Application to Appoint an Expert

1. First Party’s Details

Name:
Contact Person/Representative:
Address for Service of Notices and documents in relation to Expert Determination:

Post Code:		Phone:
Fax:		Mobile:
Email:

2. Second Party’s Details

Name:
Contact Person/Representative:
Address for Service of Notices and documents in relation to Expert Determination:

Post Code:		Phone:
Fax:		Mobile:
Email:

Add another Party

2a. Third Party’s Details

Name:
Contact Person/Representative:
Address for Service of Notices and documents in relation to Expert Determination:

Post Code:		Phone:
Fax:		Mobile:
Email:

Add another Party

2b. Fourth Party’s Details

Name:
Contact Person/Representative:
Address for Service of Notices and documents in relation to Expert Determination:

Post Code:		Phone:
Fax:		Mobile:
Email:

3. Applicant’s Details (Please complete only if different from First Party’s details)

Name:
Position/Role of Applicant:
Address for Service of Notices and documents in relation to Expert Determination:

Post Code:		Phone:
Fax:		Mobile:
Email:

4. Brief Description of the Nature of the Dispute

5. The Relief, Remedy, or Outcome that is sought

6. Agreement to Expert Determination

A copy of the parties’ agreement to refer the dispute to Expert Determination by an Expert appointed by NZDRC is attached?

Yes No

7. Special Requests/Requirements of Expert

7.1 Please state the preferred expertise / knowledge / professional background (if any) of the person to be appointed as Expert:

7.2 Are the parties in agreement as to the preferred expertise?

Yes No

7.3 A copy of the document recording the parties’ agreement as to the Expert’s expertise is attached:

8. Panel of Experts

Please advise whether the parties have reached agreement as to any person (or persons) on our Panel of Experts whom they wish to request NZDRC to appoint as Expert in this matter (please note that NZDRC will have regard to any such agreement but will not be bound by it, and any appointment will be at the sole discretion of the Registrar)

8.1 Are the parties in agreement as to whom they wish to act as Expert in this matter?

Yes No

8.2 Please name the person (or persons):

8.3 A copy of the document recording the parties’ agreement as to the Expert is attached:

9. Security Amount

Payment may be made by direct credit, cheque or credit card on the next page.

9.1 Please select Expert Determination Code: (See Appendix 3 to the Agreement for Expert Determinaton)

9.2 Please enter the amount in Dispute (inclusive of GST) (ie. Enter 98643.00 if the amount of your claim is $98,643.00)

Amount in Dispute: NZ$

Security Amount: NZ$

Calculate Security Amount

10. 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 New Zealand Dispute Resolution Centre Ltd

Please print a copy of your application for your records

APPLICATION TO APPOINT AN EXPERT

APPLICATION TO
APPOINT AN EXPERT