• Lawyers Mutual Insurance
  • Lawyers Mutual Insurance
  • Lawyers Mutual Insurance
Bar Complaint Form

GENERAL INFORMATION
*Firm Name:
Required
*Lawyer:
Required
*Complaint Filed By:
Required
*EMail:
Required
*KBA initial contact with Lawyer:
Required
*KBA required a response from Lawyer
Required
*Matter is currently:
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*Was there any employed counsel?
Required
Please provide counsel details:
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*If resolved, was the outcome:
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Suspension Details:
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Other Details:
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*Allegation of person filing Bar Complaint:
Required
*Law firm/lawyer’s description of the matter, the events surrounding the Bar Complaint:
Required

Please attach a copy of any/all the Bar Complaint filed with the KBA and any response the lawyer, the law firm, or counsel for the law firm has submitted to the KBA.
Required
Accepted file formats: .bmp | .doc | .docx | .jpg | .jpeg | .pdf | .png | .ppt | .pptx | .txt
Required
Accepted file formats: .bmp | .doc | .docx | .jpg | .jpeg | .pdf | .png | .ppt | .pptx | .txt
Required
Accepted file formats: .bmp | .doc | .docx | .jpg | .jpeg | .pdf | .png | .ppt | .pptx | .txt
Required
Accepted file formats: .bmp | .doc | .docx | .jpg | .jpeg | .pdf | .png | .ppt | .pptx | .txt

The above information has been reviewed and is certified to be correct.
I understand that the information submitted on this application becomes part of the policy for professional liability insurance and is subject to the same terms and conditions.
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