1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Plaintiff(s)/Movant(s), 16 v. 17 18 Defendant(s)/Respondent(s). 19 20 21 22 23 24 25 26 1. 2. Form 703 UNITED STATES BANKRUPTCY COURT FOR THE CENTRAL DISTRICT OF CALIFORNIA In re Debtor(s). ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Bk. No. [Chapter ] Adv. No. NOTICE OF MEDIATOR'S OR ALTERNATE MEDIATOR'S UNAVAILABILITY TO SERVE IN MEDIATION MATTER The undersigned, who was appointed by the Judge on to serve as Mediator Alternate Mediator in the above- entitled Matter, is unavailable to serve for the following reason(s): [ [ ] ] Conflict of interest Previous professional commitment 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 cc: 3. 4. [ [ ] ] Previous personal commitment Other: The undersigned represents that this notice has been mailed to the Mediator and/or alternate Mediator, (as applicable), to all parties to the Matter, their counsel, if any, and to the Mediation Program Administrator, and that a courtesy copy has been provided to the Judge, as required by the applicable provisions of Third Amended General Order No. 95-01. DATED: (Name of Mediator) (Signature of Mediator) DATED: (Name of Alternate Mediator) (Signature of Alternate Mediator) Hon. Barry Russell Mediation Program Administrator United States Bankruptcy Court 255 East Temple Street, Suite 1660 Los Angeles, California 90012 Form 703 2 Revised 11/09 American LegalNet, Inc. www.FormsWorkFlow.com