移送司法确认函
                                                                                                                                                                                                                                                                         （     ）    第      号
 
 

××××人民法院：
        当事人           与当事人           经                    主持达成调解协议。现各方当事人共同向贵院申请司法确认，故将有关材料移交你院，请依法审查后提供司法确认。