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DEMAND FOR ARBITRATION


 

 

Respondent(s): Address (City, State & Zip Code): Telephone No.:

 

 

The undersigned claimant, a party to an arbitration agreement contained in a written contract, dated  ___________________________________ which provides for arbitration under the Commercial Arbitration Rules of Arbitration Services Incorporated, hereby demands arbitration. A copy of the arbitration agreement and statement of claim is annexed hereto.

The Nature of the Dispute:

 

 

 

The Claim or Relief Sought (The Amount, If Any)

 

Please be advised that a copy this demand, statement of claim and the arbitration agreement are being filed with the Arbitration Services Inc. You must file an answering statement within fifteen days after notice from the ASI pursuant to the ASI rules, which are published at www.arbitrationservicesinc.com

Name of Claimant

 

 

Address (City, State & Zip Code)

 

Claimant's Attorney & Address

Telephone

 

Fax

 

E-Mail

Signature

Print Name

Dated