Complainants Name Date filed
I believe that the Judge is guilty of misconduct in office, persistent failure to perform his or her duties, habitual
intemperance and conduct on or off the bench which is prejudicial to the administration of justice. The judge’s
mental or physical disability prevents him or her form the proper performance of the Judge’s judicial duties, or
has violated the Code of Judicial Conduct of the Saint Regis Mohawk Tribe.
I affirm under the penalty of perjury that the statements and facts provide are true and correct to the best of my
Complainant Signature Date
State of New York
County of Franklin
Before me came _______________ on this __________
Day of ______________________ in the year ________.
Notary Public Seal