Singapore International Arbitration Centre

Is this request for an SIAC case (i.e. with an SIAC case number)?		Yes No
If so, please state
a. Case number:
b. Parties:
Section A (Complete this section A only if NOT an SIAC case)
Claimants Information
Name:
Nationality:
Solicitor's firm:
Solicitor(s)' name:
Solicitor reference no.:
Address:
Telephone no:
Fax no:
Names of persons attending hearing:
Respondents Information
Name:
Nationality:
Solicitor's firm:
Solicitor(s)' name:
Solicitor reference no.:
Address:
Telephone no:
Fax no:
Names of persons attending hearing:
Tribunal Information
*Arbitrator 1*
Name:
Resident of:
Address:
Telephone no:
Fax no:
*Arbitrator 2*
Name:
Resident of:
Address:
Telephone no:
Fax no:
*Presiding Arbitrator*
Name:
Resident of:
Address:
Telephone no:
Fax no:

Section B
Dates on which hearing room is required: (Cancellation of confirmed room booking — 100% of the room rate)
Starting time of 1st day of hearing:
Number of Persons [including counsel, representatives of all parties, witnesses and the arbitrator(s)] to be present at the hearing room at any one time:

Section C
1.	Do you require transcripts for the hearing? If yes, we will forward your request to WordWave International and they will send you a quote.	Yes No
2.	Do you require interpretation services?	Yes No
	If so, please state
	a. language(s):
	b. dates where interpreter's services are required:
3.	Do you require an overhead projector?	Yes No
4.	Do you require a multi-media projector?	Yes No
5.	Do you require a VHS / VCD / DVD player?	Yes No
6.	Do you expect the hearing to commence before 10.00 am and/or end after 5.00 pm?	Yes No
7.	Do you require assistance for arrangement of hotel accommodation for the arbitrator(s) and/or representative(s) of the parties?	Yes No
	If so, please state
	a. Date of arrival:
	b. Date of departure:
	c. Hotel preference (if any):
	d. Budget:
8.	a. Do you require refreshments during the breaks?	Yes No
	b. If so, please let us know your preference:	Coffee & Tea only Coffee, Tea & Snacks Full Day Menu, 2 Refreshment Breaks & 1 Lunch
9.	Do you have any additional requests? If so, please state the services required:
Section D
To the Registrar, SIAC We undertake to settle and pay SIAC all expenses incurred by the Centre in respect of the items set out in this Form including such additional services and facilities required for hearing dates to be fixed at a later stage. Agree