CSD 4004 [0/01/18] Name, Address, Telephone No. & I.D. No. UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West F Street, San Diego, California 92101-6991 In Re BANKRUPTCY NO. Debtor. ADVERSARY NO. Plaintiff(s) v. Defendants(s ) MEDIATOR'S CERTIFICATE OF COMPLIANCE I, , the Court appointed Mediator, declare: 1. Date of Mediation: Continued Date: (If applicable) 2. The Rules governing mediation have have not been c omplied with. 3. A settlement of this matter has: not been reached. been reached as to all claims and all parties. been reached as to some claims and parties (describe). 4. If settlement has been reached in full or in party, , (plaintiff) (defendant), shall prepare the stipulation for settlement. 5. Describe what further proceedings remain to be conducted in this case. Dated: (Mediator) FOR COURT USE ONLY (Case Management Section): cc: Courtroom Deputy CSD 4004 American LegalNet, Inc. www.FormsWorkFlow.com