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You can type the information directly into this form. When complete, please print, sign and date it, and then mail to:
ADR Center

P.O. Box 65, Hawleyville,
CT 06440.

Labor Demand for Arbitration
Date:
To: Name of Union Employer
(The party on whom the Demand is)
 
Street Address:
 
City, State, & Zip Code:
 
Telephone:
Fax:
Name of Attorney or Representative:
 
Name of Firm or Company:
 
Street Address:
 
City, State, & Zip Code:
 
Telephone:
Fax:
Name of Claiming Party Union Employer
(The party on whom the Demand is)
 
Street Address:
 
City, State, & Zip Code:
 
Telephone:
Fax:
Name of Attorney or Representative:
 
Name of Firm or Company:
 
Street Address:
 
City, State, & Zip Code:
 
Telephone:
Fax:

Claimant is a party to a written contract containing an arbitration agreement, dated ,
which provides for arbitration under its Labor Rules of the American Dispute Resolution Center, Inc., ( ADR Center)
and is demanding arbitration as stated below.

Name of Grievant:

   
Nature of Dispute:
Relief Sought:
Location of Hearing:

You are hereby notified that copies of our arbitration agreement and this demand are being filed with the ADR Center,
and we request that they initiate administration of this arbitration.


Signed: _______________________________________________ Dated: _______________________________
(Title, may be signed by representative)
 

In order to initiate the arbitration, Claimant must submit a copy of the contract and two copies of this demand form with the
proper filing fee to the ADR Center. Send the original of this demand to the Respondent.

ADR Center • P.O. Box 65, Hawleyville,
CT 06440
Overnight Mail:
23 Barnabas Rd., Ste 65,
Hawleyville, CT 06440
Phone (860) 832-8060 • www.adrcenter.net