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UNITED STATES BANKRUPTCY COURT DISTRICT OF OREGON In re ) ) ) ) ) ) )

Case No.________________ MEDIATOR'S FINAL REPORT AND NOTICE OF COMPLETION OF MEDIATION

Debtor(s)

In accordance with this court's Order of Referral to Mediation, dated __________, the mediation concluded on __________, and the results are indicated below: 1. The following individuals were present: (a) Parties (name and capacity) -

(b) Counsel (name and party representing) -

2. The following parties failed to appear and/or participate as ordered:

3. The outcome of the mediation conference was: The matter has been completely resolved and counsel (or parties) have been instructed to file an appropriate stipulated judgment or order within 20 days of the conference. The matter has been partially resolved and counsel (or parties) have been instructed to file an appropriate stipulated order or judgment regarding those claims or issues which have been resolved within 20 days of the conference. 210 (2/14/94) Page 1 of 2

The following issues remain for this court to resolve:

The matter has not been resolved and should proceed to trial or a final evidentiary hearing.

OTHER:

Dated: ___________

_________________________________ Name of Mediator __________________________________ Mailing Address _________________________________ City, State, Zip Code _________________________________ Phone No.

cc: Counsel of Record Pro Se Parties

210 (2/14/94)

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