CACB — Unavailability of Mediator to

Source: https://www.cacb.uscourts.gov/sites/cacb/files/documents/forms/Unavailability%20of%20Mediator%20to%20Serve.pdf

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5 UNITED STATES BANKRUPTCY COURT

6 FOR THE CENTRAL DISTRICT OF CALIFORNIA

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9 In re ) Bk. No. ) 10 ) [Chapter ] ) 11 ) ) 12 Debtor(s). ) ) 13 ) ) Adv. No. 14 ) ) NOTICE OF MEDIATOR'S 15 ) OR ALTERNATE MEDIATOR'S Plaintiff(s)/Movant(s), ) UNAVAILABILITY TO 16 ) SERVE IN MEDIATION v. ) MATTER 17 ) ) 18 ) Defendant(s)/Respondent(s). ) 19 )

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21 The undersigned, who was appointed by the Judge on

22 to serve as Mediator Alternate Mediator in the above-

23 entitled Matter, is unavailable to serve for the following reason(s):

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25 1. [ ] Conflict of interest

26 2. [ ] Previous professional commitment

Form 703 Revised 11/09

1 3. [ ] Previous personal commitment

2 4. [ ] Other:

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7 The undersigned represents that this notice has been mailed to the Mediator

8 and/or alternate Mediator, (as applicable), to all parties to the Matter, their counsel, if

9 any, and to the Mediation Program Administrator, and that a courtesy copy has been

10 provided to the Judge, as required by the applicable provisions of Third Amended

11 General Order No. 95-01.

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13 DATED: (Name of Mediator) 14

15 (Signature of Mediator)

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17 DATED: (Name of Alternate Mediator) 18

19 (Signature of Alternate Mediator)

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23 cc: Hon. Barry Russell Mediation Program Administrator 24 United States Bankruptcy Court 255 East Temple Street, Suite 1660 25 Los Angeles, California 90012

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Form 703 2 Revised 11/09