Mediators Final Report

UNITED STATES BANKRUPTCY COURT Southern District of New York MEDIATOR'S FINAL REPORT 1. 2. 3. 4. 5. Case name: a. Case #: Nature of dispute: Date of mediator appointment: a. Has case settled?: [ ]Yes, before first meeting [ ]Yes, in mediation [ ]Yes, after mediation, if you know [ ]Case did not settle . b. Adversary # (if applic.): . . . . b. If settled, how long from appointment to settlement of case?: . c. What were the principal terms of the settlement? (Annex a brief description if necessary): . . 6. a. What was total fee?:$ b. How was it paid?: . . 7. Please list persons in attendance (including party association, i.e., defendant, plaintiff): (Mediator) . . . 8. Please provide the names, addresses, and telephone numbers of counsel: Name: Address: Name: Address: . . . Phone: Name: Address: Phone: Name: Address: . . . . Phone: Signature of Mediator: Address: Phone: Phone: Date: . . . . American LegalNet, Inc. www.FormsWorkFlow.com