Complaint Form for Improper Conduct of an Office of Administrative Hearings Administrative Law Judge (ALJ) This form is for filing a complaint about an ALJ’s conduct. This form is not for filing a complaint about the ALJ’s ruling or decision. A complaint about a ruling or decision should be filed through the appeal or petition for review process as outlined in the decision. Within ten days after receiving your complaint, OAH will send you an acknowledgement letter. An investigation will be conducted and you will receive a written response to your complaint within 30 days after receipt of your complaint. However, if the matter under appeal is still pending before the Office of Administrative Hearings at the time you file your complaint, you will receive a written response to your complaint within 30 days after issuance of the ALJ’s decision. [WAC 10-16-010] Name of Person Making Complaint First Name Last Name Address Street Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Code Phone Phone Number Email Case Name(s) Docket Number(s) Complaint Information: Name of ALJ First Name Last Name Date of Incident Date of Incident: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Date of Incident: Day Day12345678910111213141516171819202122232425262728293031 Date of Incident: Year Year1900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 Names of Individuals Present During Incident (if known) Summary of ALJ's Conduct (please describe the conduct or behavior alleged to be improper) Details of Incident (please state specific facts and provide any other information which would assist in the investigation of the complaint) If you have a disability and require accommodations to file an ALJ complaint, please contact OAH at (360) 407-2700 / toll free 1-800-583-8271 or email us at OAH_ADACoordinator@oah.wa.gov By checking this box, I attest the above information is true and correct to the best of my knowledge. Submit Leave this field blank
