A-25 Election Complaint Form

Per AMA policy G-610.090, campaign violation complaints should be directed to the Speaker, the Vice Speaker, or the AMA General Counsel and should include the following details:

a. The name of the person(s) thought to have violated the rules
b. The date of the alleged violation and the location if relevant
c. The specific violation being alleged (i.e., the way the rules were violated)
d. The materials, if any, that violate the rules; original materials are preferred over copies. Where necessary, arrangements for collection of these materials will be made.

Please complete this form to officially file a campaign violation complaint.

Should you have additional questions or concerns please reach out to the Speaker, the Vice Speaker, or the AMA General Counsel.

Name of candidate thought to have violated the rules*

First NameLast Name

The date of the alleged violation and the location if relevant*

The specific violation being alleged (i.e., the way the rules were violated)*

The materials, if any, that violate the rules; original materials are preferred over copies. Where necessary, arrangements for collection of these materials will be made.*

List two or three sentences to describe the materials.

Name of person submitting this complaint*

First NameLast Name

Mobile number of person submitting the complaint*

Area CodePhone Number

Email of person submitting the complaint*

example@example.com

Name of delegation submitting this complaint (if applicable):

The contents of this form will be submitted to the Speaker, Vice Speaker and the Office of General Counsel. If you wish to submit to only one of these individuals, please email that person directly with the information requested in this form.