U
SCA Form
July 2021 (REVISED)
JUDICIAL COUNCIL OF THE DISTRICT OF COLUMBIA CIRCUIT
COMPLAINT OF JUDICIAL MISCONDUCT OR DISABILITY
E. Barrett Prettyman U.S. Courthouse
333 Constitution Avenue, N.W.
Washington, D.C. 20001-2866
202-216-7340
This form should be completed and mailed to the above address to the attention of the "Circuit Executive".
The envelope should be marked "JUDICIAL MISCONDUCT COMPLAINT" or "JUDICIAL DISABILITY
COMPLAINT". Do not put the name of the judge on the envelope.
The "Rules for Judicial-Conduct and Judicial-Disability Proceedings", adopted by the Judicial Conference of
the United States, contain information on what to include in a complaint (Rule 6), where to file a complaint
(Rule 7), and other important matters. Your complaint (this form and the statement of facts) should be
typewritten and must be legible. Only the original form and up to a five page statement of facts should be
submitted. No copies are required.
1. Name of Complainant:
Address:
Telephone: -
2. Name(s) of Judge(s) complained about:
Court:
3. Does this complaint concern the behavior of the judge(s) in a particular lawsuit or lawsuits?
Yes No
If "yes" give the following information about each lawsuit (use reverse side if more than one):
Court:
Case number:
Are (were) you a party or lawyer in the lawsuit?
Party
Lawyer
Neither
If you are (were) a party and have (had) a lawyer, give the lawyer's name, address, and telephone number:
Docket number(s) of any appeals of above case(s) to the Court of Appeals, D.C. Circuit:
(
)
U
SCA Form
July 2021 (REVISED)
4. Have you filed any lawsuits against the judge?
Yes No
If "yes" give the following information about each lawsuit (use the reverse side if more than one)
Court:
Case number:
Present status of lawsuit:
Your lawyer's name:
Address:
Telephone:
(
)
_
Court to which any appeal has been taken in the lawsuit against the judge:
Docket number of the appeal:
Present status of the appeal:
5. Brief Statement of Facts. Attach a brief statement of the specific facts on which the claim of judicial
misconduct or disability is based on up to five single-sided pages (8.5 x 11"). Include what happened,
when and where it happened, and any information that would help an investigator check the facts. If
the complaint alleges judicial disability, also include any additional facts that form the basis of that
allegation. See Rule 6 (a) for further information on what to include in your statement of facts.
Declaration and Signature:
I declare under penalty of perjury that the statements made in this complaint are true and
correct to the best of my knowledge.
Signature: Date:
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