UNCITRAL - Request An Appointment/Nomination Online

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 *

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City

State

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Claimant - Telephone number *

Claimant - Email *

Claimant - Case Reference *

Claimant - Additional parties (please provide details) *

Claimant(s) Representative - Address *

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Line 2

City

State

Zip Code

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Claimant(s) Representative - Email *

Claimant(s) Representative - Direct Line Number *

Respondent/Secound Party *

Respondent - Address *

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City

State

Zip Code

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Respondent - Telephone number *

Respondent - Email *

Respondent - Case Reference *

Respondent - Additional parties (please provide details) *

Respondent(s) Representative - Address *

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Line 2

City

State

Zip Code

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Respondent(s) Representative - Email *

Respondent(s) Representative - Direct Line Number *

Claimant(s) - Please provide dates regarding any holiday periods the party(s) may be unavailable *

Respondent(s) - Please provide dates regarding any holiday periods the party(s) may be unavailable *

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

Claimant - Preference for seat of hearing(s) or meeting(s) with the neutral(s) *

Respondent - Preference for seat of hearing(s) or meeting with the neutral(s) *

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:

Rules/Act - Please confirm *

If you have selected 'Other' or would like to provide further clarification, please do so within the attached box *

Please select as appropriate *

If you have selected 'Other' or would like to provide further clarification, please do so within the attached box *

UNICTRAL - Please specify the services required (please read; Prime Dispute 'Appointing Authority in UNCITRAL Rules') before completing *

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 dispute should only be sent to the neutral(s) once they have been officially appointed by Prime Dispute.

Upload File *

Max file size: 20MB

Upload File *

Max file size: 20MB

Upload File *

Max file size: 20MB

Upload File *

Max file size: 20MB

Upload File *

Max file size: 20MB

Prime Dispute will take reasonable steps to ensure that the nominated neutrals is free from conflict of interest. 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 interests. 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 *

Agree

Claimant(s) - Conflict of Interests *

Claimant(s) Upload File - Conflict of Interests *

Max file size: 20MB

Respondent(s) - Conflict of Interests *

Respondent(s) Upload File 'Conflict of Interests' *

Max file size: 20MB

Our Terms

Please tick if you agree. 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. *

Agree

Please tick if you agree (a) Pay the reasonable fees and expenses of the neutral/dispute resolver, whether or not any decision is made; (b) 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; (c) Inform the neutral(s)/Prime Dispute in the event of the settlement of the dispute before any decision is made or any further fees and expenses are incurred. *

Agree

Please tick if you agree (Do not complete this form if you do not want Prime Dispute to collect, store, share with the dispute resolver and process your information) *

I/We agree to the above terms. Both parties agree to the above terms. On behalf of our client/s we agree to the above terms. The respondent(s) are not aware we have submitted this case(s), but we agree to the terms. Other

* Indicates required field

Title *

Name *

First

Last

Or on behalf of the firm: *

Email *

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.

Please indicate if you prefer to 'pay online' or 'receive an Invoice to pay directly' once your application has been approved and accepted? *

Pay Online Receive an invoice and pay directly Other

Please note: Once you click 'submit' your application will be sent to our team to review. Please note a fee shall be required and an invoice will be sent to you (can also pay online). The invoice will include the name and address you have provided above. If you prefer an alternative name or department within the organisation to be named, please specify in the below box *

Date *

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UNCITRAL APPLICATION FORMFORMAL APPOINTMENT/NOMINATION REQUEST

UNCITRAL APPLICATION FORM
FORMAL APPOINTMENT/NOMINATION REQUEST