STATE OF SOUTH CAROLINA	)

)	BEFORE THE ARBITRATION PANEL OF COUNTY
In the matter of Arbitration between	)
)

)

)

)

Case number -CP- -
Claimant(s)	)

)	AGREEMENT

vs.	)

)
)
Defendant(s)	)

Pursuant to the South Carolina Automobile Reparation Reform Act of 1974, §38-77-710, et seq., as amended, the undersigned hereby request and agree that the arbitration of a property damage claim between , and , Defendant(s) arising out of a motor vehicle collision or accident shall be had before a single arbitrator to be designated and appointed by the Clerk of Court for County, in lieu of a panel of three arbitrators, all as provided under S.C. Code Ann. § 38-77-720.

IN WITNESS WHEREOF, we have hereunto set our hands and seals this day of , .

___________________________________

Claimant

__________________________________

Defendant
___________________________________

Defendant

SCCA/205(3/2005)

STATE OF SOUTH CAROLINA

DSmith

2005-03-24

SCJD

South Carolina Judicial Dept.