Statement of Grievance Regarding e-Filing Access Plan

FOR COURT USE ONLY
GRIEVANCE NO:
DATE RECEIVED:

Use  this  form  to  submit  specific  issues  regarding  e-Filing  access  at  a  court.    Submit  the  completed  form  to  the  court 
administrator.  The court will respond in writing to your grievance within five business days.

First and last name of person requesting review

Court no. and name

Case no. (if applicable)

Mailing address, e-mail address, and telephone no.

Describe in detail your complaint. Include dates of particular incidents, names of individuals involved, locations of
computer workstations, your concerns, and any other information that will help in reviewing your complaint. If you need 
more space, attach separate sheets.

                                                                                               

Signature of person requesting review and date

Response to Statement of Grievance 

Response:

                                                                                                

Chief judge/Court administrator and date

                                                                                                

Address

                                                                                                

COURT USE NOTE:  Distribute copies of the completed response to the grieving party, chief judge, and SCAO regional administrator.

City, state, zip                                                                            Telephone no.

Approved, SCAO
Form MC 98, Rev. 7/19
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