Pro-Standards – Form D3 – RESPONSE TO DISCIPLINARY HEARING Step 1 of 3 33% Case #:(Required)Primary Complainant(s)(Required)VS.Primary Respondent(s)(Required)Additional Parties: (optional)Complainant(s)VS.Respondent(s)Response Statement: I (we), the undersigned respondent(s), respond to the complaint and substantiate my response as set forth in the attached statement marked "Exhibit A," which is hereby incorporated by reference and made part of this response. I understand there will be a recording of the disciplinary hearing. I understand that I may purchase a copy of the recording solely for the purpose of requesting a review of the hearing decision by the Association’s Board of Directors. I understand that the proceedings regarding this matter will be kept confidential and that I have an obligation to maintain and protect this confidentiality. I understand that C.A.R. will publish my name, photo, and the decision rendered only if I am found in violation and I am disciplined with a Letter of Reprimand, Fine, Suspension, or Expulsion. If I receive such discipline for a violation, I understand that I am required to submit a photo and grant permission for its publication. I also understand that the Association may publish my name, photo, and the decision rendered pursuant to its publication policy. I understand that I must abide by the rules and procedures used by the Association to conduct disciplinary hearings, a copy of which has been provided to me for my review and use. I understand that if I am found in violation, in addition to any discipline that may be imposed, I may be subject to an administrative processing fee. I hereby affirm that the facts and circumstances and the parties in this matter are not related to any pending civil litigation matter or criminal investigation, including proceeding before a governmental regulatory agency. If I am unable to make this affirmation, I have attached a written statement describing the pending matter on a separate sheet of paper and have included it with this response. Exhibit "A":(Required) Drop files here or Select files Max. file size: 20 MB, Max. files: 5. I will be represented by an attorney:Name First Last Firm Name:Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Declarations:Under the penalties of perjury, I (we) declare that to the best of my (our) knowledge and belief that the statements in this response are true and correct.(Required) Yes, I Declare Declaration Date:(Required) MM slash DD slash YYYY Declaration Location (a city within California):(Required)Respondent(s) declaring this Statement:(Required) First Last Firm:(Required)Address:(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone:(Required)Email:(Required) Additional Respondent(s) declaring this Statement: First Last Firm:Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone:Email: Δ
