Verizon Notice of Customer Dispute at a glance
What it is: Verizon Notice of Customer Dispute: a form to provide notice to Verizon only if you intend to seek mediation or arbitration; a Verizon representative will respond to you within 30 days of receiving this form.
Who signs: By signing you certify that you are the account owner of the account(s) or a duly authorized representative of the account holder.
A filled-in Verizon Notice of Customer Dispute example: an account owner asks for mediation
How to fill out Verizon Notice of Customer Dispute, box by box
Mediation or arbitration
Check the appropriate box to indicate whether you would like to participate in the Verizon mediation program or arbitrate your dispute with the American Arbitration Association (“AAA”).
In Verizon's mediation program, Verizon will assign an employee who is not directly involved in the dispute to help both sides reach an agreement. This program is entirely voluntary, and you are not bound by the mediator's proposal unless you agree with its terms. Participating in mediation does not waive any rights you may have to seek other ways to resolve your dispute, including arbitration, if the mediation is unsuccessful.
You must send Verizon a notice of the dispute in writing at least 60 days in advance of initiating the arbitration. Even if you complete this form, you must contact the AAA to initiate the arbitration.
Account owner and account
Enter the Account Owner Name, Billing Address, Account No, Billed telephone number (if applicable), Alternate contact phone number and Email address (optional).
Your dispute and the relief you seek
Briefly describe the nature of your dispute and attach any supporting documents.
Briefly describe the relief you seek (e.g., credits, refunds, service improvement, termination of account).
Be sure to give specific amounts as to any credits or refunds sought.
Certification of customer or representative
Sign on the Signature of Account Owner or Authorized Representative line and enter the Date.
Certification for mediation request
By my signature I acknowledge that mediation is entirely voluntary and I specifically agree to the terms of the mediation as set out and waive any right to challenge them in any forum.
Under CERTIFICATION FOR MEDIATION REQUEST, sign on the Signature of Account Owner or Authorized Representative line and enter the Date.
More rules for Verizon Notice of Customer Dispute
Mark Yes or No for Are you represented by an attorney? If you are represented by counsel, please provide your attorney's contact information.
Common questions about Verizon Notice of Customer Dispute
Where do I file it?
Completed forms should be sent by email to NoticeofDispute@Verizon.com or by mail to: Verizon Dispute Resolution Manager One Verizon Way, VC54N090 Basking Ridge, NJ 07920-1097.
Sources
[1] Verizon Notice of Customer Dispute, the served file (the Official source link on this page).
