APPENDIX H (L.R. 7.05)
COURT OF COMMON PLEAS
BUTLER COUNTY, OHIO
:
Case No._________________________
Plaintiff(s),
:
:
vs.
:
ORDER TO PAY MEDIATOR
:
:
Defendant(s).
:
, attorney, being a duly appointed mediator in the within action, hereby
applies to the court pursuant to Rule 7.05 of the Rules of Court, General Division, Common Pleas Court,
Butler County, Ohio, for payment of mediator’s fee in the amount of five hundred dollars ($500).
This case did/did not settle through mediation held on _________________.
_____________________________
Mediator
_____________________________
Address
ENTRY
Upon application of the mediator in the above captioned action, the court finds the above application to be
proper in all respects and orders a fee of five hundred dollars ($500) to be paid to the applicant pursuant
to Rule 7.05 of the Rules of Court, General Division, Common Pleas Court, Butler County, Ohio. It is
further ordered that the Auditor issue a warrant payable to the appointed mediator in the amount of five
hundred dollars ($500). Said amount to be paid from Account 13284160.531000 of this
court’s budget.
_____________________________
Judge Common Pleas Court
INSTRUCTIONS TO THE CLERK:
This case did not settle, the five hundred dollar ($500) mediator fee shall be taxed as costs of this action.
The Clerk shall reimburse the General Division Account 13284160420000, with the refunded costs,
pursuant to Local Rule 7.05(C).
SO ORDERED.
____________________________________
Judge Common Pleas Court
Appendix
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