Free COMPLAINT AGAINST ATTORNEY - Connecticut

COMPLAINT AGAINST ATTORNEY
JD-GC-6 Rev. 12-99

Before completing this form you may wish to read the pamphlet: ATTORNEY GRIEVANCE PROCEDURES IN CONNECTICUT

STATE OF CONNECTICUT JUDICIAL BRANCH
www.jud.ct.gov
TYPE OR PRINT

INSTRUCTIONS

1. Complete this form using black ink and retain a copy for your records. Please type or print neatly. 2. Attach a copy of the fee agreement, if one exists, pertaining to the complaint and all pertinent correspondence with attorney. 3. Send original and 6 copies of this form with 7 copies of any attachments to the address below.

TO: The Statewide Bar Counsel, 287 Main St., 2nd Floor, East Hartford, CT 06118-1885
NAME OF PERSON MAKING COMPLAINT (Complainant) ADDRESS OF COMPLAINANT (No., Street, Town, State, Zip) NAME OF ATTORNEY COMPLAINED AGAINST PRINCIPAL OFFICE ADDRESS OF ATTORNEY COMPLAINED AGAINST (No., Street, and Town) DESCRIBE YOUR RELATIONSHIP TO THE ATTORNEY WHO IS THE SUBJECT OF YOUR COMPLAINT (Check One): TELEPHONE NO. TELEPHONE NO.

I retained/hired the attorney. The court appointed the attorney to represent me. The court appointed the attorney to represent my children.
DATE ATTORNEY FIRST ACCEPTED YOUR CASE(S) NAME OF CASE(S) DOCKET NUMBER(S)

Other (Please describe who the attorney represents):

Complete this section if applicable

IS CASE STILL PENDING?

YES
DOCKET NO. AND NAME OF COURT/AGENCY FOR ANY RELATED CASE(S)

NO NO

IS CASE STILL PENDING?

YES

NATURE OF COMPLAINT
EXPLAIN, IN CHRONOLOGICAL ORDER, THE DETAILS OF YOUR COMPLAINT. Please type or print neatly. (If more space is necessary, attach additional sheets)

NAME(S) AND ADDRESSES OF ANY WITNESSES OR PERSONS HAVING KNOWLEDGE OF THE SUBJECT OF THE COMPLAINT

SIGNED (Complainant)

DATE SIGNED

Executed under penalties of false statement.

X
FOR OFFICE USE ONLY
COMPLAINT NO.

DATE AND TIME STAMP

REFERRED TO:

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