The Disciplinary Board of the Supreme Court of Rhode Island Date Return Form to: Chief Disciplinary Counsel John E. Fogarty Judicial Annex 24 Weybosset Street, 2nd Floor Providence, RI 02903 (401) 222-3270 (401) 222-1191 (Fax) Please Print or Type: (First) (Middle Initial) (Last) (Mailing Address - Street or Post Office) (City/Town) (County) (State) Telephone Number(s) Business: (Zip Code) Home Phone: Attorney against whom you wish to file a complaint: (Name) (Mailing Address) Did you employ the attorney: Yes No If yes, give the approximate date of employment: American LegalNet, Inc. www.FormsWorkFlow.com If no, what is your connection with the attorney? Nature of Complaint. (a) Provide a detailed description(dates, names, etc.) of the attorney's conduct. (b) Attach additional pages as necessary. (c) Please provide a copy of any document(s) that you refer to in your complaint. (d) Please sign your complaint. If your complaint is about a law suit, please furnish the following information, if available: Title of Suit: Suit Number: Date Suit Filed (approximate) Name of Court: _____________________________________________ (Signature) American LegalNet, Inc. www.FormsWorkFlow.com