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AOL Inc.

Consumer Demand for Arbitration before the
American Arbitration Association

AMERICAN ARBITRATION ASSOCIATION
CONSUMER ARBITRATION RULES

To file a claim:

1. Please fill out this form and retain one copy for your records.

2. Mail two copies of this form to the American Arbitration Association’s Case Filing Services, 1101 Laurel Oak Road, Suite 100, Voorhees, NJ 08043. Please include with each form any documentation you may have relating to your dispute and a copy of AOL’s Arbitration provisions, found in AOL’s Terms of Service. If you have any questions, visit www.adr.org or call AAA Customer Service at (800) 778-7879.

3. Send a copy of your completed form to: AOL Inc., Dept. 5627, PO Box 65101, Sterling, VA 20165.

4. AOL will pay your AAA filing fees, provided your amount in dispute is less than $75,000.  If your amount in dispute is more than $75,000, please send the appropriate filing fee to the AAA with these forms.  Information about filing fees can be found in Section L-3 of AAA’s Consumer Arbitration Rules.

Your Personal Information:
 
Name: __________________________________________________________________________________
 
AOL Email Address / Username: _____________________Alternate Email Address_____________________
 
Street Address/City/State/Zip: _______________________________________________________________
 
Telephone: (____)______________________________ Fax: (____)_________________________________
If an in-person hearing is held, the arbitration will take place in the county of your billing address.  Please tell us the county and state of your AOL billing address: ________________________.

Your Attorney’s Information (Please leave blank if you are representing yourself)
 
Attorney’s Name: _________________________________ Firm: _____________________________________
 
Address: _________________________________________ City/State/Zip: ____________________________
 
Telephone: (____)________________________________ Fax: (____)_________________________________
 
Briefly explain the nature of your dispute.  You may use additional pages:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
How much money do you believe you are owed?  If none, leave blank:
$___________

Do you desire any non-monetary outcome?  If no, leave blank:
_________________________________________________________________________________________

Signature________________________________________________ Date_________________