UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF FLORIDA www.flsb.uscourts.gov In re: Case No. Chapter ________Debtor______/ FINAL REPORT OF MORTGAGE MODIFICATION MEDIATOR The undersigned court-appointed mortgage modification mediator, reports to the Court as follows regarding Debtor's real property located at ___________________________, (street address) and the mortgage on this property held by ______________("Lender"): A. The final Mortgage Modification Mediation ("MMM") conference was conducted on _____________ and the following parties were present: 1. [ ] The Debtor [and Debtor's attorney], ___________________________ 2. [ ] The co-obligor/co-borrower/or other third party, __________________ ________________________________________________________ 3. [ ] The Lender's representative, ________________________________ and Lender's attorney, _____________________________________ 4. [ ] Other: __________________________________________________ B. The final MMM conference was scheduled for _________________, but not conducted for the following reason: 1. 2. 3. 4. 5. C. [ [ [ [ [ ] ] ] ] ] The parties settled prior to attending. The case was dismissed. The Debtor or [ ] Debtor's attorney failed to attend. The Lender's representative or [ ] Lender's attorney failed to attend. Other: _____________________________________________________. The result of the MMM conference is as follows: 1. [ ] The parties reached an agreement. 2. [ ] The parties did not reach an agreement. Dated: ________________ ________________________________ Signature of Mediator Print name:_______________________ Address:_________________________ City, State, Zip Code:_______________ Telephone:_______________________ email:___________________________ Copies to: [all parties to mediation] MMM-LF-13 (rev. 06/24/15) American LegalNet, Inc. www.FormsWorkFlow.com