__________________________________________ ______________
Complainants Name Date filed
Office of the Judicial Oversight Commission
Saint Regis Mohawk Tribe
412 State Route 37, Akwesasne, New York 13655
Phone: 518-358-2272 Fax: 518-358-4295
COMPLAINANT
Last Name
First Name
Date of Birth
Address
Telephone (Res)
Telephone (Cell)
City
Telephone (Office)
E-mail
Fax ( )
I WOULD LIKE TO COMPLAIN ABOUT THE CONDUCT OF THE FOLLOWING JUDGE(S) OF THE SAINT REGIS
MOHAWK TRIBAL COURT
1 Name
2 Name
3 Name
4 Name
DATE AND HOUR OF THE EVENT THAT GIVE RISE TO THE COMPLAINT
Year
Day
Hour
Generally the time limit for filing a complaint is 2 years from the date of the
event or the awareness of the event from which the complaint arose.
PLACE(S) OF EVENT(S) complete address, if available
1
2
3
4
Number of Judicial files (if applicable)
1
2
3
4
COMPLAINT FILED
__________________________________________ ______________
Complainants Name Date filed
ENCLOSE COPY OF RELATED DOCUMENTS COURT PORCEEDINGS, CORRESPONDENCES, STATEMENT OF THE
COMPLAINANT AND FACT.
Provide a summary of the events and explain your complaint describing precisely the acts or omissions reproached and reporti
comments as accurately as possible.
ATTACH MORE SHEETS IF NECESSARY
__________________________________________ ______________
Complainants Name Date filed
__________________________________________ ______________
Complainants Name Date filed
WITNESSES
1 Name
Last Name
Telephone ( )
Address
2 Name
Last Name
Telephone ( )
Address
3 Name
Last Name
Telephone ( )
Address
4 Name
Last Name
Telephone ( )
Address
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
knowledge.
____________________________________________________________
Complainant Signature Date
State of New York
County of Franklin
Before me came _______________ on this __________
Day of ______________________ in the year ________.
_______________________________________________
Notary Public Seal