New Hampshire > Statewide > Superior Court > Civil Equity
Foreclosure Mediation Program Mediator Billing Statement NHJB-2638-SOMA - New Hampshire
| Foreclosure Mediation Program Mediator Billing Statement Form. This is a New Hampshire form and can be used in Civil Equity Superior Court Statewide . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) FORECLOSURE MEDIATION PROGRAM MEDIATOR BILLING STATEMENT Name of Mediator: SS# or Federal Tax ID # of Payee: Date of Mediation Session: ADR Report Filed with the OMA? ADR Report Filed with the Court? Evaluations provided to the Parties and Counsel at the conclusion of Mediation? Yes Yes Yes No No No Invoice amount: $400.00 fixed fee per case. AOC Accounting Note: ($300 to mediator; $100 to OMA fund--all funds are to be paid from grant) Date: Signature of Mediator Mediator Name (please print) Approved: Date: Duly Authorized Representative of: OMA To ensure prompt payment please send this form to: Foreclosure Mediation Program Office of Mediation and Arbitration P.O. Box 389 Concord, New Hampshire 03302 NHJB-2638-SOMA (02/25/2011) American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
