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. A2 117

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