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Report Of Mediation Program Conference 33 - Pennsylvania
| Report Of Mediation Program Conference Form. This is a Pennsylvania form and can be used in USBC Western Federal . |
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WPAB FORM 33 (03/12) Page 1 IN THE UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA ) ) ) ) ) ______________________________________, ) Plaintiff/Movant ) ) vs. ) ) _______________________________________ ) Defendant/Respondent ) _______________________________________ ) In re: ______________________________________, Debtor _______________________________________ Bankruptcy No. _________________________ Motion No. _____________________________ Adversary No. ___________________________ Note: Local Bankruptcy Forms 33 and 34 should not be filed on the case docket. These forms should be delivered to the Mediation Program Administrator. REPORT OF MEDIATION PROGRAM CONFERENCE I, _______________________________, mediator for the Bankruptcy Mediation Program, state: 1. A Mediation Program conference was held on ________ __, ____ and (if applicable) on the following continued date(s): ____________________________________________________________ _____________________________________________________________(attach attendance form[s]). 2. I ___ did/___ did not receive a fee for this mediation. 3. The rules governing the conference were _______/were not ________ complied with. If not, explain below: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 4. A settlement/resolution of this matter was ___/was not ___ reached. 5. If a settlement/resolution was reached, (plaintiff/defendant/other party) ________________ ______________________________________________ prepared the written stipulation for settlement. 6. Prior to the preparation of a final written agreement, the parties choose to put the agreement on the Court record. Yes ____ No ____. American LegalNet, Inc. www.FormsWorkFlow.com WPAB Form 33 (03/12) Page 2 7. I spent _____ hours in preparing for and scheduling the conference(s). 8. I spent _____ hours attending the conference(s). 9. I spent _____ hours on postconference matters. 10. Comments/Suggestions (use additional sheets if necessary): ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Dated: __________________ __________________________________________ __________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com
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