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Fill and Sign the Get the Uniform Arbitration Statement of Facts Appendix

Fill and Sign the Get the Uniform Arbitration Statement of Facts Appendix

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APPENDIX XXII-A (R. 4:21A-4) UNIFORM ARBITRATION STATEMENT OF FACTS (Use for all but Commercial Cases) Caption: (Please include Consolidated Case Docket No. If applicable) (Verbal Threshold) Yes No Docket No:_______________________________Arbitration Date/Time:_____________________Auto: P.I.: Party Represented: I. Briefly describe the accident/incident occurred. (Please attach police report or expert liability reports): II. Liability (Please attach expert reports)III. Damages A. Non-Economic Losses l. List injuries (Please attach only hospital discharge summary and/or narrative reports/IME) 2. List objective testing and dates.3. List current treatments and complaints.B. Economic Losses (List all out of pocket expenses) 1. Itemized list of all medical billsTreating Doctor/Hospital/Other Amount Total Amount Unpaid Bills Revised 7/13/2000, CN 10505-English page 1 of 1

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Appendix xxii b
NJ arbitration decisions
R 4 21A-4
New Jersey Arbitration Act
Nj arbitration court rule
NJ Arbitration awards
Benefits and drawbacks of binding arbitration
Can you go to court after arbitration

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