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MEDIATION CONFERENCE REQUEST Non-binding mediation conferences are routinely conducted in most but not all civil appeals, pursuant to Sixth Circuit Rule 33. In these conferences, Court mediators work with counsel to explore possibilities for settlement, to clarify the issues on appeal and to try to resolve procedural problems that might cause delay. They are usually conducted by telephone. If you think such a conference could be useful in this case, you may request one confidentially by completing and returning this form to: Mediation Administrator Office of the Circuit Mediators U.S. Court of Appeals 331 Potter Stewart U.S. Courthouse Cincinnati, Ohio 45202 Tel. (513) 564-7330 Fax: (513) 564-7349 firstname.lastname@example.org Please note that requests for conferences are optional; there is no need to submit this form unless you are requesting a conference. Requesting a conference does not relieve appellants of their obligation to comply timely with all other court filing requirements. * * * * * * * * * * * * (Caption & Sixth Circuit No.) Your Name (Please Print) (Signature) Telephone Number Counsel For Rev 1/15 American LegalNet, Inc. www.FormsWorkFlow.com