Grievance Form - The Oklahoma Bar Association Page 2
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1
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3GRIEVANCE FORM
RETURN FORM TO:
Oklahoma Bar Association
ATTN: General Counsel
P.O. Box 53036
Oklahoma City, OK 73152
Your Name: G Mr. _________________________________________________________________
G Mrs.
(First)
(Middle)
(Last)
G Ms.
______________________________________________________________________
(Street Address)
______________________________________________________________________
(City)
(State)
(Zip)
Telephone Number(s): Business:_________________________ Home: ______________________
Attorney against whom you wish to file a grievance:
___________________________________________________________________________________
(Name)
__________________________________________________________________________________
(Address)
(City)
(Zip)
Telephone Number(s): Business_________________________ Home: _______________________
1.
Did you employ the attorney? Yes _____ No _____
Approximate date you employed the attorney: ________________________________________
Was there a written agreement for services? Yes _____ No _____ (If Yes, attach copy)
What, if any, was the amount paid to the attorney? ___________________
Date Paid: _________________________
2.
If you did not employ the attorney, what is your connection to him/her?
___________________________________________________________________________
3.
Please furnish the following information, if available:
Name of Court/County: ________________________ Case Number: ______________________
Title of Suit :__________________________________ vs. _____________________________
___________________________________________________________________________
Approximate Date case was Filed: _________________________________________________
4.
If you are or have been represented by any other attorney with regard to this same matter, state
the name and address of the other attorney:__________________________________________
5.
If you have made a grievance about this same matter to any other Official or Agency, state its
(their) name(s), and the approximate date you reported it:
___________________________________________________________________________
6.
In the event a disciplinary hearing is held, would you be willing to appear and testify as a witness?
Yes _____ No ______
* * * DO NOT WRITE ON BACK OF FORM * * *
* * * DO NOT SEND ORIGINAL DOCUMENTS, PROVIDE COPIES
AS ORIGINALS CANNOT BE RETURNED * * *
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