UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA Fort Myers DIVISION
(Plaintiff), -v(Defendant) ARBITRATOR'S CLAIM FOR COMPENSATION Hearing Date: Number of Days: Arbitrator's Name: Check processing information: You must SELECT and COMPLETE ONE of the following as payee: (mm/dd/yy) Case No. 5:
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- OCA
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Attorney Name: Address:
OR
Firm Name: Address:
Social Security Number:
(Reportable to IRS)
Federal ID Number:
(Reportable to IRS)
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Amount Due:
$ Approved by:
Alternate Dispute Resolution Clerk
(Revised 06/04)
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