1 2 3 4 5 6 7 8 Debtor(s). 9 10 11 12 13 14 15 Defendant(s)/Respondent(s). 16 17 18 19 20 21 22 23 24 25 26 2. Plaintiff(s)/Movant(s), v. In re ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Bk. No. [Chapter ] UNITED STATES BANKRUPTCY COURT FOR THE CENTRAL DISTRICT OF CALIFORNIA Adv. No. MEDIATOR'S CONFIDENTIAL REPORT OF MEDIATION CONFERENCE CONFIDENTIAL -- NOT TO BE FILED WITH THE COURT I hereby certify that the following information is true and correct to the best of my information and belief: 1. How did you learn of your mediation assignment? (PLEASE CHECK ALL THAT APPLY) (a) Received Court order ; (b) Phone call ; . ; (c) Fax from Mediation Program staff (d) Other In what capacity did you serve? (a) Mediator ; (b) Alternate Mediator ; . Revised 11/09 American LegalNet, Inc. www.FormsWorkFlow.com (c) Successor Mediator Form 709 ; (d) Successor Alternate Mediator 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 3. How did the mediation assignment conclude? (a) Settled ; (b) Did NOT settle . 4. How many hours did you spend scheduling and preparing for the mediation conference? 5. 6. How many hours did you spend attending the conference? Which dispute resolution procedure(s) did you use? (IF MORE THAN ONE METHOD USED, PLEASE ESTIMATE PERCENTAGE OF TIME SPENT ON EACH) (a) (b) (c) (d) Early neutral evaluation: Settlement negotiation: Mediation: Other: (Describe): ( ( ( ( %) %) %) %) 7. 8. Were you compensated for your mediation services? Have you filed Form 706 (Mediator's Certificate Regarding Completion of Mediation Conference) with the Court, and mailed courtesy copies to the judge assigned to the matter and to Judge Russell (the Mediation Program Administrator)? 9. Comments/suggestions: DATED: (Name of Mediator) (Signature of Mediator) Form 709 2 Revised 11/09 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 Form 709 MEDIATION CONFERENCE ATTENDANCE FORM Case Name: Case No.: Adversary Proceeding Name: Adversary Proceeding No.: Date(s) of Conference(s): Mediator: Instructions: All attorneys and client representatives who attend the conference shall provide the following information to the Mediator. PLEASE WRITE OR PRINT CLEARLY. ATTORNEYS Name: Firm: Address: Name: Firm: Address: Phone: E-mail: Attorney for: Phone: E-mail: Attorney for: Name: Firm: Address: Name: Firm: Address: Phone: E-mail: Attorney for: Phone: E-mail: Attorney for: [Attach additional page(s) if necessary.] 3 Revised 11/09 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 Form 709 CLIENT AND/OR CLIENT REPRESENTATIVES Name: Title: Organization: Name: Title: Organization: Address: Address: Phone: Party Representing: Phone: Party Representing: Name: Title: Organization: Name: Title: Organization: Address: Address: Phone: Party Representing: Phone: Party Representing: [Attach additional page(s) if necessary.] Mail to: Hon. Barry Russell Mediation Program Administrator United States Bankruptcy Court 255 East Temple Street, Suite 1660 Los Angeles, California 90012 4 Revised 11/09 American LegalNet, Inc. www.FormsWorkFlow.com