Request For PACER Exemption By A Court Sponsored Mediator

UNITED STATES DISTRICT COURT DISTRICT OF OREGON REQUEST FOR PACER EXEMPTION BY A COURT-SPONSORED MEDIATOR Pursuant to Standing Order 2011-4 authorizing the exemption of electronic public access fees for members of the Court-sponsored Mediator Panel, I hereby request exemption from PACER fees in the conduct of research related to my work on cases assigned by the Court for mediation pursuant to Local Rule 16-4(e)(3). By requesting exemption, I certify that I will abide by all rules and guidelines set by PACER for the use of an exempt fee account and that I will not use my PACER exempt account for research not specifically intended to aid in my understanding of a case assigned to me for mediation by the Court. Furthermore, I acknowledge that any violation of the PACER terms of service could result in revocation of my exempt account and removal from the Court-sponsored Mediator Panel list. Signed this ____ day of _______, 20__. ___________________________________ Mediator Signature ___________________________________ Printed Name __________________ OSB Number U.S. District Court ­ Oregon Form revision date: May 20, 2011 Request for PACER Exemption American LegalNet, Inc. www.FormsWorkFlow.com