ATTORNEY ETHICS GRIEVANCE FORM Please Type Or Print Legibly All Information A. GRIEVANT: Mr./Mrs./Miss./Ms. (Circle One) LAST NAME FIRST MIDDLE ADDRESS STREET/P.O. BOX CITY STATE ZIP TELEPHONE: DAY (_____) ___________________ B. EVENING (_____) _____________________ THE SPECIFIC LAWYER YOU ARE COMPLAINING ABOUT IS: LAST NAME (INCLUDE SR., JR., III, ETC.) FIRST OFFICE ADDRESS STATE MIDDLE STREET/P.O. BOX CITY (1) (2) (3) (4) C. COUNTY ZIP COUNTY IS THE SPECIFIC LAWYER COMPLAINED ABOUT YOUR LAWYER? ___ YES ___NO IF SO, DOES THIS LAWYER STILL REPRESENT YOU? ___ YES ___NO IF NOT, DO YOU HAVE A NEW LAWYER? ___ YES ___NO IF SO, WHO IS YOUR NEW LAWYER? ____________________________________________________________ THE TYPE OF CASE HANDLED BY THE LAWYER WAS: (CHECK ONE) _____ _____ _____ _____ _____ Admiral/Maritime Adoption/Name Change Bankruptcy/Insolvency/Foreclosure Collection Contract (V) (A) (B) (H) (K) _____ _____ _____ _____ _____ _____ _____ Corporation/Partnership Law Criminal, Quasi-Criminal and Municipal Court Domestic Relations (Divorce, Support, Custody) Estate/Probate Federal Remedies/Civil Rights Government Agency Problems (Local thru Federal) Immigration/Naturalization (X) (C) _____ _____ _____ _____ _____ (I) (J) (L) (Q) (N) _____ _____ International Law Juvenile Delinquency Labor Landlord/Tenant Negligence (Personal Injury) Property Damage Patent/Trademark/Copyright Real Estate (D) _____ Small Claims Court (S) (E) (F) (G) _____ _____ _____ (T) (W) (Y) (M) _____ Tax Workers’ Compensation Other Litigation (specify) ________________________________ Other Non-Litigation (specify) ________________________________ IS THE CASE HANDLED BY THE LAWYER STILL PENDING? _____ YES (P) (R) (Z) _____ NO (This Section for Secretary’s Use Only) DOCKET NUMBER _________________ DATE DOCKETED _________________ ** COMPLETE BOTH SIDES ** American LegalNet, Inc. www.FormsWorkflow.com D. OTHER RELATED COMPLAINTS OR LITIGATION: (1) Have you filed a complaint regarding this matter with law enforcement authorities or any other state or federal agency? _____YES _____NO If yes, please state: Name of Agency: _________________________________________________________________ Contact Person: ____________________________ Date Filed: ____________________________ Result: __________________________________________________________________________ (2) Is the matter you are complaining about the subject of a pending civil law suit? _____YES _____NO If yes, give name of Court ___________________________________________________________ Docket Number: ___________________________ County: ________________________________ E. NATURE OF GRIEVANCE: State what the lawyer did or failed to do which may be unethical. State all relevant FACTS including dates, times, places and names and addresses of important witnesses. Attach copies of important letters and documents. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (Use Additional Sheets if Necessary) F. INVESTIGATIVE CONFIDENTIALITY The Supreme Court of New Jersey has held that persons who file grievances “may speak publicly regarding the fact that a grievance was filed, the content of that grievance, and the result of the process.” Since disciplinary officials are required by Rule 1:20-9(h) to maintain the confidentiality of the investigation process and may neither speak about the case nor release any documents, until and unless a formal complaint is issued and served, you must also keep confidential any documents you may receive during the course of the investigation of your grievance. To protect the integrity of the investigation process, we recommend that you, as well as all witnesses, not speak about the case other than to disciplinary officials while the matter is under investigation. So long as you maintain the confidentiality of the investigation process, you have immunity from suit for anything you say or write to disciplinary officials. However, the Supreme Court has stated that you “are not immune for statements made outside the context of a disciplinary matter, such as to the media or in another public forum.” R.M. v. Supreme Court of New Jersey, 185 N.J. 208 (2005). Date: ___________________________ ____________________________________ Signature PLEASE REVIEW THE PAMPHLET “INFORMATION ABOUT GRIEVANCE PROCEDURES AND DISCIPLINE OF LAWYERS” PROVIDED BY THE ETHICS SECRETARY. PLEASE NOTIFY DISTRICT SECRETARY OF DISABILITY ACCOMMODATION NEEDS. OAE 03/06 American LegalNet, Inc. www.FormsWorkflow.com