Form AOC-DRC-10 "Application for Certification to Conduct Guardianship and Estate Mediations" - North Carolina

What Is Form AOC-DRC-10?

This is a legal form that was released by the North Carolina Court System - a government authority operating within North Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2014;
  • The latest edition provided by the North Carolina Court System;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AOC-DRC-10 by clicking the link below or browse more documents and templates provided by the North Carolina Court System.

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Download Form AOC-DRC-10 "Application for Certification to Conduct Guardianship and Estate Mediations" - North Carolina

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APPLICATION
FOR CERTIFICATION TO CONDUCT
STATE OF NORTH CAROLINA
GUARDIANSHIP AND ESTATE MEDIATIONS
G.S. 7A-38.3B, Rules Implementing Mediation
in Matters Before The Clerk Of Superior Court
Name And Address Of Applicant
Date of Birth
Telephone No.
Fax No.
E-mail Address
INSTRUCTIONS:
Please type or print and mail this form with the required attachment to the NC Dispute Resolution Commission, P.O. Box
2448, Raleigh, NC 27602. There is no additional fee for this certification.
I
SECTION
. QUALIFICATIONS
1.
Pursuant to Clerk Mediation Program Rule 8.B, I am certified by the NC Dispute Resolution Commission to mediate in:
Superior Court MSC Program,
District Court FFS Program,
Both Superior and District Court Programs.
2.
I have completed at least ten (10) hours of NC Dispute Resolution Commission approved training on estate and guardianship
matters. Rule 8.B. (Please attach a copy of your certificate of training to this application.)
Program Title
Date Training Conducted
Training Conducted By
II
SECTION
. AVAILABILITY
1.
Indicate counties in which you wish to mediate Clerk referrals upon party selection*
All counties
Select counties
(List counties below.):
2.
Indicate counties in which you are willing to accept appointments to mediate Clerk referrals**
Select counties
(List counties below.):
*
The Commission will post notice of your availability on its website, but does not directly notify attorneys or litigants of your certification and availability.
** The Commission will notify the Clerk in the counties you have selected above of your interest in receiving Clerk appointments to mediate. However,
mediators should follow up with the Clerk in all counties selected to learn about local rules that affect appointment and to verify inclusion in the
rotation for appointments. Contact information for Clerks can be obtained through the Commission's office.
3.
I agree to accept, as payment in full of a party’s share of the mediator's fee, the fee ordered by the Clerk pursuant to Rule 7.
CERTIFICATION
I, the undersigned, certify that I have given true, accurate, and complete information on this application to the best of my knowledge. I
am of good moral character. I will adhere to all continuing mediator education requirements, standards of professional conduct and
other rules adopted by the NC Dispute Resolution Commission, and all rules adopted by the Supreme Court of North Carolina for
mediation of matters before Clerks of Superior Court.
Date
SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Date
Title Of Person Authorized To Administer Oaths
Signature Of Applicant
Signature
Name And Address Of Applicant (Type Or Print)
Date Commission Expires
Notary
County Where Notarized
SEAL
FOR COMMISSION USE ONLY
Pursuant to G.S. 7A-38.3B and the Supreme Court of North Carolina’s Rules Implementing Mediation in Matters Before Clerks of Superior Court, you
are certified as a mediator to conduct Clerk referred mediations in estate and guardianship matters.
Date
Name (Type Or Print)
Signature
AOC-DRC-10, Rev. 5/14
© 2014 Administrative Office of the Courts
APPLICATION
FOR CERTIFICATION TO CONDUCT
STATE OF NORTH CAROLINA
GUARDIANSHIP AND ESTATE MEDIATIONS
G.S. 7A-38.3B, Rules Implementing Mediation
in Matters Before The Clerk Of Superior Court
Name And Address Of Applicant
Date of Birth
Telephone No.
Fax No.
E-mail Address
INSTRUCTIONS:
Please type or print and mail this form with the required attachment to the NC Dispute Resolution Commission, P.O. Box
2448, Raleigh, NC 27602. There is no additional fee for this certification.
I
SECTION
. QUALIFICATIONS
1.
Pursuant to Clerk Mediation Program Rule 8.B, I am certified by the NC Dispute Resolution Commission to mediate in:
Superior Court MSC Program,
District Court FFS Program,
Both Superior and District Court Programs.
2.
I have completed at least ten (10) hours of NC Dispute Resolution Commission approved training on estate and guardianship
matters. Rule 8.B. (Please attach a copy of your certificate of training to this application.)
Program Title
Date Training Conducted
Training Conducted By
II
SECTION
. AVAILABILITY
1.
Indicate counties in which you wish to mediate Clerk referrals upon party selection*
All counties
Select counties
(List counties below.):
2.
Indicate counties in which you are willing to accept appointments to mediate Clerk referrals**
Select counties
(List counties below.):
*
The Commission will post notice of your availability on its website, but does not directly notify attorneys or litigants of your certification and availability.
** The Commission will notify the Clerk in the counties you have selected above of your interest in receiving Clerk appointments to mediate. However,
mediators should follow up with the Clerk in all counties selected to learn about local rules that affect appointment and to verify inclusion in the
rotation for appointments. Contact information for Clerks can be obtained through the Commission's office.
3.
I agree to accept, as payment in full of a party’s share of the mediator's fee, the fee ordered by the Clerk pursuant to Rule 7.
CERTIFICATION
I, the undersigned, certify that I have given true, accurate, and complete information on this application to the best of my knowledge. I
am of good moral character. I will adhere to all continuing mediator education requirements, standards of professional conduct and
other rules adopted by the NC Dispute Resolution Commission, and all rules adopted by the Supreme Court of North Carolina for
mediation of matters before Clerks of Superior Court.
Date
SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Date
Title Of Person Authorized To Administer Oaths
Signature Of Applicant
Signature
Name And Address Of Applicant (Type Or Print)
Date Commission Expires
Notary
County Where Notarized
SEAL
FOR COMMISSION USE ONLY
Pursuant to G.S. 7A-38.3B and the Supreme Court of North Carolina’s Rules Implementing Mediation in Matters Before Clerks of Superior Court, you
are certified as a mediator to conduct Clerk referred mediations in estate and guardianship matters.
Date
Name (Type Or Print)
Signature
AOC-DRC-10, Rev. 5/14
© 2014 Administrative Office of the Courts