Please contact our office if you require assistance or require an interpreter to complete this form (see back page for contact details).

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COMPLAINT FORM IMPORTANT INFORMATION BEFORE COMPLETING THIS FORM Please contact our office if you require assistance or require an interpreter to complete this form (see back page for contact details). As well as completing this form, please attach photocopies (not originals) of any documents you feel the Legal Profession Board of Tasmania will need in considering your complaint. If you wish to complain about more than one legal practitioner, please submit a separate Complaint Form about each of them. The Legal Profession Board of Tasmania is required to send a copy of your complaint to the legal practitioner or legal firm concerned unless by doing so it will or is likely to: 1. prejudice the investigation of the complaint; or 2. prejudice an investigation by the police or other investigatory or law enforcement body; or 3. place you or any other person at risk of intimidation or harassment; or 4. prejudice pending court proceedings. If you consider any of the above points (1-4) apply in your case, please explain on this form precisely why the lawyer should not receive a copy of your complaint form. Please understand this office cannot provide legal advice or legal assistance, nor influence the outcome of court proceedings. Please ensure you are as concise and brief as possible and as far as possible record dates in the order they occurred. Please ensure you sign and date the Declaration on the last page before submitting this form. Time Limit Please note that the Board may be unable to deal with your complaint if it is made more than 3 years after the conduct is alleged to have occurred. If this may be applicable, please contact us to discuss the matter before completing this form. V.4 1

1. Your details Title:... Given name:... Surname:... Address:...... Postcode:... Phone: (H)... (W)... (M)... Fax.... Email:... Date of birth (optional):... Male Female Main language spoken at home:... Are you making this complaint on behalf of another person, such as a client or relative: Yes No If yes, please tell us who you are making the complaint for and why? Complainant s name:... Address:...... Postcode:... Reason:... 2. Details of the legal practitioner against whom you wish to complain Practitioner s name:... Name of firm/chambers:... Address:...... Postcode:... Phone:... Fax:... V.4 2

3. Before you lodge a formal complaint Have you already tried to resolve this complaint? Yes No If yes, how?... Please attach copies of relevant correspondence. Have you previously complained about this matter to the Legal Ombudsman, Tasmanian Law Society or other organisation? Yes No If yes, approximate date of complaint:... File reference (if available):... 4. The legal practitioner named in question 2 (above) acted as: my solicitor my barrister lawyer for the other side other... V.4 3

5. The area of law that my complaint relates to is: administrative law employment personal injuries building family/defacto probate / family provisions commercial/corporations/franchise immigration victims compensation constitutional law insolvency wills / powers of attorney conveyancing land & environment law workers compensation criminal leases/mortgages other civil (please specify)... 6. By making this complaint to the Legal Profession Board of Tasmania, I am hoping to achieve the following outcome(s): have my documents/files transferred have the lawyer disciplined receive an apology resolve my dispute about fees improve my communication with the lawyer improve the service provided by the lawyer resolve my dispute with the lawyer receive financial compensation other (please briefly list your expectations)... V.4 4

7. Please tell us about your complaint In the space below please describe the conduct which is the subject of your complaint. It would be helpful if your were to; Give a brief description of events that led to your complaint (what happened, when, who was involved etc). State what your particular complaints are (e.g. poor communication, quality of service, behaviour, dishonesty, negligence etc). Include details of significant events such as dates of meetings and court hearings. Please attach copies of relevant documents to support your complaint and a list of these documents. Do not send original documents. If there are witnesses who could provide independent evidence that will help us deal with your complaint, please provide their names and full contact details. Please indicate why you think they could help. V.4 5

8. Costs Please only complete this section if your complaint or part of your complaint relates to costs. I received written information about the method of charging Yes No If yes, please attach a copy. I attach a copy of my bill(s) from the legal practitioner Yes No (Details of the bill must be provided) The total amount of the bill(s) in this matter is/are: Legal practitioner s fee $... Disbursements or other legal expenses $... Date(s) of bill(s):... My problem with the bill(s) is that: I was quoted a smaller amount, namely $... I think the bill is too high for the amount of work done I think the bill includes work that was not done I think the legal practitioner handled the matter badly and I should not have to pay for this Other (give details)... The legal practitioner has been paid: Yes (in full) Date of payment... Yes (in part) Amount $... Date of payment... No V.4 6

9. Declaration Note: If you are making this complaint on behalf of someone else (e.g. your partner or parent) please include a signed written authority from that person allowing you to complain on their behalf. I declare that the information I have given in, and with this complaint, is true and correct. Signed:... Date:... Please send the completed form and photocopied attachments to: Legal Profession Board of Tasmania Phone: (03) 6226 3000 GPO Box 2335 Fax: (03) 6223 6055 HOBART TAS 7001 V.4 7