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Supplementary Procedures For Consumer Related Disputes - Official Federal Forms
| Supplementary Procedures For Consumer Related Disputes Form. This is a national form and can be used in Commercial Business American Arbitration Association . |
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AMERICAN ARBITRATION ASSOCIATION SUPPLEMENTARY PROCEDURES FOR CONSUMER-RELATED DISPUTES How to file a claim; consumers should: · Fill out this form and retain one copy for your records. · Mail a copy of this form and your check or money order made payable to the AAA, to: AAA's Case Filing Services, 1101 Laurel Oak Road Suite 100, Voorhees, NJ 08043. Please consult Section C-8 of the Supplementary Procedures for ConsumerRelated Disputes for the appropriate fee. · Send a copy of this form to the business. How to file a claim; businesses should: · Fill out this form and retain one copy for your records. · Mail a copy of this form and your check or money order made payable to the AAA, to: AAA's Case Filing Services, 1101 Laurel Oak Road Suite 100, Voorhees, NJ 08043. Please consult Section C-8 of the Supplementary Procedures for ConsumerRelated Disputes for the appropriate fee. · Send a copy of this form to the consumer by registered mail, return receipt requested. 1 How is this claim being filed? Check only one. [ ] By request of the consumer (A copy of the arbitration agreement must be attached. A copy of this form must also be sent to the business) [ ] By request of the business (A copy of the arbitration agreement must be attached. A copy of this form must also be sent to the consumer by registered mail return receipt requested) -or[ ] By mutual agreement ("submission") of the parties (both parties must sign this form) 2 3 4 Briefly explain the dispute. Do you believe there is any money owed to you? [ ] Yes Are you seeking any other relief? [ ] Yes If yes, what is it? [ ] No [ ] No If yes, how much? ________________________ 5 Preferred hearing locale (if an in-person hearing is held) ______________________________________________ 6 Amount enclosed: ______________________________________________ 7 Fill in the following information: Consumer Name of Consumer ______________________________ Address _______________________________________ City/State/Zip___________________________________ Telephone _____________________________________ Fax ___________________________________________ Email Address ______________________________ Signature of Consumer ___________________________ Representative __________________________________ Firm __________________________________________ Address _______________________________________ City/State/Zip___________________________________ Telephone _____________________________________ Fax ___________________________________________ Email Address ______________________________ Business Name of Business ___________________________ Address ___________________________________ City/State/Zip_______________________________ Telephone _________________________________ Fax _______________________________________ Email Address _______________________________ Signature of Business ________________________ Representative _____________________________ Firm _____________________________________ Address ___________________________________ City/State/Zip_______________________________ Telephone _________________________________ Fax _______________________________________ Email Address _______________________________ American LegalNet, Inc. www.FormsWorkFlow.com AAA Case Filing Services 1-877-495-4185 www.adr.org
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