VIJAYA BANK
 
APPLICATION FORM for arbitration to be submitted to the
Banking Ombudsman
 
Before the Banking Ombudsman

Arbitration Application No of 200 (state the year)
(under clause (21) of the Banking Ombudsman Scheme 2002)
 
1. Name(s) of the applicant(s) with Complete address * /Phone No./Fax No :
2. Name(s) of other parties to the arbitration with full addresses **/Phone No./Fax. No.
3. Name(s) of Advocate appointed by the parties with full address. ***
4. Brief written statement describing the general nature of the dispute and the points at issue (the parties may annex additional sheets of papers in case the space given here is not adequate.)
5. Valuation of subject matter. ****
6. Relief or remedy sought
 
Affidavit of Undertaking
(Duly stamped and notarised on a non-judicial stamp paper)
(Please delete whichever is not applicable)
I ______________________ solemnly undertake and affirm as under :-
  1. That I am the complainant/claimant/opposite party to the accompanying
    Complaint/claim/reply/counterclaim.

  2. That I hereby give voluntary consent to the Banking Ombudsman concerned,
    To settle disputes as per the Banking Ombudsman Scheme, 2002.

  3. That the applicable law shall be the principles of natural justice, the Rules of the Banking Ombudsman Scheme, 2002 and the Arbitration and Conciliation Act, 1996.

  4. That I further give my consent to the Banking Ombudsman concerned to decide the ex equo et bono or as amiable compositeur.

    (Deponent)

 ***********************************
* The applicants could be either the bank and its constituent or two banks for
arbitration of inter-bank dispute.
** This will include names of the guarantors and other third parties against whom
Relief might have been sought for or it may be necessary to make them parties to the arbitration.
*** Advocates if appointed should submit their Vakalatnama along with this Application Form.
**** Since the Banking Ombudsman has jurisdiction only up to the sum of Rs.10 lakhs, valuation may be checked by his Secretariat to decide whether the dispute is maintainable before him.