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Arbitrators Fee Statement CV-01 - California
| Arbitrators Fee Statement Form. This is a California form and can be used in Civil Imperial Local County . |
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NAME AND ADDRESS OF ATTORNEY: FOR COURT USE ONLY TELEPHONE NUMBER: SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 220 Main Street, Brawley, CA 92227 415 East Fourth Street, Calexico, CA 92231 939 West Main Street, El Centro, CA 92243 PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: ARBITRATOR'S FEE STATEMENT CASE NUMBER: Pursuant to California Rules of Court, rule 3.819 and Local Rules Superior Court of California, County of Imperial, rule 3.5.6, the following fee(s) are requested for conducting arbitration proceedings in the above named case. Date session concluded: _________________ Date Award/Settlement filed with Court:_______________ Name of Arbitrator: _______________________ Name of Payee: __________________________ Address of Payee: ______________________ Length of Session: _______________________ Fee(s) Requested:________________________ ______________________ ______________________ Social Security number or Taxpayer Identification number: ______________________________ I declare under penalty of perjury, under the laws of the State of California that the foregoing is true and correct. Date: ___________________ Signature of Arbitrator: ______________________________ FOR COURT USE ONLY Amount authorized _____________ Date: ____________________ ____________________________________ (ARBITRATION ADMINISTRATOR) Form Adopted for Mandatory Use CV-01 (Adopted 01/01/12, Revised 01/01/13) ARBITRATOR'S FEE STATEMENT American LegalNet, Inc. www.FormsWorkFlow.com
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