SUPERIOR COURT Docket No. STATE OF MAINE DISTRICT COURT , ss Location: Docket No. , Plaintiff v. DEFENDANT'S FORECLOSURE MEDIATION INFORMATION , Defendant The defendant homeowner(s), (by and through undersigned counsel) submit(s) the following information: A. Name, current address, telephone number and other contact information for the homeowner: B. Has the homeowner moved out of the property under foreclosure? ! Yes ! No If yes, when? C. This homeowner's gross monthly income, from all sources, as a preliminary estimate for mediation purposes: $___________ D. Homeowner's goal(s) for the property (if known): ! Retain the home ! Sell or deed over to bank. Signature: Printed Name: Name, title, and telephone number of person who prepared this form: Dated: DEFENDANT MUST FILE A COMPLETED COPY OF THIS FORM WITH THE COURT AND PROVIDE A COMPLETED COPY OF THIS FORM TO PLAINTIFF'S ATTORNEY ON THE DATE OF INFORMATIONAL SESSION AND MEDIATION. FDP-02B, Rev. 09/14 American LegalNet, Inc. www.FormsWorkFlow.com