Facilitative Mediation Request Form

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Monday, September 25, 2023

You can fill out the online form below to directly submit your Facilitative Mediation request to Amway and the IBOAI.

REQUEST FOR FACILITATIVE MEDIATION

Your Individual Name(s), if different

Your IBO Number

Street Address

City

State/Province

Zip +4 (if known)

Business Phone No.

Cell Phone No.

Home Phone No.

Sponsor Name

First Upline Platinum Name

First Upline Diamond Name

Approved Provider / Affiliation

I (we) request Facilitative Mediation under Rule 11.4 of the Amway Rules of Conduct (“Rules”) to resolve a dispute. My (our) request is based on the following: (Please provide a description of the dispute, the Rules that may pertain to the Dispute, and support with all documents, correspondence or evidence.)

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Size limit for each file is 100 MB

I (we) understand that current/former IBOs may at his/her/their sole discretion, opt out of the Mediation process at any time, before or during either the Facilitative Mediation or Hearing Panel stages, and may instead proceed directly to Binding Arbitration pursuant to Rule 11.5.

I (we) also understand that while inperson mediation is not required, if the IBO(s) choose(s) to attend Facilitative Mediation in person, the IBO(s) are responsible for their own expenses.

I (we) understand that this Request for Mediation will result in the provision of Mediation.

Date

REQUEST FOR FACILITATIVE MEDIATION

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