AOL Inc.

Consumer Demand for Arbitration before the
American Arbitration Association


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 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_________________