Violations Submission Form

    Violation Submission Form

    This form is for victim that their human rights were violated. Please fill the form completely. Questions with “*” are mandatory, please answer them to assist us on documenting. This data will be used accordingly with our privacy policy.

    1. Please inform us with your status ?A victimReporting on behalf of a Victim
    Victim’s Information

    Please enter the victim contact information if you'd like for us to follow up with you.

      1. Gender [group group-gender-other][/group]
      2. Was the victim under 18 years of age when the violation occurred? YesNo
    [group info-group-field]
    A Reporter Information
  • Do you have an authorization by the victim’s family to directly submit the form on their behalf? YesNo
  • Will you be able to follow and transfer information between the family and Huqooq team in case any further explanations were needed? YesNo
  • Please enter your contact information so we could follow up with you.

    [/group]
    Information Regarding the Incident

    Please provide detailed informations as possible.

      1. [group group-vttype-other][/group]
    1. More Information Regarding the Incident
    2. Party responsible for the violation, please explain why you think this party is the responsible one. e.g. uniform, you already know them…etc.:
    3. Please provide detailed information about the case and the circumstances the case in chronological order. Please specify if the incident is continuous and/or still going on
    4. If there were any witnesses to the incident, please give their names, relation to the victim. If they wish to keep their identity confidential please clarify, if they are relatives, pass-byers, or else. If there is an evidence, please point it out
    5. Has there been any action taken by the family or acquaintances after the violation was committed (reporting to official authority / informing Human Rights organizations) if not clarify why?
    6. YesNo
    7. [group group-img]
    8. Attach an image of the victim before and after the victim’s death or any related documents below
    9. [/group]