Arbitrator s Declaration

SCHEDULE -IV

ARBITRATOR'S DECLARATION OF ACCEPTANCE AND STATEMENT OF INDEPENDENCE

I, the undersigned

 

Name:                                                     

First Name:                                               

 

 

 ACCEPTANCE

 

hereby declare that I accept to serve as arbitrator under the Rules of the Delhi International  Arbitration Centre in the instant case. In so declaring, I confirm that I have familiarized myself with the requirements of the Rules of the  Centre and  I  am  capable and  available  to  serve  as  an  arbitrator  in accordance with all of the requirements of the Rules of the Centre and accept to be  remunerated in accordance therewith. I accept that the obligation to disclose  any  facts  or   circumstances  which  may  call  into  question  my independence or impartiality in the eyes of  any  of the parties shall remain binding on me till the arbitration proceedings are finally concluded.

 

 

 

Please tick the boxes below as may be applicable:

          I am independent of each of the parties and intend to remain so; to the best of my knowledge, there are no facts or circumstances, past or present, that need be disclosed for they might be of such  nature as to call into question my independence or impartiality in the eyes of any of the parties.

 

OR

        I am independent of each of the parties and intend to remain so; however I wish to call your  attention to the following facts or circumstances which I hereafter disclose because they might  be  of such a nature as to call into question my independence or impartiality in the eyes of any of the parties. (Use separate sheet if necessary)

 

NON-ACCEPTANCE  hereby declare that I decline to serve as arbitrator in the subject case. (If you wish to state the reasons please do so.)

 

 

Date:                                                        Signature:               ____