Details of outstanding farm debts: BALANCE OUTSTANDING FACILITY (as at date of issue of section 18A notice) TOTAL SECTION 2 OF THE MEDIATION – Mediator’s fees and expenses: For all preparation time and the hours of the mediation session: first $ to be shared as agreed between the parties. Additional time: up to $ to be shared as agreed between the parties. Room hire and out of pocket expenses at cost – SIGNING OF THE INTAKE AGREEMENT The parties and the mediator have signed this Intake Agreement as follows: Date: 20 (day) (month) (year) (name of mediator please write clearly) (signature) – (name of co-mediator please clearly) (signature) – (name of farmer party or representative please write clearly) (signature) – (name of farmer party or representative please write clearly) (signature) – (name of guarantor or representative please write clearly) (signature) – (name of creditor party or representative please write clearly) (signature) – (name of creditor party or representative please write clearly) (signature) – ANNEXURE A CONFIDENTIALITY AGREEMENT
Details of outstanding farm debts: FACILITY BALANCE OUTSTANDING (as at date of issue of section 18A notice) TOTAL SECTION 2 – OF THE MEDIATION Mediator’s fees and expenses: For all preparation time and the first hours of the mediation session: $ to be shared as agreed between the parties. Additional time: up to $ to be shared as agreed between the parties. Room hire and out of pocket expenses – at cost SIGNING OF THE INTAKE AGREEMENT The parties and the mediator have signed this Intake Agreement as follows: Date: 20 (day) (month) (year) (name of mediator – please write clearly) (signature) (name of co-mediator – please clearly) (signature) (name of farmer party or representative – please write clearly) (signature) (name of farmer party or representative – please write clearly) (signature) (name of guarantor or representative – please write clearly) (signature) (name of creditor party or representative – please write clearly) (signature) (name of creditor party or representative – please write clearly) (signature) ANNEXURE A CONFIDENTIALITY AGREEMENT
RINT18-29624-Form-9-Intake-Agreement-for-Farm-Debt-Mediation.docx