CANB — BDRP Resolution Advocate Application 3 22

Source: https://www.canb.uscourts.gov/sites/default/files/forms/BDRP%20Resolution%20Advocate%20Application%203%2022%202022.pdf

United States Bankruptcy Court Northern District of California

Bankruptcy Dispute Resolution Program Resolution Advocate Application

Applicant’s Name: Firm: Address: City/State/Zip: Telephone: FAX: E:MAIL:

AREAS OF EXPERTISE OR BACKGROUND:

Accounting Environment Mediation
Banking Family Partnerships
Bankruptcy Labor/Employment Personal Injury
Business Landlord/Tenant Real Estate
Commercial Lender Liability Workouts
Construction Malpractice Other (Please specify)

ALTERNATIVE DISPUTE RESOLUTION BACKGROUND:

Training: (Provider and Number of Hours)

Other Relevant Skills/ Participation in other programs or panels:

GEOGRAPHIC AREAS IN WHICH IN WHICH YOU ARE WILLING TO CONDUCT RESOLUTION CONFERENCES: McKinleyville/Eureka San Jose Oakland Santa Rosa Salinas/Monterey Other (Please specify) San Francisco ___ Remote Virtual/Video

ATTORNEY APPLICANTS:

I am member in good standing of the California bar or other states as itemized, and the

Northern District of California.

Bar # Date Admitted State of Admission

Date Admitted to Northern District

NON-ATTORNEY APPLICANTS:

I am a member in good standing of or have valid and current license with the following:

Date Admitted

Date Admitted

ALL APPLICANTS:

I hereby certify I am willing to serve as a Resolution Advocate for a term of one year and all the information in this application is true and correct. I consent to the disclosure of the information contained in this application to court personnel and to parties and their representatives whose matters have or may be referred to the BDRP. If I am applying as a bankruptcy attorney, I hereby certify that I have served as the principal attorney of record in active matters in at least three (3) bankruptcy cases from case commencement to the earlier of the date of this application or conclusion of the case or have served as the principal attorney of record for a party in interest in at least three (3) adversary proceedings or contested matters from commencement through conclusion. SIGN

DATED: Signature

Complete the application and mail to:

Ron Mastroianni United States Bankruptcy Court 450 Golden Gate Avenue Mail Box 36099 San Francisco, CA 94102

or Fax to: (415) 268-2304 Attn: Ron Mastroianni Rev. March 22, 2022

or Email to: ron_mastroianni@canb.uscourts.gov