Form #E-1

__________________________________________________________________________________________________________

Board or State Association

__________________________________________________________________________________________________________

Address City State Zip

Ethics Complaint

To the Grievance Committee of the ___________________________________________________________________________

Board or State Association

Filed _______________________________, 20___________

__________________________________________________ __________________________________________________

__________________________________________________ __________________________________________________

Complainant(s) Respondent(s)

Complainant(s) charge(s):

An alleged violation of Article(s) ___________________________________ of the Code of Ethics or other membership duty as set

forth in the bylaws of the Board in ________________________________________________ and alleges that the above charge(s)

Article, Section

(is/are) supported by the attached statement, which is signed and dated by the complainant(s).

This complaint is true and correct to the best knowledge and belief of the undersigned and is filed within one hundred eighty (180)

days after the facts constituting the matter complained of could have been known in the exercise of reasonable diligence or within one

hundred eighty (180) days after the conclusion of the transaction, whichever is later.

I (we) declare that to the best of my (our) knowledge and belief, my (our) allegations in this complaint are true.

Are the circumstances giving rise to this ethics complaint involved in civil or criminal litigation or in any proceeding before the state

real estate licensing authority or any other state or federal regulatory or administrative agency?

p Yes p No

You may file an ethics complaint in any jurisdiction where a Realtor® is a member or MLS participant. Note that the Realtors® Code

of Ethics, Standard of Practice 14-1 provides, in relevant part, “Realtors® shall not be subject to disciplinary proceeding in more than

one Board of Realtors® . . . with respect to alleged violations of the Code of Ethics relating to the same transaction or event.”

Have you filed, or do you intend to file, a similar or related complaint with another Association(s) of Realtors®?

p Yes p No

If so, name of other Association(s): _______________________________________ Date(s) filed: _________________________

I understand that should the Grievance Committee dismiss this ethics complaint in part or in total, that I have twenty (20) days from

transmittal of the dismissal notice to appeal the dismissal to the Board of Directors.

Complainant(s):

__________________________________________________ __________________________________________________

Type/Print Name Signature

__________________________________________________ __________________________________________________

Type/Print Name Signature

_________________________________________________________________________________________________________

Address

__________________________________________________ __________________________________________________

Phone Email

(Revised 11/14)

Code of Ethics and Arbitration Manual