Demand for Arbitration

DEMAND FOR ARBITRATION

Please provide the following information in connection with your dispute with 910 Zen, LLC a (“Responding Party”), as submitted by you or the organization that you represent (“Initiating Party” and together with the Responding Party, the “Parties”):
Name and Address of Initiating Party
Full Name

First Name Last Name

Address

Name and Address of Responding Party

910 Zen LLC, 68 Southfield Ave #100, Stamford, CT 06902. 1-(800) 518-4072
The Initiating Party previously agreed to the applicable Revenate Media Website Terms and Conditions (“Terms”). The Terms contain a valid and binding arbitration clause for the resolution of disputes, a copy of which is attached hereto as Exhibit A. The Parties are in dispute as to the following issue(s): *
As the Parties cannot agree as to the resolution of the subject dispute, the Initiating Party hereby demands that the Responding Party submit to arbitration pursuant to the rules and procedures set forth by either the American Arbitration Association (“AAA”), the Judicial Arbitration and Mediation Services, Inc. (“JAMS”) or another reputable arbitration provider, as selected by the Initiating Party. The Initiating Party is claiming the following damages: *
Damages Claimed: $
In filing this Demand for Arbitration ("Demand"), the Initiating Party certifies the following: He/she/it has provided the Responding Party with a copy of this Demand by both e-mail and certified mail, return receipt requested. So demanded and certified by:
Initiating Party Signature
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DEMAND FOR ARBITRATION