-SIXTH SCHEDULE[See section 12(1)(b)]Name :Contact details :Prior experience (including experience with arbitrations):Number of on-going arbitrations:Circumstances disclosing any past or present relationship with or interest in any of the parties or in relation to the subject-matter in dispute, whether financial, business, professional or other kind, which is likely to give rise to justifiable doubts as to your independence or impartiality (list out):Circumstances which are likely to affect your ability to devote sufficient time to the arbitration and in particular your ability to finish the entire arbitration within twelve months (list out).
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