CSD 1168 [04/28/96] 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. RS NO. Moving Party v. Respondent(s) MEDIATOR'S CERTIFICATE OF COMPLIANCE I, 1. Date of Mediation: Continued Date: (If applicable) 2. 3. 4. , the Court appointed Mediator, declare: The Rules governing mediation have A settlement of this matter has have not has not been complied with. been reached. , (movant)(respondent) If settlement has been reached, shall prepare the stipulation for settlement. Dated: (Mediator) FOR COURT USE ONLY (Case Management Section): cc: Courtroom Deputy CSD 1168 American LegalNet, Inc. www.USCourtForms.com