[Firm Name]

[Firm Address]

[Firm Phone Number]

[Firm Fax]

[Firm Email]

[Attorney Name and Bar Number]

Attorney for [Plaintiff]


Arizona Superior Court, Yavapai County


  Case No.


Plaintiff’s Certificate Regarding Compulsory Arbitration



The undersigned certifies that he or she knows the dollar limits and any other

limitation set forth by the local rules of practice for the applicable superior court and

further certifies that this action [is/is not] subject to compulsory arbitration, as provided in Rules 72 through 77 of the Arizona Rules of Civil Procedure.

Dated [Date]


[Firm Name]

By /s/ [Attorney Name]                                

[Attorney Name]

[Attorney Address]
Attorneys for [Plaintiff Name]