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(check one) consumer business . briefly explain the dispute: . specify the amount of money in dispute, if any: $ . state any other relief you are seeking: attorney fees interest arbitration costs other; explain: . identify the requested city and state for the hearing if an in-person hearing is held:

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https://www.adr.org/sites/default/files/Demand%20for%20Arbitration%20Consumer%20Arbitration%20Rules.pdf

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