FORM 13 Plaintiff (s) vs. Defendant(s) : IN THE COURT OF COMMON PLEAS : OF LACKAWANNA COUNTY : : : : : : NO. ____CIV_____ AFFIDAVIT PURSUANT TO LACKA. CO. R.C.P. 3129.1 I, _______________________________, counsel for plaintiff in the above action, do hereby certify that on _________________, I served the "Notice of Residential Mortgage Foreclosure Diversion Program" upon defendant(s) or defendant's counsel and that: More than 60 days have elapsed since the service of the Notice and, to the best of my knowledge, information and belief, defendant has not opted to participate in the diversion program by taking the affirmative steps required by the Notice. Plaintiff(s) and defendant(s) have participated in a court-supervised conciliation conference, but the parties have been unable to resolve this matter and no further conciliation conferences have been scheduled. Respectfully submitted _____________ Date _________________________________ [Plaintiff's Counsel] American LegalNet, Inc. www.FormsWorkFlow.com