CERTIFICATE OF OBSERVATION Family Financial Settlement Conference Program Rule 8.D, Rules Implementing Settlement Procedures in Equitable Distribution and Other Family Financial Cases Note: All applicants for mediator certification are advised to review FFS Rule 8.D prior to completing their observations.* Pre-Litigation: Case Caption: Case/File No.: 1. Forcustodyand/orfamilyfinancialmediationsobservedpursuanttoFFSRule8.D,themediatorstates: A. I am: an Advanced Practitioner member of the Association for Conflict Resolution. a mediator affiliated with the NC Administrative Office of the Court's Custody and Visitation Mediation Program. a mediator certified by the NC Dispute Resolution Commission to conduct mediated settlement conferences in family financial cases. B. On , 20 , I conducted a mediated settlement conference of the above-captioned or referenced case involving custody and/or family financial issues. C. The mediated settlement conference was observed from its beginning until its conclusion by settlement or impasse by . (Type Or Print Name Of Observer) Yes No 2. ormediationsobservedpursuanttoFFSRule8.Dwhichdidnotinvolvecustodyorfamilyfinancialissues,themediator F states: A. I am a mediator certified by the NC Dispute Resolution Commission to conduct mediated settlement conferences in superior court civil actions. B. On case. , 20 , I conducted a mediated settlement conference of the above-captioned or referenced C. The mediated settlement conference was observed from its beginning until its conclusion by settlement or impasse by . (Type Or Print Name Of Observer) Signature Of Mediator Name Of Mediator (Type Or Print) Email Address Of Mediator This, the day of 20 . *Attorneyapplicants must observe two (2) mediated settlement conferences involving custody and/or family financial issues, from beginning through impasse or settlement, which are conducted by 1) a mediator certified by the NC Dispute Resolution Commission to conduct mediated settlement conferences in family financial cases; 2) an Advanced Practitioner member of the Association for Conflict Resolution; or 3) a NCAOC mediator. Conferences eligible for observation also include those disputes mediated prior to litigation of family financial issues which are mediated by agreement of the parties and which incorporate the FFS Rules. FFS Rule 8.D. Non-attorneyapplicants must observe five (5) mediated settlement conferences involving civil or family issues from beginning through impasse or settlement. Two (2) observations shall involve custody and/or family financial issues conducted by 1) a mediator certified by the NC Dispute Resolution Commission to conduct mediated settlement conferences in family financial cases; 2) an Advanced Practitioner member of the Association for Conflict Resolution; or 3) a NCAOC mediator. The three (3) additional eligible observations must be conducted by a mediator certified by the NC Dispute Resolution Commission and may include disputes mediated prior to litigation by agreement of the parties and cases conducted pursuant to court order, all of which must be conducted pursuant to the rules of a NC state or federal court or the rules of the NC Dispute Resolution Commission. FFS Rule 8.D. AOC-DRC-08, Rev. 7/14 © 2014 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com