Attorney name: (ONE
ATTORNEY PER REQUEST) ______________________________________________________________________________________________
Street and Number: ___________________________________________________________________________________________
City, Zip Code and State: _________________________________________________________________________
Area Code and telephone number: ______________________________________
Date attorney was hired/appointed?___________________
Type of case: (divorce, criminal, probate, etc.) ____________________________
Name of Court _____________________________ Case # ________________
Have you previously complained to
our office about this attorney?_______ When?____________
| You must
provide two (2) completed copies of this form and two (2)
copies of all attachments. We cannot process unsigned complaints. (Name – type or print)_______________________________ Date: ___________________ (Signature) _______________________________________ ________________________________________________
|