Office of Congressional Workplace Rights
110 Second Street, SE, Room LA-200 | Washington, DC 20540-1999
(202) 724-9250 (O) | (202) 426-1913 (F)
www.ocwr.gov
OCWR Form 404 03/2020
Office of Congressional Workplace Rights
Request for Mediation
OCWR Case no.: __________________________
Mediation is a process provided by the Office of Congressional Workplace Rights
(OCWR) for the parties involved in a claim to explore possible alternatives to litigation.
Mediation is voluntary, may be initiated by either party, and may only proceed if both
parties agree to mediate. The time to request mediation begins after a claim is filed and
ends on the date on which a merits hearing officer issues a written decision on the claim,
or until the claimant files a complaint to initiate a civil action in Federal court. For more
information on mediation under the Congressional Accountability Act of 1995, as
amended by the Congressional Accountability Act of 1995 Reform Act of 2018,
see 2 U.S.C. § 1403 and OCWR Procedural Rule § 4.07.
To request mediation in the above-referenced matter, please provide your information
below and return this completed form to the OCWR via email (OCWRefile@ocwr.gov),
fax (202-426-1913), mail or hand-delivery to the Library of Congress, John Adams
Building, 110 Second Street, SE, Room LA-200, Washington, DC 20540.
Name: ___________________________________________________________________
Please check one: □ Claimant □ Respondent
Preferred phone no.:________________________________________________________
Secondary phone no.: ______________________________________________________
Mailing address (mail will be delayed due to anthrax screening): ___________________
_________________________________________________________________________
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