Court of Appeals
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In The Court of Appeals For The First District of Texas
NO. 01-___-______-CV
______, Appellant(s)
V.
______, Appellee(s)
On Appeal from the ______Court ______County, Texas Trial Court Cause No. ______
MEDIATOR’S REPORT
The Court referred this cause to mediation.
______served as mediator in this appeal based on the agreement of the parties. After the referral to mediation, the cause:
settled before the mediation was conducted.
settled during mediation.
did not settle.
Check one of the following:
Based on the agreement of the parties and the mediator, the mediator has been paid a fee as follows:
$______paid by
______.
$______paid by
______.
$______paid by
______.
$______paid by
______.
The parties ask the Court to tax this fee as a cost of the
appeal.
The parties have agreed to another method of payment and
understand that the Court will not tax this fee as a cost of
2 appeal.
______Mediator’s name: State Bar of Texas identification number: Mailing address: Telephone number: Fax number:
3