Note For Arbitration Template
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1PIERCE COUNTY SUPERIOR COURT, STATE OF WASHINGTON
)
________________________________________
)
)
________________________________________
)
Plaintiff(s),
)
)
Case No. __________________________
vs.
)
)
NOTE FOR ARBITRATION
________________________________________
)
________________________________________
)
Defendant(s).
)
CASE CATEGORY:
COL
Commercial/Contract _________
PIN
Personal Injury ________
CONS Construction
_________
COM
Real Estate
________
DIS
Family Law
_________
OTHER (Specify)
________
PLAINTIFF’S ATTORNEY:
NAME
____________________________WSB#________
ADDRESS
_________________________________________
_________________________________________
PHONE
_________________________________________
DEFENDANT’S ATTORNEY:
NAME
____________________________WSB#________
ADDRESS
_________________________________________
_________________________________________
PHONE
_________________________________________
(
Please note additional attorneys on an attached page)
STATEMENT OF ARBITRABILITY
[ ]
This case is subject to arbitration because the sole relief sought is a money judgment and
involves no claim on excess of Fifty Thousand Dollars ($50,000), exclusive of attorney
fees, interest and costs.
[ ]
This case is not subject to mandatory arbitration because:
[ ] Plaintiff’s claim exceeds Fifty Thousand Dollars ($50,000).
[ ] Plaintiff seeks relief other than a money judgment.
[ ] Defendant’s counter or cross claim exceeds Fifty Thousand Dollars ($50,000).
[ ] Defendant’s counter or cross claim seeks relief other than a money judgment.
[ ]
The undersigned contends that its claim exceeds Fifty Thousand Dollars ($50,000). But
hereby waives any claim in excess of Fifty Thousand Dollars for the purpose of arbitration.
Signed ______________________________________________________
WSB# _____________
You may obtain additional copies of this form or use the interactive forms from our Web site at
Arbit\Arbnote08-2005.doc
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