Petition For Order Referring Case To Mediated Settlement Conference {MSC2} | Pdf Fpdf Docx | North Carolina

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Petition For Order Referring Case To Mediated Settlement Conference {MSC2} | Pdf Fpdf Docx | North Carolina

Petition For Order Referring Case To Mediated Settlement Conference {MSC2}

This is a North Carolina form that can be used for Workers Comp.

Alternate TextLast updated: 4/1/2019

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I.C. Form MSC2 (rev. 10/2017) NORTH CAROLINA INDUSTRIAL COMMISSION FILE VIA ELECTRONIC DOCUMENT FILING PORTAL I.C. File No. HTTP://WWW.IC.NC.GOV/DOCFILING.HTML Carrier No. County NCIC-Mediation Section mediation@ic.nc.gov 1236 Mail Service Center Raleigh, NC 27699-1236 Plaintiff v. Defendant Carrier PETITION FOR ORDER REFERRING CASE TO MEDIATED SETTLEMENT CONFERENCE Appearances Name of Plaintiff or Plaintiff222s Attorney Telephone and Fax numbers of Plaintiff or Plaintiff222s Attorney Address of Plaintiff or Plaintiff222s Attorney Name of Defendant or Defendant222s Attorney Telephone and Fax numbers of Defendant or Defendant222s Attorney Address of Defendant or Defendant222s Attorney Now comes the undersigned party, petitioning the Commission to order the above captioned case to a mediated settlement conference pursuant to the Rules for Mediated Settlement Conferences of the Industrial Commission, and in support of the Petition says: This case should be ordered to a mediated settlement conference for the following reasons (attach additional pages if necessary, designated with the I.C. file number and titled 223Attachment to Form MSC2224): Notice to parties: Objections must be filed in writing with the Commission within 10 days of the service of this petition and may be ruled on by the Commission without further hearing. The foregoing motion was served by Petitioner on all non-moving parties by depositing a copy of same with the U.S. Postal Service, in a postage-paid envelope, addressed to the last known address of all non-moving parties or of said parties222 attorney(s), as listed below: This the day of , . Petitioner: American LegalNet, Inc. www.FormsWorkFlow.com

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