Here you can download the declaration of independence 

THE CEPANI SECRETARIAT
RUE DES SOLS, 8
B-1000 BRUSSELS
-----------------------------------

Arbitration case No.

DECLARATION OF INDEPENDENCE BY THE ARBITRATOR (*)

I the undersigned,

Surname: .......................................................First name: ................................................

? declare that I shall abide by the "Rules of good conduct for procedures requiring the intervention of CEPANI" enclosed as Annex II to the CEPANI Rules. 

? declare that I am fully independent of: 

? the parties 
? their legal counsel

? draw CEPANI's attention to the following facts and circumstances that could lead any of the parties to doubt my independence (use a separate sheet if necessary).

Done at .............................., on ......................................

Signature:

Name: 

* Tick the corresponding boxes.