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反请求申请书
申请人(答辩人)：____________________________________________________________
住所：______________________________________________________________________
法定代表人：________________职务：________________电话：________________
委托代理人：________________工作单位：________________
性别：________________年龄：________________
职务：________________电话：________________
被申请人(被答辩人)：________________________________________________________
住所：______________________________________________________________________
法定代表人：________________职务：________________电话：________________
委托代理人：________________工作单位：________________
性别：________________年龄：________________
职务：________________电话：________________
反请求：
1． 由被申请人承担因其违约行为给申请人造成的经济损失____________元；
2．仲裁费用由被申请人负担。
事实与理由：
(事实经过)____________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________
(要求被申请人承担责任的理由)__________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________
此致
________________仲裁委员会
申请人：_____________
(盖章)
_____年___月___日
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