Request For Reimbursement Of Out Of Pocket Expenses Incurred By Panel Mediator {ADR-24}

ADR-24, REQUEST FOR REIMBURSEMENT OF OUT-OF-POCKET EXPENSES INCURRED BY PANEL MEDIATOR. This form is used in the United States District Court for the Central District of California related to Alternative Dispute Resolution (ADR) proceedings. It is used by panel mediators to request reimbursement of out-of-pocket expenses they incurred during the ADR process. The instructions on the form indicate: (1) Complete a separate form for each case. (2) Do not submit unless you have already filed your Mediation Report (ADR-03). (3) If requesting reimbursement for mileage, provide the addresses driven to and from and round-trip mileage. (4) Attach copies of receipts. (5) You may not claim more than $50 per case unless you attach a Request by Panel Mediator to Incur Costs in Excess of $50.00 (ADR-23) that was approved before you incurred the claimed expenses. (6) Return completed form and supporting documents by email to ADR_Coordinator@cacd.uscourts.gov. www.FormsWorkflow.com