Formal Application Form

Please use this 'Application Form' for all cases except 'Landlord & Tenant' disputes
If you prefer to complete the application in word document or PDF, please email us.
Please find attached a link to our 'Schedule of Fees for all Cases'.
If you are applying under the UNCITRAL Arbitration Rules, please read; Prime Dispute 'Appointing Authority in UNCITRAL' Rules (this document includes the Fees).
This application form is the contract between the applicant and Prime Dispute. Prime Dispute will rely entirely upon the information contained herein to help select a 'Neutral(s)'. The information submitted on this application is accepted as being accurate and complete. Neither Prime Dispute or the appointed 'Neutral' accept liability in relation to the appointment, if the information provided is inaccurate or incomplete.

Please select the required Neutral/s *

'Other' or 'Documents Only' , please confirm *

If more than one neutral is required please provide a number and reasons *

Any applicable time limits *

Please upload any agreements between the parties: (i.e: notice of arbitration, as referred to respectively in Articles 3 and 4 of the UNCITRAL Rules) *

Max file size: 20MB

Prime Dispute supports third party funding. Do you require third party funding? *

Yes No Please provide me with details of a third party funder I/We have already sourced third party funding

Please upload the agreement if you have already sourced third party funding *

Max file size: 20MB

In the matter of:

Claimant/First Party *

Claimant - Address *

Line 1

Line 2

City

State

Zip Code

Country

Claimant - Telephone number *

Claimant - Email *

Claimant - Case Reference *

Claimant - Additional parties (please provide details) *

Please provide full details of any representative(s) supporting the claimant(s) - (Organisation, position, individual name(s), email, contact details) *

Respondent/Secound Party *

Respondent - Address *

Line 1

Line 2

City

State

Zip Code

Country

Respondent - Telephone number *

Respondent - Email *

Respondent - Case Reference *

Respondent - Additional parties (please provide details) *

Please provide full details of any representative(s) supporting the Respondent(s) - (Organisation, position, individual name(s), email, contact details) *

Claimant(s) - Please provide brief details (nature, amount of claim & circumstances) regarding the issues concerned (you are able to attach relevant documents below (i.e: Statement of Claim) or email them *

Claimant - Upload Documents *

Max file size: 20MB

Respondent(s) - Please provide brief details (nature, amount of claim & circumstances) regarding the issues concerned (you are able to attach relevant documents below (i.e Statement of Claim) or email them *

Respondent - Upload Documents *

Max file size: 20MB

Preference for the neutral(s) background and skills:

Party one:

Claimant - Industry/Sector *

Claimant - Professional or Academic qualifications *

Claimant - Specialist experience (if any) *

Claimant - Knowledge/Profession: *

Claimant - Language of the neutral(s) *

Claimant - The applicable rule of law *

Claimant - Additional information (i.e: name(s) of suitable neutral(s), with reasons - No guarantee can be placed that the individual(s) will be appointed) *

Party two:

Respondent - Industry/Sector *

Respondent - Professional or Academic qualifications *

Respondent - Specialist experience (if any) *

Respondent - Knowledge/Profession: *

Respondent - Language of the neutral(s) *

Respondent - The applicable rule of law *

Respondent - Additional information (i.e: name(s) of suitable neutral(s), with reasons - No guarantee can be placed that the individual(s) will be appointed) *

The purpose of your request

Please highlight the applicable box *

If you have selected 'Rules' or 'Act'' from the above box, please provide further information:

Attach supporting documents
Please attach or email separately any correspondence which you feel may support the administration of the case. Please note, all documents relating to the case should only be sent to the neutral(s) once they have been officially appointed by Prime Dispute.

Our Terms

Fees

A fee will be charged by Prime Dispute for the 'Appointment/Nomination'.
An additional fee will be charged if all parties to the dispute request Prime Dispute to administer the case.
Please read 'Schedule of Fees for all Cases' .

It is agreed as a condition of such an appointment/nomination and/or administration that the applicant/parties shall:

Pay the reasonable fees and expenses of the neutral/dispute resolver, whether or not any decision is made.
Prime Dispute reserves the right to copy the application form and/or any accompanying documentation to the respondent (second party) and/or representatives. This is on the basis that your application is accepted.
Inform the neutral/Prime Dispute in the event of the settlement of the dispute before any decision is made or any further fees and expenses are incurred.

Privacy
Prime Dispute takes the privacy and security of the personal information you provide seriously. Your details are held in a secure database with access provided to senior personal only. We apply data processing policies in compliance with the Data Protection Act 2018. Prime Dispute will not use the information you provide in this request to contact you with offers of products and services. Prime Dispute will not share your information with third parties for the purpose of sending you details of offers of products or services. Please read our Terms and Conditions on our website.

Conflicts
Prime Dispute will take reasonable steps to ensure that the nominated neutrals is free from conflict of interests. It is therefore essential that you provide detail(s) of the parties involved, which include any companies or related entities that a neutral would need to consider in their conflict checks. Neutral(s) are required to disclose involvement or potential conflicts of interest to Prime Dispute prior to nomination. Prime Dispute will never knowingly nominate a neutrals who has a conflict of interest. If in your view there are any neutral(s)who would have a conflict of interest regarding this matter, you should list them in the box below. Please also provide for such person; brief but clear reasons for this statement. Your attention is drawn to the decision in "Eurocom Ltd -v- Siemens Plc [2014] EWHC 3710 (TCC) " to the effect of misrepresentations in this statement could invalidate the nomination process in its entirety, rendering any decision/award made unenforceable. Your application is accepted on this basis - .

APPLICATION FORMFORMAL APPOINTMENT/NOMINATION REQUEST

APPLICATION FORM
FORMAL APPOINTMENT/NOMINATION REQUEST