Form#A-1

Tacoma-Pierce County Association of REALTORS®

Board or StateAssociation

2550 S. Yakima Ave., Suite CTacomaWA98405

AddressCityStateZip

Request and Agreement toArbitrate

(1)The undersigned, by becoming and remaining a member of the Tacoma-Pierce County AssociationofRealtors®

(orParticipantinitsMLS),haspreviouslyconsentedtoarbitrationthroughtheBoardunderitsrulesandregulations.

(2)I am informed that each person named below is a member in good standing of the Board (or Participant in its MLS), or was a memberofsaidBoardofRealtors®atthetimethedisputearose.

(3)AdisputearisingoutoftherealestatebusinessasdefinedbyArticle17oftheCodeofEthicsexistsbetweenme(ormyfirm)and (listallpersonsand/orfirmsyouwishtonameasrespondentstothisarbitration):*

,Realtor® principal

NameAddress

,Realtor®principal

NameAddress

FirmAddress

(NOTE:ArbitrationisgenerallyconductedbetweenRealtor®[principals]orbetweenfirmscomprisedofRealtor®principals. Naming a Realtor®[principal] as respondent enables the complainant to know who will participate in the hearing from the respondent’sfirm;namingafirmmayincreasethelikelihoodofcollectinganyresultingaward.)

(4)Thereisdue,unpaidandowingtome(orIretain)fromtheabove-namedpersonsthesumof$. My claim is predicated upon the statement attached, marked Exhibit I and incorporated by reference into this application.The

disputed funds are currentlyheldby.

(5)IrequestandconsenttoarbitrationthroughtheBoardinaccordancewithitsCodeofEthicsandArbitrationManual(alternatively, “inaccordancewiththeprofessionalstandardsproceduressetforthinthebylawsoftheBoard”).Iagreetoabidebythearbitration awardand,ifIamthenon-prevailingparty,to,withinten(10)daysfollowingtransmittaloftheaward,either(1)paytheawardto theparty(ies)namedintheawardor(2)depositthefundswiththeProfessionalStandardsAdministratortobeheldinanescrow or trust account maintained for this purpose. Failure to satisfy the award or to deposit the funds in the escrow or trust account withinthistimeperiodmaybeconsideredaviolationofamembershipdutyandmaysubjectthemembertodisciplinaryactionat thediscretionoftheBoardofDirectorsconsistentwithSection53,TheAward,CodeofEthicsandArbitrationManual.

In the event I do not comply with the arbitration award and it is necessary for any party to this arbitration to obtain judicial confirmationandenforcementofthearbitrationawardagainstme,Iagreetopaythepartyobtainingsuchconfirmationthecosts andreasonableattorney’sfeesincurredinobtainingsuchconfirmationandenforcement.

(6)Ienclosemycheckinthesumof$250.00 forthearbitrationfilingdeposit.**

(7)IunderstandthatImayberepresentedbylegalcounsel,andthatIshouldgivewrittennoticenolessthanfifteen(15)daysbefore thehearingofthename,address,andphonenumberofmyattorneytoallpartiesandtheBoard.Failuretoprovidethisnoticemay resultinacontinuanceofthehearing,iftheHearingPaneldeterminesthattherightsoftheotherparty(ies)requirerepresentation.

*Complainantsmaynameoneormore Realtor® principalsorafirmcomprisedofRealtor® principalsasrespondent(s).Or,complainantsmay

nameRealtor®principalsandfirmsasrespondents.

**Not to exceed$500.

Code of Ethics andArbitrationManual208

(8)EachpartymustprovidealistofthenamesofwitnessesheintendstocallatthehearingtotheBoardandtoallotherpartiesnotless thanfifteen(15)dayspriortothehearing.Eachpartyshallarrangeforhiswitnessestobepresentatthetimeandplacedesignated forthehearing.ThefollowingRealtor®nonprincipal(orRealtor®-associate®nonprincipal)affiliatedwithmyfirmhasafinancialinterestintheoutcomeoftheproceedingandmaybecalledasawitness,andhastherighttobepresentthroughoutthehearing:

.

Allpartiesappearingatahearingmaybecalledasawitnesswithoutadvancenotice.

(9)Ideclarethatthisapplicationandtheallegationscontainedhereinaretrueandcorrecttothebestofmyknowledgeandbeliefand thisrequestforarbitrationisfiledwithinonehundredeighty(180)daysaftertheclosingofthetransaction,ifany,orwithinone hundredeighty(180)daysafterthefactsconstitutingthearbitrablemattercouldhavebeenknownintheexerciseofreasonable diligence, whichever islater.

Date(s) alleged dispute took place ______

(10)IfeitherpartytoanarbitrationrequestbelievesthattheGrievanceCommitteehasincorrectlyclassifiedtheissuepresentedinthe request(i.e.,mandatoryorvoluntary),the party has twenty (20) days from the date of transmittal oftheGrievanceCommittee’s decisiontofileawrittenappealofthedecision.OnlythosematerialsthattheGrievanceCommitteehadatthetimeofitsdetermination maybeconsideredwiththeappealbytheBoardofDirectors.

(11)Arethecircumstancesgivingrisetothisarbitrationrequestthesubjectofcivillitigation?YesNo

(12)Important note related to arbitration conducted pursuant to Standard of Practice 17-4 (1) or (2): Where arbitration is conducted betweentwo(ormore)cooperatingbrokerspursuanttoStandardofPractice17-4(1)or(2),theamountindisputeandtheamount ofanypotentialresultingawardislimitedtotheamountpaidtotherespondentbythelistingbroker,seller,orlandlordandany amountcreditedorpaidtoapartytothetransactionatthedirectionoftherespondent.

(13)Addressofthepropertyinthetransactiongivingrisetothisarbitrationrequest:

(14)The sale/lease closedon:

(15)Agreementstoarbitrateareirrevocableexceptasotherwiseprovidedunderstatelaw.

Complainant(s):

Name(Type/Print) / SignatureofRealtor®Principal / Date
Address
Telephone / Email
Name(Type/Print) / SignatureofRealtor® Principal / Date
Address
Name ofFirm* / Address
Telephone / Email

*IncaseswherearbitrationisrequestedinthenameofafirmcomprisedofRealtor®(principals),therequestmustbesignedbyatleastoneofthe

Realtor® principalsofthefirmasaco-complainant.

(Revised11/15)

209CodeofEthicsandArbitrationManual