Form 6—Application for arbitrationForm 6—Application for arbitration

Form 6—Application for arbitration

(regulation 67D)

<table cellspacing="0" cellpadding="0" style="width:100%; border-collapse:collapse"><tbody><tr style="height:29pt"><td rowspan="4" style="width:46.82%; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableText0" style="text-align:right; page-break-inside:avoid; page-break-after:avoid"><span style="font-family:Helvetica, sans-serif; font-size:10pt; font-weight:bold">[</span><span style="font-family:Helvetica, sans-serif; font-size:10pt">name of court</span><span style="font-family:Helvetica, sans-serif; font-size:10pt; font-weight:bold">]</span></p><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid; line-height:16pt"><br><br><span style="font-family:Helvetica, sans-serif; font-size:14pt; font-weight:bold">Application for arbitration</span></p><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><br><br><br><span style="font-size:10pt">Form 6 — Family Law Regulation</span><span style="font-size:10pt"> </span><span style="font-size:10pt">67D</span><br><span style="font-size:10pt"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top; background-color:#000000"><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt; color:#ffffff">Fill in box A (file numbers)</span></p></td></tr><tr style="height:29pt"><td style="width:21.66%; border-left:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.03pt; vertical-align:top"><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt">A</span><span style="width:44.95pt; font-size:9pt; display:inline-block"> </span><span style="font-size:9pt">File</span><br><span style="width:35.96pt; font-size:9pt; display:inline-block"></span><span style="font-size:9pt">Number</span></p></td><td style="width:31.52%; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt"></span></p></td></tr><tr style="height:29pt"><td style="width:21.66%; border-left:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.03pt; vertical-align:top"><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt">B</span><span style="width:32.2pt; font-size:9pt; display:inline-block"> </span><span style="font-size:9pt">Filed at</span></p><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt"></span></p><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt"></span></p></td><td style="width:31.52%; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt"></span></p></td></tr><tr style="height:29pt"><td style="width:21.66%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.03pt; vertical-align:top"><p class="TableText0" style="page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt">C</span><span style="width:29.32pt; font-size:9pt; display:inline-block"> </span><span style="font-size:9pt">Hearing date</span></p><p class="TableText0" style="text-align:right; page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt">Hearing time</span></p></td><td style="width:31.52%; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText0" style="text-align:right; page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt">AM</span></p><p class="TableText0" style="text-align:right; page-break-inside:avoid; page-break-after:avoid"><span style="font-size:9pt">PM</span></p></td></tr></tbody></table>