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Before submitting your application form please ensure:

1. You have read and understood our Arbitration Agreement

2. The other party is aware that you wish to submit your dispute to Arbitration, and they agree to Arbitrate.


The Applicant hereby requests the FDR Centre to appoint an Arbitrator and to manage and administer the procedures in relation to that Arbitration.
All questions marked with an * are compulsory and you must enter something in the field or the form won't submit - if you have any problems completing the form please contact us on (09) 486 7146 / 0508 FDR CENTRE.
***Please ensure that you complete this application carefully and that all details provided are correct***
Claimant Details
Second Respondent
Four or more Respondents to this dispute
Description of Dispute
The Relief or Remedy that is sought
Agreement to Arbitrate
Special Requests/Requirements of Arbitrator
Panel of Arbitrators
Please advise whether the parties have reached agreement as to any person (or persons) on our Panel of Arbitrators whom they wish to request the FDR Centre to appoint as Arbitrator in this matter
(please note that we will have regard to any such agreement but will not be bound by it, and any appointment will be at the sole discretion of the Registrar)
Inspection of the Subject Matter of the Dispute
Please advise whether the parties are likely to request the Arbitrator to carry out an inspection of the subject matter of the dispute or any other thing to which the dispute relates
(Please note that any inspection will be carried out at the sole discretion of the Arbitrator)
Security Amount
Payment can be made online by direct credit/internet banking (please note: some banks may require special approval from you to authorise payments larger than a certain amount per payment or per day, if in doubt please phone your bank)
Please make payments to: Westpac Bank Account Number: 03 0252 0839830 02 for NEW ZEALAND DISPUTE RESOLUTION CENTRE. Please use your full name as the payer reference
An email will be sent to you after submitting this form which includes our bank account details for your records so that you can make payment. (Please note: payment is required before an arbitrator will be appointed)