(individual filing the complaint)


(individual against whom the complaint is directed)

Summary of Complaint

Please describe your complaint and attach supporting documents below.

Complainants Signature (read, then check all boxes below and sign)

I read the instructions for Filing a Complaint of Alleged Violation of the AAPL Code of Ethics

I read the Code of Ethics* and cited the sections(s) that have allegedly been violated.

I enclosed a written summary of facts on which this complaint is based.

I enclosed supporting documentation (if any) that corroborates and supports the allegations in the complaint and redacted confidential information, if any.

If this complaint was filed with another organization (e.g., licensing board), I enclosed correspondence related to this filing and status/final resolution.

I affirm that the statements and information in this complaint are correct, complete, and truthful to the best of my knowledge and belief.

Note to Complainants who are AAPL members: It is the duty of AAPL members to come forward with evidence of perceived violations of the AAPL Code of Ethics. However, each AAPL member should be mindful of his or her obligation regarding confidentiality and possible sanctions for abuse of complaint procedures. Your signature above signifies that the complaint brought to the Ethics Advisory Committee in good faith and not for the purpose of resolving private, business, legal, or other disputes for which a more appropriate forum exists.