STATE BAR OF NEVADA FEE DISPUTE ARBITRATION The Board of Governors of the State Bar of Nevada offers a Fee Dispute Arbitration Program to assist attorneys and their clients in settling fee disputes. The Fee Dispute Arbitration Committee is comprised of volunteer attorneys and lay members located throughout the State who serve as mediators and arbitrators. Attorneys and clients are not mandated to participate in the fee dispute arbitration process, unless specifically directed in the Fee Dispute Committee By-Laws or through a contractual relationship. However, parties are encouraged to do so as a means of avoiding litigation in the court system. The Committee has the authority to decide any disagreement between a client and attorney concerning the fee paid, charged or claimed for legal services provided by an attorney licensed to practice in Nevada, or licensed in another state and practicing in this state under Supreme Court Rule 42, where there is an expressed or implied contract establishing an attorney-client relationship. Prior to filing a claim, you should make a good faith effort to resolve your dispute. If your effort is unsuccessful and you decide to file a claim: Read the By-Laws for Fee Dispute Arbitration and gain familiarity with the fee dispute mediation and arbitration processes Complete and sign this claim form (you are the Petitioner) Attach copies of documentation concerning the disputed fees (retainer agreement, billing statements, correspondence, etc.); this is critical and failure to do so will result in a processing delay. Note: all documentation will be scanned and submitted to your assigned mediator or arbitrator electronically. Please avoid using staples, binders, etc. and make sure any exhibits are clearly marked. Complete and sign the "Waiver of Personal Appearance at Hearing" if you wish to waive your right to be present at the arbitration hearing (the arbitrator will then consider the evidence you submit in support of your position). Return your Petition and documents to the Las Vegas office. You may also e-mail your Petition and documents (PDF) to feedispute@nvbar.org Please note, the entire fee dispute process may take 6-8 months to complete. ATTENTION The Petitioner's Agreement for Arbitration of Fee dispute will be considered "filed" with the Fee Dispute Committee on the date it is received at the State Bar of Nevada's Las Vegas office. You will receive confirmation within a week of filing. Any documentation relevant to this fee dispute matter must accompany this Petitioner's Agreement or it is considered incomplete and will be returned to you. American LegalNet, Inc. www.FormsWorkFlow.com PETITIONER'S AGREEMENT FOR ARBITRATION OF FEE DISPUTE IN PROCEEDINGS BEFORE THE FEE DISPUTE ARBITRATION COMMITTEE of the STATE BAR OF NEVADA 600 East Charleston Boulevard Las Vegas, NV 89104 Petitioner: v. Respondent: The undersigned Petitioner hereby petitions the Fee Dispute Arbitration Committee of the State Bar of Nevada and agrees as follows: 1. I, City: Email (optional): State: Zip: , whose address is: Telephone: Telephone: Primary Alternate , State: Zip: hereby request resolution of the fee dispute between myself and Respondent, whose address is: Telephone: 2. City: I consent to electronic service of all fee dispute related communications at the above e-mail address. . 3. (a) The total amount of legal fees charged was $ (b) The amount in dispute is $ . (c) A brief statement of facts giving rise to the claim is as follows: (Attach a separate page if necessary) American LegalNet, Inc. www.FormsWorkFlow.com Page 1 4. By checking the boxes below, I attest/acknowledge: I have made a good faith effort to resolve the dispute with Respondent before filing the Petition. Please explain your good faith effort to resolve the dispute. This dispute is not one which is presently the subject of civil action or which is pending before any court. This matter is not one which has been finally decided by a Court. My right to be represented at my own expense by an attorney of law at the hearing or at any stage of arbitration. This fee dispute may be heard and decided by the Fee Dispute Arbitration Committee of the State Bar of Nevada in accordance with its prescribed rules. The Arbitration Award to be made in this matter shall be final and binding upon Petitioner and I will comply with its terms. A Court having jurisdiction may enter a judgment upon the award. For all claims in which the amount in dispute is $5,000 or less, the Fee Dispute Arbitration Committee will first appoint a mediator to see if this matter can be resolved by settlement. The mediator confers with both parties, together and individually, in an effort to resolve the dispute. The mediator does not make a decision; the mediator's purpose is to help you and the other party negotiate a settlement. If no agreement is reached, then the matter is assigned to Arbitration. 5. Mediation is also an option for disputes of $5,000 or more if both parties agree to mediation as a first primary method for dispute resolution. Check here if your fee dispute is for $5,000 or more and you elect mediation as a primary method for dispute resolution. Signature of Petitioner Date APPEARANCE OF COUNSEL The undersigned hereby appears for the Petitioner in the above-captioned arbitration as counsel of record. Name: Address: City: Telephone: State: Zip: Any alterations to the Petitioner's Agreement for Arbitration of Fee Dispute are ineffective and void. American LegalNet, Inc. www.FormsWorkFlow.com Page 2 WAIVER OF PERSONAL APPEARANCE AT HEARING IN PROCEEDINGS BEFORE THE FEE DISPUTE ARBITRATION COMMITTEE of the STATE BAR OF NEVADA 600 East Charleston Boulevard Las Vegas, NV 89104 Petitioner: v. Respondent: I, City: State: Zip: , whose address is: hereby waive my right to be personally present at the hearing concerning the above-mentioned fee arbitration dispute and request that the Committee use the documentary evidence I have or may submit as evidence in support of my position. Signature of Petitioner American LegalNet, Inc. www.FormsWorkFlow.com