SUPERIOR COURT OF THE DISTRICT OF COLUMBIA MULTI-DOOR DISPUTE RESOLUTION DIVISION CONFIDENTIAL SETTLEMENT STATEMENT RESIDENTIAL FORECLOSURE CASES Parties in cases involving foreclosure of a residential mortgage or deed of trust are required to file this Confidential Settlement Statement (CSS) with the Multi-Door Dispute Resolution Division (202-879-1557). This statement is for the use of the mediatorconfidential information submitted in this statement will not be shared with any other party except with the express permission of the party who submitted it. The statement must be filed no later than fourteen days prior to the scheduled mediation session. Parties and counsel are cautioned that sanctions may be imposed on those who do not file the CSS by the due date. You may submit the form in one of three ways: e-mail, regular mail, or hand-delivery. To submit the form by e-mail, send it to: CivilCSS@dcsc.gov. The form should be titled by the case number. Do not send any other information or inquiries to this e-mail address. It is used only to receive completed CSS forms. The form may be mailed or delivered to: Multi-Door Dispute Resolution Division 410 E Street, NW, Suite 2900 Washington, D.C. 20001 Hand-delivery must occur between the hours of 8:30 am and 5:00 pm. There is no after-hours filing box for CSS forms. Do not deliver CSS forms to the Civil Division or any after-hours filing box in the courthouse. Proper filing with the Multi-Door Division will ensure that the CSS remains confidential and is not filed in the Court's case jacket or shown to anyone other than the mediator assigned to the case. Do not serve or send a copy of the statement to opposing counsel or the opposing party. Please be candid in your responses; this information is important to the mediation process. Responses need not be confined within the spaces provided. You are encouraged to attach additional pages or expand as much as needed. If the case has been settled and you therefore are not submitting a CSS form, a settlement praecipe must be filed in the Civil Clerk's Office and a copy sent to the Multi-Door Dispute Resolution Division. Thank you. American LegalNet, Inc. www.FormsWorkFlow.com RESIDENTIAL FORECLOSURE CONFIDENTIAL SETTLEMENT STATEMENT Multi-Door Dispute Resolution Division Judge Calendar # Case Number Case Caption This case is scheduled for mediation on at Date Time Submitted by: Check one: Plaintiff Defendant Name of Party (if unrepresented) or Attorney (please print) Law Firm Name (if applicable) Address City State Zip Telephone Email address Do any of the parties involved require an interpreter? Yes No If yes, please identify the language: For Attorneys: List below the names of all parties you represent. (Attach an additional page if necessary). The filing of one settlement statement will suffice for all of the parties that you represent in this matter, provided all of the parties are listed. Name of Party Name of Party Name of Party Name of Party Name of Party Name of Party American LegalNet, Inc. www.FormsWorkFlow.com Plaintiff Only Please provide the following information: 1. A brief summary of the facts of this case: 2. The total amount due under the note, as of [date] a. Unpaid principal $ b. Interest due $ c. Late charges $ d. Escrow $ e. Other (please describe) $ f. Total $ 3. The amount the borrower(s) must pay to reinstate the loan/cure the default: $ 4. The estimated value of the real property: $ Basis for the estimated value stated above: 5. Describe in detail any loss mitigation options requested by the defendant(s) and the 6. Describe what loss mitigation options may be available to the defendant(s): 7. List and explain any particular factors the parties may need to address when assessing options to resolve this case (e.g. liens on the property, divorced or deceased borrowers, tenants, bankruptcy): American LegalNet, Inc. www.FormsWorkFlow.com 8. Describe any other possible resolutions of this case that the plaintiff(s) is willing to consider: 9. Describe any other matters that may assist the mediator and facilitate the mediation: 10. Identify any attorneys who will represent the plaintiff(s) at mediation and any other persons with authority who will attend mediation for the plaintiff(s): Name and title Party/entity represented Name and title Party/entity represented Name and title Party/entity represented Please attach any documents or materials relevant to this case that may assist the mediator and advance the purposes of the mediation session. American LegalNet, Inc. www.FormsWorkFlow.com Defendant Only Please provide the following information: 1. A brief summary of the facts of this case: 2. nature of the challenge or defense and/or any counterclaims the defendant has against the plaintiff. 3. keep the property not keep the property 4. primary residence second home investment 5. The property is: owner occupied renter occupied vacant 6. State the estimated value of the real property: $ 7. Is the property currently listed for sale? yes no If yes, please provide the following information: Has defendant received an offer on the property? yes no Date of offer: Amount of offer: Please state whether the property is listed for sale through an agent or is for sale by owner: Name, phone number, and email address of agent: American LegalNet, Inc. www.FormsWorkFlow.com 8. Has the defendant(s) contacted a housing counseling agency for assistance? yes no If yes, please provide the following information: s name: Agency: Are you currently working with this counselor: yes no 9. Has the defendant(s) ever filed for bankruptcy? yes no If yes, please provide the following information: Type of bankruptcy: Chapter 7 Chapter 13 Filing Date: Has the bankruptcy been discharged? yes no Bankruptcy court location: Bankruptcy case number: 10. List any additional mortgages, liens or judgments on this property and include the amount: 11. Describe any circumstances that make it difficult for the defendant(s) to make the current monthly mortgage payments: 12. Describe how defendant(s) thinks this foreclosure case could be resolved: American LegalNet, Inc. www.FormsWorkFlow.com 13. Provide any additional information that may help the mediator understand the mortgage: 14. State the amount the defendant(s) can afford to pay per month toward the mortgage and the source(s) of that payment. If the defendant(s) is able to make a lump sum payment, state the amount and source of that payment: 15. If defendant(s) has applied for a loan modification or other loss mitigation, state analysis and describe any questions or concerns about how the analysis was conducted or the results of the analysis: 16. Describe any issues or special concerns that defendant(s) would like to discuss in attempting to resolve this case (e.g. second mortgages, liens on the property, divorced or deceased borrowers, tenants, bankruptcy, counterclaims): 17. State any other matters that may assist the mediator and facilitate the mediation: American LegalNet, Inc. www.FormsWorkFlow.com 18. Identify each person that defendant(s) expects will participate in mediation for defendant(s): Defendant (or person with settlement authority) Defendant (or person with settlement authority) . Party represented ttorney . Party represented Other persons attending mediation Role/title Other persons attending mediation Role/title . Attach any documents or materials relevant to this case that may assist the mediator and advance the purposes of the mediation session. American LegalNet, Inc. www.FormsWorkFlow.com