Know all men by these presents, that whereas a controversy is now existing between (name), of (residence), and (name), of (residence), touching (here state nature of controversy):
Now, therefore, we, the said (here give names of parties), do hereby submit said controversy to the decision and arbitration of (here give names of three persons selected as arbitrators), of (here state residences), and do covenant each with the other that we will faithfully keep and abide by the decision and award that they, or any two of them, may make in writing—said award to be made and signed on or before (here give date).
And it is agreed by the parties hereto, that the party that shall fail to abide by and observe said award, made in accordance with the foregoing submission, shall forfeit and pay to the other the sum of (here insert amount).
Witness our hands this ____ day of ____ A. D. ____.
____ Name.
____ Name.
AWARD OF ARBITRATORS.
The undersigned to whose arbitration was submitted the matters in controversy between (here give names of parties) as more fully appears by their written submission hereto attached, Report that on the day of ____ A. D. 18__, after having been duly sworn according to law, and having given both parties ____ day’s notice in writing of the time and place of our meeting to consider said matter, we proceeded to the discharge of our duty; said (name of party) appearing in person (if by Att’y also so state,) and said (name of party) appearing in person (if by Att’y also so state.) And having heard the allegations and proofs of said parties, and the witnesses introduced by them, and having examined the matter in controversy submitted by them, do make and declare this as and for our award.
Here state findings of Arbitrators.