JUDICIAL COUNCIL OF THE DISTRICT OF COLUMBIA CIRCUIT COMPLAINT OF JUDICIAL MISCONDUCT OR DISABILITY E. Barrett Prettyman U.S. Courthouse 333 Constitution Avenue, N.W. Washington, D.C. 20001-2866 202-216-7340 his form should be completed and mailed to the above address to the attention of the "Circuit Executive". The envelope should be marked "JUDICIAL MISCONDUCT COMPLAINT" or "JUDICIAL DISABILITY COMPLAINT". Do not put the name of the judge the envelope. 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. Your complaint (this form and the statement of facts) should be typewritten and must be legible. 1. Address: Complai : Telephone: 2. Court: 3. Judge ( ) _ omplained about: Does this complaint concern the behavior of the judge(s) in a particular lawsuits? Yes No If "yes" give the following information about each lawsuit (use reverse side if more than one): Court: Case number: Are (were) you a party or lawyer in the lawsuit? Party Lawyer Docket number(s) of any appeals of above case(s) to the Court of Appeals, D.C. Circuit: USCA Form June 2016 (REVISED) American LegalNet, Inc. www.FormsWorkFlow.com 4. Have you filed any lawsuits against the judge? Yes No If "yes" give the following information about each lawsuit (use the reverse side if more than one) Court: Case number: Present status of lawsuit: Your lawyer's name: Address: Telephone: ( ) _ 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. a brief statement of the specific facts on which the claim of sconduct or disability is based . Include what happened, when and where it happened, d any information that would help an investigator check the facts. If the complaint alleges icial disability, also include any additional facts that form the basis of that allegation. See e 6 (a) for further information on what to include in your statement of facts. 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: ____________________ USCA Form June 2016 (REVISED) American LegalNet, Inc. www.FormsWorkFlow.com