BASIC INFORMATION
Date of interview/testimony;
Place and circumstances of the interview/testimony;
Names of those present, including the interpreter;
Personal details of the individual: name, age, sex, family, education, occupation,
political or other relevant activity or background, address, and telephone numbers;
Names, addresses, and telephone numbers of contact persons, if different from the victim.
CASE-SPECIFIC INFORMATION ABOUT THE INCIDENT
The date of the incident or violation;
The place of the incident or violation;
The human right alleged to have been violated;
The nature of the incident or violation;
The identity of the victim(s);
The identity of the alleged perpetrator(s);
The official status of the alleged perpetrator(s), or other official connection;
Witnesses, including their names, positions, addresses/contact numbers;
All other relevant factual details, including full details and chronological narration
of the case;
Information on which authorities, if any, have been notified of the violation,
what their reaction has been, and what steps they have taken;
Information on whether the complaint or appeal has also been lodged with a court
or other international or domestic organizations, and what the reaction has been;
Copies of relevant documents or evidence should be attached.
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