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Application For Initial Certification As Arbitration Panelist 01-406 - Pennsylvania
|Application For Initial Certification As Arbitration Panelist Form. This is a Pennsylvania form and can be used in Civil Trial Philadelphia Local County .||
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Application for Initial Certification as Arbitration Panelist (Please print or type) NAME SOCIAL SECURITY NO. HOME ADDRESS PRINCIPAL BUSINESS ADDRESS BUSINESS TELEPHONE ATTORNEY STATE I.D. NO. DATE OF ADMISSION TO PENNSYLVANIA SUPREME COURT I hereby certify that I have been admitted to the Bar of the Court for one year, have tried at least one civil case in any forum in Pennsylvania, am currently engaged in the active practice of law and maintain my principal office in Philadelphia. I further certify that I attended the Court-approved Seminar in Arbitration Practices and Procedure on . If my status is changed in regard to any of the above, I will immediately contact the Court of Common Pleas, Arbitration Center, and ask that my name be removed from the certified list of arbitrators. (a) My practice primarily consists of representing defendants. (b) My practice primarily consists of representing plaintiffs. (c) My practice cannot be designated as either (a) or (b). Are you available to sit as an emergency arbitrator? Yes No Date: Signature Note: See Rule 51302 01-406 2002 © American LegalNet, Inc.