Appointment of one of two arbitrators by one of parties

In the Matter of an intended arbitration between [parties]

WHEREAS:

1. By a deed [or an agreement] dated the _____ day of _____ and made between [insert the name, address etc. of party not making the appointment] and me the undersigned [insert the name, address etc. of name] it is agreed that disputes and differences arising between the parties thereto shall be referred to two arbitrators, one to be appointed by each party; or their umpires therein provided.
2. Disputes and differences within the meaning of the said arbitration agreement have arisen and are now depending between us the said parties thereto.

NOW THEREFORE in pursuance of the power in the said deed [or agreement] contained I hereby nominate and appoint you [insert the name, address etc. arbitrator] to be the arbitrator on my behalf to act in the reference [in accordance with the provisions of the said agreement].

AS WITNESS my hand this _______ day of ______.

 

Signature of party making the appointment]

To [insert the name, address etc. arbitrator].