Rev. 9/16
Magistrate Complaint Form
VIRGINIA MAGISTRATE SYSTEM
Mail to:
DEPARTMENT OF MAGISTRATE SERVICES
OFFICE OF THE EXECUTIVE SECRETARY
100 N. Ninth Street
Richmond, VA 23219-2335
Telephone: (804) 786-8476
NOTE: Complete and submit this form if you have a complaint about a
magistrate’s conduct. The Office of Executive Secretary of the Supreme
Court of Virginia, the appointing and supervising authority for Virginia
magistrates, takes all complaints against magistrates very seriously. Your
complaint will be given our full attention and will be resolved as quickly as
possible.
YOUR NAME:
Mr.
Mrs.
Miss
Ms.
First
Initial
Last
YOUR
ADDRESS:
Daytime Telephone No.:
Street
Home:
( )
Street
Work:
( )
Other Telephone No. & times you can be reached:
City State Zip
( )
( )
E-mail
M
AGISTRATE
S
NAME
First
Initial
Last
MAGISTRATES
OFFICE
ADDRESS:
Street or P.O. Box
Magistrate’s Telephone No.:
City
State
Zip
( )
DESCRIBE YOUR COMPLAINT AGAINST THE MAGISTRATE:
(Continue on the back or a separate page if you need more space. Also, attach copies of any documents that help explain your complaint.)
Answer the following questions:
Have you or any member of your family contacted us about this magistrate before? Yes or No.
If yes, did the previous contact involve the same complaint? Yes or No.
Furthermore, if yes, please state when you or your family member made the complaint and what was the outcome?
Y
OUR
SIGNATURE:
Signature
Date
FORM MUST BE SIGNED AND DATED
click to sign
signature
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