Office of Lawyers Professional Responsibility

COMPLAINT FORM

Complainant's Name:                                                                                                                      

Address:                                                                                                                                             

City, State, Zip Code:                                                                                                                       

Telephone:  Home: (       )                                        

Work: (       )                                            

Name of Lawyer:                                                                                                                              

Address:                                                                                                                                             

City, State, Zip Code:                                                                                                                       

Telephone: (       )                                                      

Complaint (Please state what the lawyer did or failed to do which you feel is unethical.  Please also send copies of any documents which would help explain or support your complaint.):

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

(If you need more pages, please attach them.)

Signature of Complainant:                                                            

Date: