SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE BLYTHE 265 N. Broadway, Blythe, CA 92225 MURRIETA 30755 - D Auld Rd., Ste. 1226, Murrieta, CA 92563 CORONA 505 S. Buena Vista, Rm. 201, Corona, CA 92553 PALM SPRINGS 3255 Tahquitz Canyon Way, Palm Springs, CA 92262 MORENO VALLEY 13800 Heacock St., #D201, Moreno V a lley , RIVERSIDE 4050 Main St., Riverside, CA 92501 CA 92553 RI - ADR016 ATTORNEY OR PARTY WITHOUT ATTORNEY ( Name, State Bar Number and Address) FOR COURT USE ONLY TELEPHONE NO: FAX NO. (Optional): E - MAIL ADDRESS (Optional): ATTORNEY FOR (Name ): CASE NUMBER: ARBITRATOR CERTIFICATION AND OATH CERTIFICATION I, , hereby accept my appointment to the Riverside Superior Court Arbitration Panel and agree to abide by all applicable statutes, rules, policies and procedures and ethical requirements. I certify that I am aware of and agree to comply with the following: - California Code of Civil Procedure sections 170.1, 1141. 10 1141. 31; - California Rules of Court 3.810 - 3.830; and - Applicable provisions of C anon 6 of the Code of Judicial Ethics. I understand that a violation of the above statutes, rules, policies and/or procedures may result in suspension and/or I declare under penalty of perjury under the laws of the State of California tha t the foregoing is true and correct. Date: (ARBITRATOR SIGNATURE) OATH I, solemnly swear (or affirm) that I will perform, according to the law, the duties of arbitrator, and will faithfully and fairly hear and examine the matter in controversy properly before me, and will make a just award according to the best of my ability. EXECUTED ON , at (ARBITRATOR SIGNATURE) Page 1 of 1 Approved for Optional Use Riverside Superior Court RI - ADR016 [ Rev. 11/14/12] [Rev. Format 01/07/19 ] A RBITRATOR CERTIFICATION AND OATH riverside.courts.ca.gov/localfrms/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com