WISCONSIN JUDICIAL COMMISSION 110 East Main Street, Suite 700 Madison, WI 53703 Phone: (608) 266-7637 Fax: (608) 266-8647 Instructions for Completing “REQUEST FOR INVESTIGATION” Please read the following instructions carefully before completing your Request for Investigation. 1. Print or type all information except your signature. 2. Provide as much information about the alleged misconduct or disability as you can; including relevant dates, times, and places; identify known witnesses. 3. Attach any pertinent documents in your possession, such as transcripts of proceedings, or clearly indicate which documents you believe contain evidence of the alleged misconduct or disability. Send copies of documents or transcripts only, no originals. 4. Make a copy of this Request for Investigation for your files. 5. You may use additional sheets of paper, if necessary. 6. Please check the box on page 3 if you request the Commission not to disclose your identity to the judge or court commissioner prior to the filing of a petition or formal complaint with the Supreme Court. 7. Sign and date the form and send it to the Wisconsin Judicial Commission at the above address. 8/10/06 American LegalNet, Inc. www.FormsWorkflow.com WISCONSIN JUDICIAL COMMISSION 110 East Main Street, Suite 700 Madison, WI 53703 (608) 266-7637 REQUEST FOR INVESTIGATION Name: _______________________________________________________________________ (please type or print) Address: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Phone: Daytime ( ) ____________________ Evening ( ) _____________________ I have information of possible misconduct or disability on the part of _________________________________, of the _____________________________________ Court in (name of judge or court commissioner) __________________________________________, ___________________________, Wisconsin. (city) (county) STATEMENT OF FACTS 1. When and where did this happen? Date(s): 2. Time: Location:____________________________ If your information arises out of a court case, please answer these questions: a) What is the name and number of the case? Case name: ____________________________ Case no.: _______________________ b) What kind of case is it? criminal, civil, domestic relations, juvenile, small claims, probate, other (specify): ________________________________ _______________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com c) What is your relationship to the case? plaintiff/petitioner defendant/respondent attorney for ___________________________________________________________ witness for ___________________________________________________________ other (specify): ________________________________________________________ d) If you were represented by an attorney in this matter at the time of the conduct of the judge or court commissioner, please identify the attorney: Name: __________________________________________________________ Address: __________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Phone: ( e) ) ___________________________________________________________ Identify any other attorney(s) who represented you or any person involved in the case: Name of attorney: ________________________ __________________________ Addresses: ________________________ __________________________ ________________________ __________________________ Phone: Represented: 3. ( ) ____________________ ( ________________________ ) _____________________ __________________________ List documents that help support your information that the judge or court commissioner has engaged in misconduct or has a disability, noting which ones you have attached: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com 4. Identify, if you can, any other witnesses to the conduct of the judge or court commissioner: Name(s): ________________________ __________________________ Addresses: ________________________ __________________________ ________________________ __________________________ ( ( Phone: 5. ) _________________ ) ____________________ Specify below the details of what the judge or court commissioner did that you think constitutes misconduct or indicates disability. (Please type or print legibly; attach additional paper if necessary.) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I UNDERSTAND THAT STATE LAW PROVIDES THAT THE JUDICIAL COMMISSION'S PROCEEDINGS ON THIS REQUEST FOR INVESTIGATION ARE CONFIDENTIAL AND THAT I MAY REQUEST THE COMMISSION NOT TO DISCLOSE MY IDENTITY TO THE JUDGE OR COURT COMMISSIONER PRIOR TO THE FILING OF A PETITION OR FORMAL COMPLAINT WITH THE SUPREME COURT. I REQUEST THE COMMISSION NOT TO DISCLOSE MY IDENTITY TO THE JUDGE OR COURT COMMISSIONER. Signature: _____________________________ Date: _____________________________ American LegalNet, Inc. www.FormsWorkflow.com