REQUEST FOR MEDIATION OF A BUSINESS DISPUTE

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I request for Mediation of a business dispute with:
Respondent
First Middle Last Suffix
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Respondent
First Middle Last Suffix
I allege that there is due, unpaid, and owing to me (or I retain) from the above-named person the sum of:
My claim is predicated upon the statement attached and incorporated by reference into this application.
Upload Statement
Accepted file types: pdf, Max. file size: 8 MB.
Note: Before uploading documents, redact all privileged and/or confidential information such as bank accounts, social security numbers, etc.
ACKNOWLEDGEMENT
I have not, as of this date, requested arbitration of this dispute before this or any other Association of REALTORS®.
REALTOR® Principal / Authorized Designee
First Middle Last Suffix
Date
MM slash DD slash YYYY
Signature*
I understand that by entering my electronic signature below I agree to have all correspondence, documents, and notices sent electronically to the email address provided and I am solely responsible for ensuring such emails are not blocked.
REALTOR® Associate
First Middle Last Suffix
Date
MM slash DD slash YYYY
Signature*
I understand that by entering my electronic signature below I agree to have all correspondence, documents, and notices sent electronically to the email address provided and I am solely responsible for ensuring such emails are not blocked.
Add Another REALTOR® Associate?

Yes

No
REALTOR® Associate
First Middle Last Suffix
Date
MM slash DD slash YYYY
Signature*
I understand that by entering my electronic signature below I agree to have all correspondence, documents, and notices sent electronically to the email address provided and I am solely responsible for ensuring such emails are not blocked.

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REQUEST FOR MEDIATION OF A BUSINESS DISPUTE

Request For Mediation Of A Business Dispute

ACKNOWLEDGEMENT

REQUEST FOR MEDIATION OF A BUSINESS DISPUTE

Request For Mediation Of A Business Dispute

ACKNOWLEDGEMENT

Arizona Association of REALTORS®

Arizona Association of REALTORS®

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