I, [Advocate Name], Advocate ______ High Court hereby state as under:

1. I have been informed by [Customer Name] that I have been appointed as Arbitrator in Arbitration proceedings initiated by him/her/them, against [Defendant Name], which are to be conducted using the Dispute Resolution Services Integration Platform designed and created by the Platform Operator (Hanin Business & Consulting Private Limited).

2. I have accepted the said appointment, and have agreed to charge a fee of Rs. 18,000/- for the same. I further agree that the said fee shall be paid via the Platform Operator or held in escrow with the Platform Operator until the conclusion of the Arbitral Proceedings.

3. Having perused the brief of the dispute provided to me, and having gone through the Fifth to Seventh schedules to the Arbitration & Conciliation Act 1996 (“the Act”), this is to disclose that:

  • I have no direct or indirect or any past or present, relationship with any of the parties to the dispute, nor do I have any direct or indirect, past or present, interest in relation to the subject matter in dispute, whether financial, business, professional or any other kind, which is likely to give rise to justifiable doubts as to my independence or impartiality to adjudicate upon the disputes between the parties.
  • I will be able to devote sufficient time to the Arbitration and I will be able to complete the entire Arbitration within a period of twelve months form the date of my appointment as the Sole Arbitrator. 

4.  This disclosure made in the form specified in the Sixth Schedule to the Act is enclosed herewith.

Dated this         day of _______, 2020
[Advocate Name]
Advocate, ______ High Court