Examples of Notice of Dispute Form in a sentence
Fill out and send the Notice of Dispute Form to us according to the directions on the form.
Claimant’s Name: Social Security Number: Address: Telephone Number: ( ) Claimant’s Attorney’s Name: Address: Telephone Number: ( ) Employer: Address: Telephone Number: ( ) Date of injury or illness: Please note: Employee’s Report of Claim Form filed by Claimant and the Notice of Dispute Form filed by Claimant’s employer or the employer’s insurance company must be provided to the Fund before claims will be paid based on this Agreement.
CPS Energy shall consider the findings of the Attaching Entity’s investigation provided that the investigation is completed within forty-five (45) calendar days of the Attaching Entity submitting to CPS Energy a Notice of Dispute Form.
In the event liability is disputed for a claim of damages to CPS Energy Facilities, the Attaching Entity must submit a Notice of Dispute Form, a copy of which is provided as Appendix J, to the CPS Energy Claims Department within five (5) business days of receiving CPS Energy’s tender explaining the reason for the disputing liability and providing documentary support for the dispute.
General Information.Claimant’s Name:Social Security Number:Address:Telephone Number: ()Claimant’s Attorney’s Name:Address:Telephone Number: ()Employer:Address:Telephone Number: ()Date of injury or illness: Please note: Employee’s Report of Claim Form filed by Claimant and the Notice of Dispute Form (or similar documents) filed by Claimant’s employer or the employer’s insurance company must be provided to the Fund before claims will be paid based on this Agreement.
Fill out andsendthe Notice of Dispute Form to us according to the directions on the form.
However for the purposes of this Agreed Procedure the following indicative categories are identified on the Notice of Dispute Form.
UBISOFT may offer to settle the claim, provided however that if the dispute is not resolved within 30 days from the date of UBISOFT's offer to settle or UBISOFT's receipt of the Notice of Dispute Form (whichever is later), you may invoke binding arbitration by filing a separate Demand for Arbitration accessible at xxxxx://xxxxx.xxx.xxx/documents/demandforarbitration_US.html.
Thus, for any claim related to these Terms or our Services where the total amount sought (i) is equal to or more than $10,000 USD, you may, or (ii) is less than $10,000 USD, you must, initiate dispute proceedings by completing the Notice of Dispute Form.
Thus, for any claim related to this XXXX where the total amount sought (i) is equal to or more than $10,000 USD, you may, or (ii) is less than $10,000 USD, you must, initiate dispute proceedings by completing the Notice of Dispute Form accessible at xxxxx://xxxxx.xxx.xxx/documents/noticeofdispute_US.html.