New York State Commission on Judicial Conduct

Complaint Form -- Confidential

Download, complete and mail this form to the Commission office nearest
you:

61 Broadway, New York, NY 10006 
38-40 State Street, Albany, NY 12207 
400 Andrews Street, Rochester, NY 14604 

The law requires that complaints to the Commission be in writing and
signed by the complainant.  (See Section 44.1 of the Judiciary Law of
the State of New York.)  A complaint does not have to be sworn or
notarized.  You may submit a complaint by letter or by using this
complaint form. If you submit a letter, please include the kind of
information requested by this form.

Background Information                        Today's Date:
____November 18, 2005___________

Your Name:         ______Samuel H. Sloan
__________________________________________

Address:               ______1664 Davidson Avenue, Apt. 1B
_____________________________

                            _______Bronx NY 10453
_________________________________________

Home Phone:        ______917-507-7226__         Business Phone:
______347-869-2465_____

Are you represented by a lawyer?          _____ Yes    ___X__ No

Lawyer's Name:
____________________________________________________________

        Address:
____________________________________________________________

        Telephone:
____________________________________________________________

Complaint Information

Judge's Name:         ______Kristin Booth Glen
_______________________________

Judge's Court:         _____Supreme Court__  County:    ______New York
____________

Date(s) of Incident(s):         _____September 4, 1986
______________________________

Details of Complaint:

Below and on the back of this sheet, describe the alleged misconduct.
Include as much detailed information as possible, such as what
happened, where and when; the names of witnesses; who said what to
whom, and in what tone of voice; etc.  Use additional sheets if
necessary.

Notarized Affidavit detailing the alleged misconduct is on the
attached sheets 

Complainant's Signature:      _____Samuel H. Sloan


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