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STATE OF NEW YORK
SUPREME COURT, APPELLATE DIVISION
ATTORNEY GRIEVANCE COMMITTEE
THIRD JUDICIAL DEPARTMENT

COMPLAINT FORM

Questions marked with a * are required
Date:
COMPLAINANT INFORMATION:
Your Name:
Address:
Telephone:
Email Address:
ATTORNEY COMPLAINED OF:
Attorney Name:
Address:
Telephone:
Email Address:
DATE YOU HIRED/RETAINED ATTORNEY (If Applicable):
CONTACT WITH OTHER AGENCIES
Have you contacted any other agency, such as a Bar Association, another Grievance Committee, Attorney General's Office, or any other State Agency concerning this matter?
If so, state the name of the agency:
What action was taken by the agency?
COURT ACTION TAKEN BY YOU AGAINST THE ATTORNEY
Have you taken any civil or criminal action against the attorney?
If so, please name the court and provide the index number:
What is the status of the matter and/or what action was taken by the Court?
ALLEGATIONS:
Explain your complaint against the attorney in as much detail as possible. Please be sure to include the following information: Was the attorney paid any money, and if so, how much? What legal services did the attorney agree to perform? What work did the attorney do? What conduct did the attorney engage in that you believe was improper? Please provide a digital copy of all relevant documents, including the retainer agreement, written communications (letters and emails) to and from the attorney, and the names of any witnesses and their contact information (address, telephone number, and email).