SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom – Happiness
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REQUEST FOR RECOGNITION OF SUCCESSFUL OUT-OF-COURT MEDIATION RESULT
To: The People’s Court of …………………………… (1)
The requester: (2) ………………………………
Address: (3) …………………………………………………………………………………………..
Telephone (if any): ………………………………….. ;
Fax (if any): ……………………………………………….
Email (if any): ……………………………………………………………………..
Name and address of other party in dispute:(4)
Name and address of mediator or mediation institution:(5) ……………………………………….
Contents of the successful mediation result requesting the Court to recognize:(6)
- ……………..
- ……………..
…
Attached documents, evidence:(7)
1 ………………
2 ………………
…
I (We) hereby certify that the information provided above is true and correct in all details.
……………, [date] (8)
THE REQUESTER
______________________
Instructions:
(1) People’s courts of districts where the requester resides or works (or where the requester headquartered, applicable to the requester is an organization) (pursuant to clause 7 Article 27, letter a) clause 2 Article 35, letter s) clause 2 Article 39 of the Civil Procedure Code 2015).
(2) Party (parties) in the dispute.
(3) Address where the requester resides or works, applicable to individuals; address of headquarter, applicable to organizations.
(4) Name, address (and business code, applicable to organizations) of the other party in dispute (in case not all of the parties in dispute request for recognition).
(5) Name, address of ad hoc commercial mediator or name, address of Mediation Institution or Arbitration Center which conducts the mediation.
(6) Write the contents of successful mediation result in accordance with the Written Record of successful mediation results.
(7) Contract arising dispute; separate written about commercial mediation agreement (in the case of a contract without a provision on commercial mediation); written record of successful mediation result.
(8) The requester who requests for recognition of successful out-of-Court mediation result must submit the request to the Court within 06 months from the day on which the successful mediation agreement between parties is reached (clause 1 Article 418 Civil Procedure Code 2015).
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