREETINGS:
connection with this matter is no longer accurate, please note the number of the entry on the request
for COMMAND YOU, changed, and state the change(s) you wish to make:
WE counseling form to bethat all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
3.
Date counseling was
Witness, Honorable initiated
Court in
County,
day of
, one of the Justices of the
, 20
4.
Date of receipt of the notice of conclusion of counseling
5.
Name of person who provided counseling
This request for mediation is submitted by:
Signature
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Date
Name of Person to whom submitted:
Signature of Recipient
Telephone No.:
Date of Receipt:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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