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Fill and Sign the Uniform Commercial Arbitration Memorandum Appendix Xxii B

Fill and Sign the Uniform Commercial Arbitration Memorandum Appendix Xxii B

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Over APPENDIX XXII-B (R. 4:21A-4) UNIFORM COMMERCIAL ARBITRATION MEMORANDUM (All Information Must Be Legibly Printed Or Typed) PLEASE RETURN TO: Number of Witnesses you areAnticipated length of time offering at Arbitration: _______________________ for your presentation: __________________ 1. Brief factual outline as to your position: 2. Set forth disputed facts and issues by any party in outline form: 3. Provide facts that you anticipate will be undisputed: 4. Set forth legal issues to be addressed by arbitrator: 5. Please quantify elements of your alleged damages: 6. Set forth issues addressed in expert reports (attach copies): 7. Discuss mitigation of damages (if applicable): Revised 7/13/2000, CN 10506-Englishpage 1 of 2 8. Describe the basis for the defenses you assert to the complaint and/or counterclaim: 9. Have all parties been served:Yes_________No__________ 10. Are any parties in default?Yes_________No__________ 11. List any unserved and/or defaulted parties: 12. Should any special expertise be required by the arbitrator, e.g., should the arbitrator be familiar with a particular discipline and/or industry? If yes, please specify: I certify this information to be complete and accurate and that copies of this statement have been timely served on all adversaries pursuant to R. 4:21A-4. Date: Signature of Attorney or Pro Se Litigant (Please print or type name) Attorney for: NOTE: Information provided on this form can not be used for evidentiary purposes in any trial of this matter . Revised 7/13/2000, CN 10506-Englishpage 2 of 2

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