Complaint Form Against Judges

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APPENDIX

COMPLAINT FORM

A two-page complaint form follows.

If the complaint is about a single judge, the complainant must file five
copies of (1) the complaint form, (2) the statement of facts, and (3) any documents
submitted. If the complaint is about more than one judge, one extra copy must be
filed for each additional subject judge.
These materials should be mailed to:

Clerk, United States Court of Appeals


P.O. Box 193939
San Francisco, CA 94119-3939.
Judicial Council of the _________________ Circuit

COMPLAINT OF JUDICIAL MISCONDUCT OR DISABILITY

To begin the complaint process, complete this form and prepare the brief statement of facts
described in item 5 (below). The RULES FOR JUDICIAL-CONDUCT AND JUDICIAL-DISABILITY
PROCEEDINGS, adopted by the Judicial Conference of the United States, contain information on
what to include in a complaint (Rule 6), where to file a complaint (Rule 7), and other important
matters. The rules are available in federal court clerks’ offices, on individual federal courts’
Web sites, and on www.uscourts.gov.

Your complaint (this form and the statement of facts) should be typewritten and must be legible.
For the number of copies to file, consult the local rules or clerk’s office of the court in which
your complaint is required to be filed. Enclose each copy of the complaint in an envelope
marked “COMPLAINT OF MISCONDUCT” or “COMPLAINT OF DISABILITY” and submit
it to the appropriate clerk of court. Do not put the name of any judge on the envelope.

1. Name of Complainant:
Contact Address:

Daytime telephone: ( )

2. Name(s) of Judge(s):
Court:

3. Does this complaint concern the behavior of the judge(s) in a particular lawsuit or
lawsuits?
[ ] Yes [ ] No
If “yes,” give the following information about each lawsuit:
Court:

Case Number:

Docket number of any appeal to the Circuit: ___________________

Are (were) you a party or lawyer in the lawsuit?

[ ] Party [ ] Lawyer [ ] Neither

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If you are (were) a party and have (had) a lawyer, give the lawyer’s name, address, and
telephone number:

4. Have you filed any lawsuits against the judge?


[ ] Yes [ ] No
If “yes,” give the following information about each such lawsuit:
Court:
Case Number:
Present status of lawsuit:
Name, address, and telephone number of your lawyer for the lawsuit against the judge:

Court to which any appeal has been taken in the lawsuit against the judge:

Docket number of the appeal:

Present status of the appeal:

5. Brief Statement of Facts. Attach a brief statement of the specific facts on which the
claim of judicial misconduct or disability is based. Include what happened, when and
where it happened, and any information that would help an investigator check the facts.
If the complaint alleges judicial disability, also include any additional facts that form the
basis of that allegation.

6. Declaration and signature:


I declare under penalty of perjury that the statements made in this complaint are true and
correct to the best of my knowledge.

(Signature)__________________________________ (Date)__________________

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