Form 41.55

Form of reference on a preliminary point under an ACAS Scheme

UNTO THE RIGHT HONOURABLE

THE LORDS OF COUNCIL AND SESSION

REFERENCE ON A PRELIMINARY POINT

Under

(specify the ACAS Scheme under which the reference is being made)

by 

[A.B.] (address)

Arbitrator in the case of 

[C.D.] (address) against [E.F.] (address)

[or by

[C.D.] (address) and [E.F.] (address) parties in a case in which [A.B.] (address) is the arbitrator]

(Here state in numbered paragraphs the facts and circumstances out of which the reference arises and set out the question for answer by the court)