Verification Of Qualifications To Act As Meadiator {ND-MMM-200} | Pdf Fpdf Doc Docx | California

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Verification Of Qualifications To Act As Meadiator {ND-MMM-200} | Pdf Fpdf Doc Docx | California

Verification Of Qualifications To Act As Meadiator {ND-MMM-200}

This is a California form that can be used for USBC Northern within Federal.

Alternate TextLast updated: 8/13/2015

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1 2 3 4 5 6 UNITED STATES BANKRUPTCY COURT 7 NORTHERN DISTRICT OF CALIFORNIA 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3. I, 1. , hereby declare as follows: I am seeking to be included on the Register of Mediators maintained by the Clerk In re MORTGAGE MODIFICATION MEDIATION PROGRAM. VERIFICATION OF QUALIFICATIONS TO ACT AS MEADIATOR IN THE MORTGAGE MODIFICATION MEDIATION PROGRAM of the Court for purposes of the Mortgage Modification Mediation Program (the "MMM Program"). I have personal knowledge of the following and could testify competently thereto if called upon to do so. 2. In accordance with General Order 29, I verify that I am qualified to serve as a mediator for a period of three (3) years, after which I must reapply, based upon the following qualification (select one): I am an active and licensed member of the State Bar of California and admitted to practice law in a state court or federal court within California for at least the past five (5) years; I am a retired California state court or federal court judge; or I am an active and licensed member of the State Bar of Florida and an approved member on the Register of Mediators with the Clerk of the Court for the United States Bankruptcy Court, District of Florida (all divisions) accepting MMM Assignments, and I will accept MMM Assignments for a period limited to one (1) year commencing August 1, 2015 and ending July 31, 2016. I have never been disbarred or suspended from practice before any court, department, bureau or commission of any state or the United States, and I have never received a FORM ND-MMM-200 1 VERSION 1.00 (August 1, 2015) VERIFICATION OF QUALIFICATIONS TO ACT AS MEADIATOR IN THE MORTGAGE MODIFICATION MEDIATION PROGRAM American LegalNet, Inc. www.FormsWorkFlow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 reprimand or been subject to other disciplinary action from any such court, department, bureau or commission, except as follows: 4. follows: I have never been denied admission to the State Bar of California, except as 5. I am a member in good standing of the following Bar Associations: 6. I agree to accept the current compensation rate established by the United States Bankruptcy Court for the Northern District of California. 7. I am familiar with and will comply with all notice and reporting requirements as implemented in General Order 29 through the MMM Procedures. 8. I will promptly disclose to the Court any bias or prejudice which may disqualify me as a mediator. 9. I will accept referrals for cases filed in the Northern District of California in the Oakland, San Francisco, Santa Rosa, and San Jose Divisions. I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. Executed at , on this day of ______, 20 . Signature FORM ND-MMM-200 2 VERSION 1.00 (August 1, 2015) VERIFICATION OF QUALIFICATIONS TO ACT AS MEADIATOR IN THE MORTGAGE MODIFICATION MEDIATION PROGRAM American LegalNet, Inc. www.FormsWorkFlow.com

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