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Claimant

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Phone

Nationality

Claimant’s Representative (if any)

Name *

First

Last

Email

Phone

Respondent

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Phone *

Nationality

Respondent’s Representative (if any)

Name

First

Last

Email

Phone

Multiple claimants/respondents

Are there multiple Claimant’s and/or Respondents? If so, please insert their details below

Please insert name, address, email and phone number for each and state if they are an additional claimant or additional respondent

Upload documents

Upload Notice of Arbitration *

Drag & Drop Files, Choose Files to Upload

Upload any supporting documents under Article 5.5 of the ACICA Arbitration Rules

Drag & Drop Files, Choose Files to Upload

Payment

Registration fee: $1

Single Item *

Price: $1.00

Total

$0.00

Stripe Credit Card *

Card

Name on Card

Claimant

Claimant’s Representative (if any)

Respondent

Respondent’s Representative (if any)

Multiple claimants/respondents

Upload documents

Payment

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