Report Of Mediator {17}

Local Form 17 UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF NORTH CAROLINA [insert correct division name] DIVISION IN RE: ) ) ) ) ) ) Case No: Chapter March 2013 Debtor(s). REPORT OF MEDIATOR 1. Convening of Mediation. The mediated settlement conference ordered in this case: was held on . was NOT held because ______________________________________________ _________________________________________________________________. 2. 3. Attendance. No objection was made on the grounds that any required attendee was absent. Outcome. The mediation resulted in: Complete settlement of the case Partial settlement of the case Recess (i.e., mediation to be resumed at later date) Impasse Other disposition. Specify: ___________________________________________ _________________________________________________________________. 4. Settlement Filings a. The document(s) to be filed to effect the settlement are:_______________________ ___________________________________________________________________. b. The person responsible for filing the document(s) is:__________________________ ___________________________________________________________________. c. The agreed deadline for filing the document(s) is:____________________________. I have submitted this completed report within 14 days after conclusion of the conference. _______________________________________ Signature of Mediator ___________________ Date American LegalNet, Inc. www.FormsWorkFlow.com