=== {Insert the case name} ===
'''Initiated by ''' ~~~ '''at''' ~~~~~
==== Involved parties ====
<!-- use {{admin|username}} if the party is an administrator -->
*{{userlinks|yourusername}}, ''filing party''
*{{userlinks|username2}}
<!-- The editor filing the case should be included as a party for purposes of notifications. -->
;Confirmation that all parties are aware of the request`
<!-- All parties must be notified that the request has been filed, immediately after it is posted, and confirmation posted here. -->
*Diff. 1
*Diff. 2
;Please provide the link(s) relevant to the decisions or the case you are wanting reviewed
<!-- Identify prior dispute resolution, arbitration, AN and AN/I threads here, with links/diffs to the page where the resolution took place. -->
*Link 1
*Link 2
==== Statement by {Party 1} ====
==== Statement by {Party 2} ====
==== Clerk notes ====
<span class="mw-poem-indented" style="display: inline-block; margin-inline-start: 1em;">''This area is used for notes by non-recused Clerks.''</span>
==== OmbCom members opinion on hearing this matter (0/0/0/0) ====
*
----
