For SCJC use only. State Commission on Judicial Conduct PO Box 12265 Austin, TX 78711-2265 Tel. (512) 463-5533 · Toll Free: (877) 228-5750 Complaint Form • If you are filing a complaint about more than one judge, please use a separate form for each judge. • You may complete this form online before printing. • Send the completed form and any additional pages or related documents to SCJC. *  Indicates required fields. Please note that faxed complaints will NOT          be accepted. *  Submitter Name:   *  Mailing Address:   *  City, State Zip:   *  Date of Birth:   *  Submitter Email:   Your Day Phone: ( ) - Your Cell/Other Phone: ( ) - Your Evening Phone: ( ) - Best time to call you: A.M P.M *  Judge:   *  Court Number:   *  City and County:   If your complaint involves a court case, please provide the following information: Cause Number: Your attorney: Address: City/Zip: Phone Number: ( ) - Status of your case: Pending   Concluded   On Appeal   Opposing Attorney: Address: City/Zip: Phone Number: ( ) - PLEASE FILL IN ALL INFORMATION AVAILABLE FOR ANY WITNESSES (attach additional pages as needed) Name: Address: Phone Number: ( ) - What did this person witness?
Name: Address: Phone Number: ( ) - What did this person witness?
If you are submitting documents, please provide copies, not originals. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I understand that as part of the Commission's investigation the judge may be provided a copy of this complaint. Please note - the Commission will do its best to maintain your confidentiality, if you so request. However, it may not be possible for us to pursue our investigation without revealing your identity at some point. If it is necessary to reveal your identity directly to the judge, we will advise you before proceeding. *  I request that my identity be kept confidential. Yes   No     *  Signature:   *  Date:   Revised 01/30/2016 Details of Complaint Please type or print the factual details of your complaint in the space provided below. Please include the date(s) of the alleged misconduct. If more space is needed, attach additional sheets. Please sign and date each additional sheet. Your complaint should be as specific as possible, PLEASE DO NOT CITE CASE LAW IN YOUR COMPLAINT. *  Date(s) of Alleged Misconduct of Judge:   *  Factual Details of your complaint against Judge:   How did you hear about the State Commission on Judicial Conduct? ( please select one ) State Bar of Texas   Another State agency   News media   Attorney   Friend   Other: *  Printed Name:   *  Signature:   *  Date:  


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