COMPLAINT MAIL TO: Judicial Inquiry and Review Commission Post Office Box 367 Richmond, Virginia 23218-0367 Note: The Commission does not accept fax or e-mail complaints. Name of Judge Location of Court Date of Incident Case Name or Number (if known) Name and telephone number of persons who witnessed the judge's conduct: Description of what the judge said or did that you believe was improper: Name: (printed/typed) (additional pages may be attached) Daytime Telephone: Address: _______________________________________________ Date: ________________ Signature Note: The Commission does not accept unsigned complaints. Revised: 04/03/2006 American LegalNet, Inc. www.FormsWorkflow.com