Confidential Joint Request to Enter Appellate Mediation Program

• Legal Form Number: 27
• Date: 01 March 2021
• Court: U.S. Court of Appeals — Federal Circuit
• Section: United States Court of Appeals for the Federal Circuit

Form27. Confidential Joint Request to Enter Appellate Mediation ProgramForm 27

March2021

UNITED STATES COURT OF APPEALS

FOR THE FEDERAL CIRCUIT

CONFIDENTIAL JOINT REQUEST TO ENTER

APPELLATE MEDIATION PROGRAM

Case Number:

Short Case Caption:

We would like the above case considered for entry into the Appellate Mediation

Program (counsel for all parties must sign).

Signature of Counsel for:Appellant/Petitioner Cross-Appellant

Appellee/Respondent Intervenor

Name of Party Represented:

Law Firm:

Address:

Phone Number: EmailAddress:

Date: _________________Signature:

Name:

Signature of Counsel for:Appellant/Petitioner Cross-Appellant

Appellee/Respondent Intervenor

Name of Party Represented:

Law Firm:

Address:

Phone Number: EmailAddress:

Date: _________________Signature:

Name:

This Joint Mediation Request must be submitted to the Circuit Mediation

Administrator. Please send the completed form to

Circuit Mediation Administrator

U.S. Court ofAppeals for the Federal Circuit

717 Madison Place, NW

Washington, DC 20439

Save for Filing