UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF FLORIDA www.flsb.uscourts.gov In re: Case No. Chapter Debtor / Plaintiff vs. Adversary Proceeding No. Defendant / NOTICE OF SELECTION OF MEDIATOR Pursuant to Local Rule 9019-2(B)(1) of this court, the parties agree to and select the following mediator in this matter: Name of Mediator Address City, State, Zip Code Telephone Signature of party or counsel for party Print Name Address Telephone Counsel for Dated: copies to: (all parties to the mediation) Signature of adverse party or counsel for adverse party Print Name Address Telephone Counsel for Submitted By: LF-52 (rev. 12/01/09) American LegalNet, Inc. www.FormsWorkFlow.com