FORM 9 Plaintiff (s) vs. Defendant(s) : IN THE COURT OF COMMON PLEAS : OF LACKAWANNA COUNTY : : : : : : NO. ____CIV_____ REQUEST FOR CONCILIATION CONFERENCE Pursuant to the local rules governing the Lackawanna County Residential Mortgage Foreclosure Diversion Program, the undersigned hereby certifies as follows: 1. Defendant is the owner of the property which is the subject of this mortgage foreclosure action; 2. Defendant lives in the subject property which is defendant's primary residence; 3. Defendant has been served with a "Notice of Residential Mortgage Foreclosure Diversion Program" and has taken all of the steps required in that Notice to be eligible to participate in a court-supervised conciliation conference under Lacka. Co. R.C.P. 1143.1. The undersigned verifies that the statements made herein are true and correct. I understand that false statements are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. ____________________________________ Signature of Defendant/Defendant's Counsel ______________ Date American LegalNet, Inc. www.FormsWorkFlow.com