Arbitration Claim Form

1. PARTIES:
Name of Claimant:*
First Last
Address of Claimant (or Claimant's Attorney):*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Claimant Telephone:
Claimant Facsimile:
Claimant E-mail:
Name of Respondent:*
First Last
Address of Respondent (or Respondent's Attorney):
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Respondent Telephone:
Respondent Facsimile:
Respondent E-mail:
2. NOTICE OF RESPONDENT:

Claimant hereby serves upon you this demand for arbitration before the International Yacht Arbitration Council (“IYAC”). In the near future, the IYAC will give notice of the commencement of arbitration proceedings. You will have twenty (20) days from then to file a Response to this Claim with the IYAC and serve a copy on the Claimant. IF YOU FAIL TO TIMELY RESPOND, AN ARBITRATION AWARD MAY BE MADE AGAINST YOU. This proceeding is governed by the IYAC’s Arbitration Rules. Copies of the Rules are available from the IYAC upon request, by calling 954-522-9270.
3. ALLEGATIONS:
Claimant makes the following allegations against Respondent (submit additional pages if necessary):*
4. DEMANDS:
Claimant demands the following monetary award, or other relief or remedy from Respondent:*
5. VENUE:
Claimant requests that the arbitration hearing be held in the following venue (city and state):*
6. A copy of the agreement or court order requiring arbitration of this dispute is attached to this Claim.
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Verification*
I agree to the terms below.
I, the undersigned, declare under penalty of perjury under the laws of the United States of America that I have read the foregoing Claim and that the same is true of my own knowledge, or to the best of my information and belief.
Type Your Full Name:*
First Middle Last
Executed at:*
Dated:*
Month
Day
Year
Signature
Select Your Claim Amount
Amount of Claim US$ Single Country Dispute
Hearing & Filing Fee
Amount of Claim US$ Cross-Border Dispute
Hearing & Filing Fee. Three arbitrators required for claims over $1,000,000.
Total
$0.00
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Billing Email*
Billing Address*
Street Address Address Line 2 City State ZIP Code
Billing Phone

Arbitration Claim Form

1. PARTIES:

2. NOTICE OF RESPONDENT:

3. ALLEGATIONS:

4. DEMANDS:

5. VENUE:

6. A copy of the agreement or court order requiring arbitration of this dispute is attached to this Claim.

Select Your Claim Amount