General Motors – Request for Mediation Filing Form

Please review the instructions and complete the online request for mediation form below to file for mediation:

• Request for Mediation:    Provide a description (no more than 5000 characters) of the facts involved in your dispute and an explanation as to why you are seeking mediation.
• Audit Summary:    If results of an audit are in dispute, please upload the one-page debit summary (as a PDF) from GM Audit Services.
• Filing Fee:    Pay the filing fee (defined below) to be used as a retainer against the total costs of mediation, professional fees, and expenses.
• Representation by Counsel:    Mediation is a non-adversarial process designed to give the Dealer and GM an opportunity to resolve matters as partners in a business-to-business setting. While either party reserves the right to bring counsel to the mediation, GM’s practice is to bring counsel only if the dealer decides to do so.
• Costs:    The total cost of most mediations falls within the range of $3,000 to $5,000 per party, plus or minus other potential expenses. All costs associated with the mediation are split evenly between the Dealership and General Motors. Please refer to the GM Dispute Resolution Process, page 8, Item “D. Expenses”.

To complete the process, please submit the online form and pay the $1,000 deposit by visiting https://www.paypal.me/mwiepay and selecting “Send.”

Alternative Submission Options:  To request mediation using GM’s Request for Mediation form, please scan the completed form and all attachments and email them to MWI’s GM Administrator, Clarice Parsons, at cparsons@mwi.org. The deposit may be paid via PayPal at https://www.paypal.me/mwiepay. For ACH payment instructions, please contact MWI’s Operations Manager, Lisa Dowell, at ldowell@mwi.org. Checks (payable to Mediation Works Incorporated) may be mailed to MWI at the address listed on the form.

For more information, contact Clarice Parsons, MWI’s GM Administrator, at cparsons@mwi.org or 617-895-4030.