ARBITRATION

Home Arbitration

Step 1
Notice of Intent
Step 2
Review & Submit
Step 3
Completed

Notice of Intent

Name*

Please enter a name.

Address 1*

Please enter an address.

Address 2

Address 3

City*

Please enter a city.

State*

Please enter a state.

Country

Please enter a valid country.

Zip Code*

Please enter a valid zip code.

Phone*

Please enter a phone number.

Fax

Please enter a fax number.

Email Address*

Please enter a valid email address.

List the dispute dates below. (e.g. 01/01/2020)

Start Date

Please enter a valid date.

End Date

Please enter a valid date.

When did you/your client(s) first know that the dispute existed? (e.g. 01/01/2020) *

Date First Knew

Please enter a valid date.

Who is the claim against? List every individual and/or firm (with NFA ID if known). Please note the intent is only valid with respect to parties listed in this field. * Maximum 4000 Characters (Count: 0)

Text length 0 exceeds maximum value of 4000.

Which of the following describes you/your client(s)?

Customer

Current or former Member or Associate

If you are an attorney, enter your client's name(s):

Please enter a client name.

* Required field.

Review & Submit Notice of Intent

Please review your information before submitting your Notice of Intent to NFA.

By submitting this form electronically, you agree to receive electronic communication from NFA.

Name

Address 1

Address 2

Address 3

City

State

Country

Zip Code

Phone

Fax

Email Address

List the dispute dates.

When did you/your client(s) first know that the dispute existed?

Who is the claim against? List every individual and/or firm (with NFA ID if known). Please note the intent is only valid with respect to parties listed in this field.

Which of the following describes you/your client(s)?

If you are an attorney, enter your client's name(s):

Thank you.

Your notice of intent has been submitted. You should receive an email from NFA with instructions on how to file an arbitration claim. If you do not receive this email, please contact the Arbitration Department at 800-621-3570 or 312-781-1410.

You must submit a completed arbitration claim form to NFA within 35 days from today.

Please note: The information you have submitted is listed below. It will not be included in the verification email sent to you. If you wish to retain a record of this information, you must print this page. It will not be available after you leave this page.

Name

Address 1

Address 2

Address 3

City

State

Country

Zip Code

Phone

Fax

Email Address

List the dispute dates.

When did you/your client(s) first know that the dispute existed?

Who is the claim against? List every individual and/or firm (with NFA ID if known). Please note the intent is only valid with respect to parties listed in this field.

Which of the following describes you/your client(s)?

If you are an attorney, enter your client's name(s):

Notice of Intent

Review & Submit Notice of Intent

Thank you.

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