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Voucher For Compensation Of Assigned Neutral - Georgia
| Voucher For Compensation Of Assigned Neutral Form. This is a Georgia form and can be used in 2nd District Local County . |
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IN THE SUPERIOR COURT OF__________________ COUNTY, GEORGIA ALTERNATIVE DISPUTE RESOLUTION PROGRAM SOUTHERN JUDICIAL CIRCUIT VOUCHER FOR COMPENSATION OF ASSIGNED NEUTRAL ________________________________ PLAINTIFF CIVIL ACTION FILE NO. ___________________ ________________________________ DEFENDANT NEUTRAL'S CERTIFICATION I certify that a Alternative Dispute Resolution, ("ADR"), session was conducted with the parties named above on ____________________________________________________, with the following results: ___________ A full agreement ___________ No agreement ___________ Other Request is hereby made for compensation in the amount of $__________________ for ADR services rendered. (1) Time spent in mediation: __________________ (2) Time spent in preparation: __________________ (3) Expenses: __________________ (Attach detailed statement) ____________________________________________________ Neutral's Signature ____________________________________________________ Printed or Typed Name ____________________________________________________ P.O. Box or Street Address ____________________________________________________ City, State, and Zip Code AUTHORIZATION FOR PAYMENT American LegalNet, Inc. www.FormsWorkflow.com Approved for payment in the amount of $______________ to the above-named Neutral. This ________ day of ________________________________ , 20_____. ____________________________________________________ Tim C. Hendrick Administrator Alternative Dispute Resolution Program Southern Judicial Circuit Post Office Box 2227 Moultrie, Georgia 31776-2227 Telephone: (229) 890-5624 American LegalNet, Inc. www.FormsWorkflow.com
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