UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF FLORIDA www.flsb.uscourts.gov In re: Case No. Chapter Debtor / Plaintiff vs. Defendant / REPORT OF MEDIATOR The undersigned court-appointed mediator, reports to the court as follows: A. B. A mediation conference was conducted on The conference resulted in the following: Adversary Proceeding No. Agreement signed (total resolution). The parties reached an impasse. The parties settled the following issues: (a) (b) (c) C. D. Attendance: Parties and Counsel present: Parties and Counsel not present: Dated: signature of mediator print name address city, state, zip code telephone Copies to: [all parties to mediation] LF-54 (rev. 12/01/09) American LegalNet, Inc. www.FormsWorkFlow.com The conference was continued and an additional mediation conference will be scheduled. The matter was settled prior to mediation conference.