The Applicant hereby requests the Building Disputes Tribunal Ltd (the Tribunal) to appoint an Arbitrator and to manage and administer the procedures in relation to that Arbitration.

***Please ensure that you complete this application carefully and that all details provided are correct***

1. Claimant’s Details
2. Respondent’s Details
Add another Party
2a. Second Respondent’s Details
Add another Party
2b. Third Respondent’s Details
3. Applicant’s Details (Please complete only if different from Claimant’s details)
4. Brief Description of the Nature of the Dispute
5. The Relief or Remedy that is sought
6. Agreement to Arbitrate
Yes No
7. Special Requests/Requirements of Arbitrator
Yes No
8. Panel of Arbitrators
Yes No
9. Inspection of the Construction Work
Yes No
10. Security Amount
Please Note: If your application relates to an arbitration with three arbitrators or you require an overseas based arbitrator to act please use the BCA code.
If your Code is BCA we will contact you to finalise the amount to be paid and arrange for payment
Amount in Dispute: NZ$ 
Security Amount: NZ$ 
Calculate Security Amount
11. Agreement
I confirm that the information I have supplied is true and correct to the best of my knowledge and that I have read and accepted the terms and conditions of the Building Disputes Tribunal