230 W. Towne Ridge Parkway, Ste. 200, Sandy, Utah 84070 Phone: 801-542-8856 Email: holly@slrealtors.com COMPLAINT FORM #E-1
GR
EIVANCE COMMITTEE
FILED ON: ____________
INSTRUCTIONS
1. Please download, fill, save, and electronically submit this form to holly@slrealtors.com.
2. Once submitted, your complaint will be presented to the Grievance Committee of the Salt Lake Board of Realtors®.
SECTION 1 COMPLAINANT & RESPONDENT INF
ORMATION
To the Grievance Committee of the Salt Lake Board of Realtors®:
I (COMPLAINANT), __________________________________________
___________________________________________
Primary Complainant Name
Company (if applicable)
and I, _______________________________________
_____
___________________________________________
Additional Complainant Name Company (if applicable)
hereby file an ethics complaint against the following RESPONDENT(S):
__________________________________________ ___________________________________________
Respondent Name Company
__
________________________________________ ___________________________________________
Respondent Name Company
SECTION 2 VIOLATED ARTICLES
Please read the enclosed Code of Ethics. Check the box(es) for the Article(s) you are alleging to
have been violated by
the RESPONDENT(S).
1 4 7 10 13 16
2 5 8 11 14 17
3 6 9 12 15
SECTION 3 ADDITIONAL EVIDENCE
Please ATTACH to this form any additional facts that are relevant and supportive of your claims above, including:
a separate, typed explanation or time-line of events
documents that support your claim (emails, contracts, text messages, etc.)
ETHICS COMPLAINT FORM
1. Have you attempted to communicate with the respondent to resolve this conflict personally?
2. Is the respondent aware that you are now contacting the Salt Lake Board of Realtors®?
3. Would you be willing to allow an ombudsman (a representative of the SLBR Professional Standards Committee) to
contact the respondent(s) to attempt to resolve your complaint? (Further information available upon request.)
4. If the Grievance Committee determines there is a possible violation of the Code of Ethics, you will be required to
attend a formal hearing before the Professional Standards Committee. Are you willing to attend the hearing and
present your case?
5. Are the circumstances giving rise to this ethics complaint involved in civil or criminal litigation?
6. Are the circumstances giving rise to this ethics complaint involved in any proceeding before the state real estate
licensing authority or any other state/federal regulatory or administrative agency or another Realtor® Association?
SECTION 5 PRIMARY COMPLAINANT CONTACT INFORMATION
FIRST NAME: __________________________ MIDDLE NAME: __________________
LAST NAME: ___________________________
PHONE: ____________________________________________ HOME CELL WORK OTHER
EMAIL ADDRESS: ______________________________________________________________________________________________
HOME ADDRESS: ______________________________________________________________________________________________
CITY: ________________________________________ STATE: _______________________ ZIP: ___________________________
GENDER: Male Female Non-binary
I (PRIMARY COMPLAINANT) understand that if the Grievance Committee dismisses this ethics complaint in part or in total,
and I wish to appeal to the Board of Directors, I must do so within 20 days of receiving the dismissal notice.
Under penalty of perjury, I declare that this complaint is true and correct to the best of my knowledge and belief.
I certify that this complaint has been filed within 180 days of the occurrence of the event(s) that constitute the reason(s) for
this complaint OR within 180 days of discovering the alleged issue(s) through exercise of reasonable due diligence.
PRIMARY COMPLAINANT SIGNATURE: ____________________________________
ADDITIONAL COMPLAINANT SIGNATURE: __________________________________
ADDITIONAL COMPLAINANT SIGNATURE: __________________________________
DATE: __
_________________
DATE:
___________________
DATE: ___________________
SECTION 4 CONFLICT RESOLUTION OPTIONS
Please check the appropriate box, as it applies to you.
Please understand that in any ethics hearing, the ultimate burden of proof that the Code of Ethics was violated rests at all times on
the COMPLAINANT. In accordance with NAR policies, "Clear, strong, and convincing" shall be the standard of proof by which the
validity of alleged violations of the Code of Ethics is determined.
230 W. Towne Ridge Parkway, Ste. 200, Sandy, Utah 84070 Phone: 801-542-8856 Email: holly@slrealtors.com COMPLAINT FORM #E-1
SECTION 6 SIGNATURES
PRIMARY COMPLAINANT: Please initial each box and sign below. Have any additional complainants sign below.
YES NO