Complaint Form

I. Person Making Complaint

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

III. Statement of Facts

In the following section, please state the specific facts and circumstances that you believe amount to judicial misconduct or disability. Please be sure to provide all relevant details, names, dates, places, addresses and phone numbers which may assist the Commission in their review of your complaint.Each allegation that you state should be factual and specific, but as brief and to the point as you can state it.*

b. If you were represented by an attorney in this matter at the time of the judge’s conduct, please identify the attorney:

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Email

c. Attach copies of any relevant documents which you believe support your claim that the judge has engaged in judicial misconduct or has a disability.

Please combine files if you have multiple files.

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Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 40 MB.

d. Identify, if you can, any other witnesses to the conduct about which you complain:

Person 1:

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Person 2:

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

In filing this complaint, I understand that:

The Commission’s rules provide that all proceedings of the Commission, including complaints filed with the Commission, shall be kept confidential, until this complaint has been resolved. I further understand that this rule of confidentiality attaches and becomes effective upon the filing of this complaint and that any violation could result in a citation for contempt of the Supreme Court. The Commission may find it necessary to disclose my identity and the existence of this complaint to the involved judge. By filing this complaint I expressly consent to any such disclosure.

Consent*

V. Under penalty of perjury, I declare that I have examined and understand this complaint form and to the best of my knowledge and belief, the above information is true, correct, and complete and submitted of my own free will.

Date*

Complainant’s Signature*

Name

This field is for validation purposes and should be left unchanged.

Complaint Form

Complaint against a Georgia judge

I. Person Making Complaint

II. Judge Against Whom Complaint Is Made

Court is located in:

III. Statement of Facts

IV. Additional Information (if available)

a. If your complaint arises out of a court case, please answer the following questions:

b. If you were represented by an attorney in this matter at the time of the judge’s conduct, please identify the attorney:

c. Attach copies of any relevant documents which you believe support your claim that the judge has engaged in judicial misconduct or has a disability.

d. Identify, if you can, any other witnesses to the conduct about which you complain:

Person 1:

Person 2:

In filing this complaint, I understand that: