OFFICE OF LAWYER REGULATION GRIEVANCE FORM You cannot save this form or submit it on-line. Please fill it out, print it, sign it and mail to the address below. I hereby request investigation on the basis of the following: Attorney’s name: Your name: Attorney's Street Address: Your Street Address: City: City: State: Zip Code: State: Area Code/Telephone: Was this your attorney? Yes No Zip Code: Area Code/Telephone: Date Attorney Date(s) or time period when was hired: conduct occurred: If no, whose? STATEMENT OF FACTS: Describe specifically, and in chronological order, what the attorney did or failed to do, that you believe was unprofessional. Be sure to include dates. When you are finished, scroll down to page 2. American LegalNet, Inc. www.FormsWorkflow.com What services was the attorney hired to provide? If the representation concerned a lawsuit, give the name of the case and identify the court in which it was filed. What witnesses, if any, are available to support your allegations? Provide their names, addresses and phone numbers and a brief description of the information they have. What documents, if any, support your allegations? Submit with your grievance copies of any such documents in your possession. The Wisconsin Supreme Court requires that this agency conduct all grievance investigations in confidence. I understand that a copy of this grievance and all documents attached hereto will be sent to the attorney who is the focus of this grievance. I certify that all information submitted herewith is true and correct to the best of my knowledge. Signature________________________________ Date________________ THIS FORM CANNOT BE SUBMITTED ONLINE. YOU MUST PRINT IT, SIGN IT AND MAIL IT TO: OFFICE OF LAWYER REGULATION 110 East Main Street, Room 315 Madison, WI 53703-3383 (877) 315-6941 (toll free) or 608-267-7274 For more information regarding the Office of Lawyer Regulation, see our website at www.wicourts.gov/olr American LegalNet, Inc. www.FormsWorkflow.com