Complaint Cover Sheet

OFFICE OF DISCIPLINARY COUNSEL FOR THE STATE OF MONTANA P.O. Box 1099 Helena, Montana 59624-1099 (406) 442-1648 * PLEASE NOTE ODC222S FORMS AND INFORMATION ARE NOW AVAILABLE ONLINE AT www.montanaodc.org COMPLAINT COVER SHEET (Please read attached information before completing.) Date Your Name Please Print Legibly Mailing Address Street or Box No. City State Zip Home Phone Work Phone May we call you at work? Attorney222s Name Name of attorney this complaint is directed against Mailing Address Street or Box No. City State Zip Date you Hired Attorney Amount Initially Paid Attorney Total Amount Paid Do You Presently Owe the Attorney Any Fees? Do You Have a Written Fee Agreement? Y / N If Yes, Please Send Us a COPY. Type of Legal Problem Attorney was Hired to Handle? Is This Matter Still Pending in Court? If Yes, Provide the Names of the Other Parties Involved and the Court File Number if You Have this Information: Have You Previously Filed a Discipline Action Against an Attorney? Y / N If Yes, Please Provide the Details on a Separate Sheet of Paper. 1. Attach a separate sheet of paper with a detailed explanation of the reasons you are filing a complaint against the attorney. Please print legibly. 2. Include as much factual data as possible (i.e. dates, names, phone numbers, amounts of money involved, witnesses, etc.). Please put the information in chronological order. 3. If you have any documents that will help to explain your complaint, please attach copies (do not attach original documents ). 4. Keep the following questions and answers for future reference. American LegalNet, Inc. www.FormsWorkFlow.com