Request For Replacement Settlement Facilitator

STATE OF NEW MEXICO COUNTY OF _________________ FIRST JUDICIAL DISTRICT COURT CASE NUMBER: D-____-____-_____________ _______________________________, Plaintiff / Petitioner, vs. _______________________________, Defendant / Respondent. REQUEST FOR REPLACEMENT SETTLEMENT FACILITATOR COMES NOW _________________________ Plaintiff /Defendant ____, (circle one) Settlement Facilitator herein, and requests the court to replace the settlement facilitator appointed in the Settlement Conference Referral Order issued on _________________________. Submitted by: ________________________________ Signature (Print Name:_____________________) Mailing address Phone XC: Plaintiff/Attorney for Plaintiff/Petitioner (name, mailing address, phone) Defendant/Attorney for Defendant/ Respondent (name, mailing address, phone) z/Forms/SF/Req for Replacement SF rev 08.12.11 1 American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing Request for Replacement Settlement Facilitator was (circle one) mailed /faxed / hand-delivered / emailed, to all parties of record listed above on this ______ day of _____________, 201__. ________________________________ z/Forms/SF/Req for Replacement SF rev 08.12.11 2 American LegalNet, Inc. www.FormsWorkFlow.com