VTB MM Form # 1 04/2018 See Vt. LBR 4001-7(a) UNITED STATES BANKRUPTCY COURT DISTRICT OF VERMONT In re: , Chapter Debtor(s). Case # MOTION FOR MORTGAGE MEDIATION NOW COMES [debtor/mortgagor or creditor/mortgagee] (the 223Movant224) by and through attorney [name] of [city], Vermont, seeking an order directing the parties to proceed with mortgage mediation/loss mitigation (hereinafter 223mortgage mediation224) with respect to the mortgage described below. In support of this motion, the Movant states the following: 1. The above-named debtor granted creditor [creditor name] a mortgage to secure a loan [redacted loan #] evidenced by a promissory note dated [date] payable to [creditor name] in the original amount of $, on [date], secured by the debtor222s primary residence, which is a property that has four units or less, located at [address]. 2. The debtor sent the last payment, in the amount of $, on [date] to [servicer or bank to which the debtor makes payments] at [address to which the debtor sends mortgage payments]. 3. The debtor filed for relief under chapter [7, 11, 12, or 13] on [date]. 4. As of the date of the bankruptcy filing, the status of the mortgage payments and any pending litigation with respect to this mortgage was as follows: 5. The Court has not entered either a discharge order or an order granting relief from stay to creditor [creditor name] on the subject property, or The creditor [creditor222s name] consents to the instant motion. 6. The Movant seeks mediation because it will be useful to the parties in the following way(s) [may specify here or attach affidavit or hardship letter]: 7. The Movant believes that the mediation will benefit the estate by [enumerate benefits / needs]: American LegalNet, Inc. www.FormsWorkFlow.com VTB MM Form # 1 04/2018 See Vt. LBR 4001-7(a) 8. The United States holds the mortgage. If so, the specify the federal statute and/or regulation authorizing mediation: WHEREFORE, the Movant respectfully requests this Court enter an order approving mortgage mediation and directing the parties to engage in mediation of the above-referenced mortgage, and to appoint a mediator to conduct that mediation. Dated: By: [Signature] [typed name, with address, e-mail address, and telephone number] American LegalNet, Inc. www.FormsWorkFlow.com