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UNITED STATES DISTRICT COURT <br /> CENTRAL DISTRICT OF CALIFORNIA <br /> CASE NUMBER <br /> Plaintiff(s) <br /> V. <br /> MEDIATION REPORT <br /> Defendant(s), <br /> Instructions: The mediator shall file this Report within 5 days after the conclusion of a mediation <br /> session even if the negotiations continue. If the case later settles with the assistance of the mediator, <br /> the mediator shall file a subsequent Report. <br /> 1. ❑ A mediation was held on (date): <br /> ❑ A mediation did not take place because the case settled before the session occurred, <br /> 2. The individual parties and their respective trial counsel,designated corporate representatives, and/or <br /> representatives of the party's insurer: <br /> ❑ Appeared as required by Civil L.R. 16-15.5(b). <br /> ❑ Did not appear as required by Civil L.R. 16-15(b). <br /> ❑ Plaintiff or plaintiffs representative failed to appear. <br /> ❑ Defendant or defendant's representative failed to appear. <br /> ❑ Other: <br /> 3, Did the case settled? <br /> ❑ Yes, fully. <br /> ❑ Yes,partially, and further facilitated discussions are expected. (See No. 4 below.) <br /> ❑ Yes, partially, and further facilitated discussions are not expected. <br /> ❑ No, and further facilitated discussions are expected. (See No. 4 below.) <br /> ❑ No,and further facilitated discussions are not expected, <br /> 4. If further facilitated discussions are expected,by what date will you check in with the parties? <br /> (date:) <br /> Dated: <br /> Signature of Mediator <br /> Name of Mediator(print) <br /> The Mediator is to electronically file original document. <br /> ADR-03(03/12) MEDIATION REPORT Page Iof1 <br />