UnitedStatesBankruptcyCourtWesternDistrictofMichiganAPPLICATIONTOSERVEASQUALIFIEDNEUTRALTheundersignedherebycertifiesunderpenaltyofperjury:(1)IamwillingtoserveasaNeutralandtoundertaketoevaluateormediatesettlementofmatterssubjectonlytounavailabilityduetoconflicts,personalorprofessionalcommitments,orothermatterswhichwouldmakesuchserviceinappropriate.(2)Iam,andhavebeen,amemberingoodstandingofthebaroftheUnitedStatesDistrictCourtfortheWesternDistrictofMichigan,andhaveregularlypracticedinBankruptcyCourtforatleast10years.(3)Ihaveservedastheprincipalattorneyofrecordinactivemattersinatleast10bankruptcycases(withoutregardtothepartyrepresented)fromcasecommencementtotheearlierofthedateoftheapplicationorconclusionofthecase,orIhaveservedastheprincipalattorneyofrecordforapartyininterestinatleast10adversaryproceedingsorcontestedmattersfromcommencementthroughconclusion.(4)Ihavecompletedtherequired40hourmediationtrainingprovidedorapprovedbytheCourtandhaveattachedacertificateofcompletion.(Acourtapprovedtrainingprogramincludesa40hourprogramapprovedbytheU.S.DepartmentofJustice226NationalAdvocacyCenterandstatecourtgeneralcivilmediationtrainingprograms,suchastheoneapprovedbytheMichiganStateCourtAdministrativeOfficepursuanttoMCR2.411(F)(2)(a)oranotherstate222sequivalent.)(5)IagreetobegovernedbyanystandardsofprofessionalconductandethicalrulesadoptedbytheMichiganSupremeCourtforstatecourtmediators,asthosestandardsandrulesmaybeamended,andtocomplywithitsadvancedmediatortrainingrequirementsofeighthourseverytwoyears.(6)IagreetomediateatleastoneprobonomatterperyearandtoabidebyandtomeetalloftherulesandrequirementsestablishedbytheBankruptcyCourtunderitsBankruptcyADRProgram.Date:Applicant222ssignaturePleasereturnedsignedapplicationandattachmentsto:ShelliFreas,ADRAdministratorUnitedStatesBankruptcyCourtOneDivisionNorthGrandRapids,MI49503Orviaemail:shellifreas@miwb.uscourts.gov American LegalNet, Inc. www.FormsWorkFlow.com