1 2 3 4 5 6 7 8 9 10 11 12 SUPERIOR COURT OF WASHINGTON IN AND FOR THURSTON COUNTY NO. Plaintiff, vs. STIPULATION TO ARBITRATOR Defendant. The parties stipulate to the following person as arbitrator in this matter: 13 14 15 16 17 18 19 20 Arbitrator's Name: Address: ________________________________________ ________________________________________ ________________________________________ Telephone Number: ________________________________________ The Arbitrator has been contacted jointly and has agreed to serve in this matter. Dated: Attorney for Plaintiff/Petitioner WSBA No. Dated:__________________________ ______ Attorney for Defendant/Respondent WSBA No.__________________________ Attorney for: WSBA No. The original of this form must be returned within 14 days of receipt to the ARBITRATION DEPARTMENT Thurston County Superior Court WASHINGTON STATE SUPERIOR COURT THURSTON COUNTY 2000 Lakeridge Drive SW Olympia, Washington 98502 (360) 786-5560 fax: (360) 754-4060 American LegalNet, Inc. www.FormsWorkFlow.com 21 22 23 24 25 26 27 Dated:__________________________ ______ STIPULATION TO ARBITRATOR - 1