Loss Recovery Center, Inc. 1-877-GO-NASAC (466-2722) / Fax: (775) 201-1233
BACK to Uniform Submission Agreement Main
UNIFORM SUBMISSION AGREEMENT NATIONAL ASSOCIATION OF SECURITIES DEALERS In Matter of the Arbitration Between Name of Claimant(s) Name of Respondent(s) 1. The undersigned parties hereby submit the present matter in controversy, as set forth in the attached statement of claim, answers, cross claims, and all related counterclaims and/or third party claims which may be asserted, to arbitration in accordance with the Constitution, ByLaws, Rules, Regulations and/or Code of Arbitration Procedure of the sponsoring organization. 2. The undersigned parties hereby state that they have read the procedures and rules of the sponsoring organization relating to arbitration. 3. The undersigned parties agree that in the event a hearing is necessary, such hearing shall be held at a time and place as may be designated by the Director of Arbitration or the arbitrator(s). The undersigned parties further agree and understand that the arbitration will be conducted in accordance with the Constitution, ByLaws, Rules, Regulations and/or NASD Code of Arbitration Procedure of the sponsoring organization. 4. The undersigned parties further agree to abide by and perform any award(s) rendered pursuant to this Submission Agreement and further agree that a judgment and any interest due thereon may be entered upon such award(s) and, for these purposes, the undersigned parties hereby voluntarily consent to submit to the jurisdiction of any court of competent jurisdiction which may properly enter such judgment. 5. IN WITNESS WHEREOF, the parties hereto have signed and acknowledged the foregoing Submission Agreement. Party(ies) Signature ____________________________ Client Name ____________________________ Client Name FOR PARTIES WHO ARE INDIVIDUALS STATE OF _______________________ ss: COUNTY OF ________________________ On the _________ day of ________ , 20___, before me personally appeared ___________________, to me known and known to me to be the person who executed the foregoing instrument, and s/he acknowledged to me that s/he executed the same. Notary Public FOR PARTIES WHO ARE CORPORATIONS STATE OF _____________________ ss: COUNTY OF ____________________
__________________ of _____________________ the corporation described in and which executed the foregoing instrument; that s/he full has full and complete authority to file and execute the said instrument and all papers contained here, in the name of and on behalf of the said corporation; that s/he knows the seal of said entity; that is was so affixed by order of the Board of Directors of the said corporation; and that s/he signed her/his name thereto by like order. Notary Public FOR PARTIES WHO ARE NEITHER CORPORATIONS NOR INDIVIDUALS STATE OF ) ss: COUNTY OF ___________________ On the _________ day of __________, 20___, before me personally appeared _____________ to me known, who first being duly sworn by me, did depose and say that s/he is the ______________ of _____________________, the entity described in and which executed the foregoing instrument; that s/he has full and complete authority to file and execute the said instrument and all papers contained here, in the name of and on behalf of the said entity; that s/he executed the same as an act and deed of the said entity for the specific uses and purposes stated and described therein. Notary Public
UNIFORM SUBMISSION AGREEMENT
ss: COUNTY OF ________________ On this ________ day of _________, 20___, before me personally appeared ______________ to me known, who first being duly sworn by me, did depose and say that s/he executed the foregoing instrument and that s/he had full and complete authority to do so and to file thee said statement and all papers contained herein for the trust of and that s/he had the authority to sign the same and s/he did duly acknowledge to me that s/he executed the same as an act and deed of the said trust of for the specific uses and purposes stated and described herein. _______________________________
Loss Recovery Center, Inc. |