Arbitrators Fee Statement
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Arbitrators Fee Statement Form. This is a California form and can be use in Sacramento Local County.
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Tags: Arbitrators Fee Statement, CV-E-ARB-125, California Local County, Sacramento
SUPERIOR COURT OF CALIFORNIA
For Court Use Only
County of Sacramento
720 Ninth Street, Room 102
Sacramento, CA 95814-1380
(916) 874-5522—Website www.saccourt.ca.gov
Arbitrator (Name and Address):
Telephone No.:
E-Mail Address:
Fax No.:
Case Number:
Plaintiff:
Defendant:
Arbitrator’s Fee Statement
Pursuant to rule 3.814(d), California Rules of Court (CRC), I served as Arbitrator and performed
all official responsibilities herein and declare I am in good standing with the California State Bar.
VENDOR ID NUMBER:
ARBITRATION HEARING DATE:
ARBITRATION AWARD DATE:
HOURS IN HEARING:
PREPARATION HOURS:
TOTAL HOURS:
Settlement Date: _____________
Mediation Date: _____________
Arbitrator Signature:_____________________________________ Date:_________________
In accordance with CRC 3.819(c) ▪ I hereby affirm that the above entitled information is true and
correct and request payment for services rendered as Arbitrator in this matter.
For Court Use Only
As defined in the CRC/Local Rules; the fee of $________ is approved for payment on:________.
Arbitration Administrator / Representative: ______________________________
Claim Date: ______________________
Arbitrator’s Fee Statement
CV\E–ARB–125 (Rev 02.13.09)
Local Form Adopted for Mandatory Use
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