BDRP - ADR Certification Form

File Attachments

Attachment:

UNITED STATES BANKRUPTCY COURT
NORTHERN DISTRICT OF CALIFORNIA

In Re:	)
	)	SAMPLE
Debtor	) )	Bankruptcy No. ___________________________
	)
	)
Plaintiff	) )
	)
vs.	)	Adversary No. ____________________________
Defendant	) )
	)	ADR CERTIFICATION
	)

Pursuant to B.L.R. 9040-3, each of the undersigned certifies that he or she has read the

Bankruptcy Dispute Resolution Program Information Sheet, discussed the available dispute

resolution options provided by the court, reviewed dispute resolution options offered by private

entities, and considered whether this matter might benefit from any of them.

Dated: ____________________	___________________________________ [Type name of plaintiff or cross plaintiff under the signature.]
Dated: ____________________	____________________________________ [Type name of counsel for plaintiff or cross plaintiff, and the name of the party counsel represents, under the signature.]
Dated: ____________________	___________________________________ [Type name of defendant or cross defendant under the signature.]
Dated: ____________________	___________________________________ [Type name of counsel for defendant or cross defendant, and the name of the party counsel represents, under the signature.]

Note: This ADR Certification shall be served by the plaintiff on all defendants and must be signed by each party and its counsel. If there is more than one plaintiff, the plaintiff listed first in the caption of the adversary proceeding shall also serve this ADR Certification on all other plaintiffs. If there are additional parties (e.g., additional plaintiffs, defendants, cross plaintiffs, or cross defendants), additional sheets should be filed.