UNITED STATES BANKRUPTCY COURT

EASTERN DISTRICT OF MISSOURI

____________DIVISION

In re	DEBTOR NAME,	)

)	Case No.___-________-___

)	Chapter ___

Debtor(s).	)

)	REPORT OF MEDIATOR

The undersigned court-appointed mediator, reports to the Court as follows:

____	A.	A mediation conference was conducted on

____	B.	The conference resulted in the following:

__________	Agreement signed (total resolution).

The parties reached an impasse.

The parties settled the following issues:

(a)

(b)

(c)

____	C.	The conference was continued and an additional mediation conference has be scheduled on:

__________________________________________

____	D.	The matter was settled prior to mediation conference.

Attendance:

Parties and Counsel present:

Parties and Counsel not present:

Dated:	Signature of Mediator

Print Name

Address

City, State, Zip Code

Telephone