Application for assistance

1. DETAILS OF THE ALLEGED VICTIM

Name and surname(s)*:

City*:

Country*:

E-mail*:

Sex*:
OtherMaleFemale

Date of birth*:

Marital status*:

Is the alleged victim deprived of freedom?*:
NoYes

Additional information about the alleged victim (studies, job, ...):

Does the alleged victim have a lawyer? *:
NoYes

If the alleged victim has a lawyer, provide us with his/her name and surname(s):

His/her phone number:

His/her email address:

2. INFORMATION OF THE VICTIM'S REPRESENTATIVE

The representative and the victim are the same person:
NoYes

Name of the representative of the alleged victim to the CART:

Sex of the representative:
OtherMaleFemale

class="level1"> Relation of the representative to the victim:

Telephone number(s) of the representative *:

Email of the representative *:

Other means of communication (Skype,...):

Does the representative of the victim have a mandate to act as a legal representative to the CART?
NoYes

3. FACTS

Relate the facts as complete and detailed as possible and in chronological order.
In particular, specify the place, the date and the circumstances in which the alleged violations took place.*

4. ACCUSATIONS

What are the charges against the alleged victim?*

5. AUTHORITIES ALLEGEDLY RESPONSIBLE

Identify the persons or authorities that you consider responsible for the reported acts.*

6. RIGHTS ALLEGEDLY VIOLATED

Mention the rights that you considered violated, the irregularities in the process and the violations of due process.*

7. LEGAL SITUATION OF THE ALLEGED VICTIM

Detail the actions attempted by the alleged victim or his or her representative(s) before the courts. Explain at what stage of the judicial process the alleged victim is.*

Indicate if there is a serious and urgent situation of risk of irreparable physical or psychological harm to the alleged victim.*
NoYes

If Yes, please explain the reasons:

Indicate if the alleged victim has been tortured.*
YesNo

If Yes, please explain:

If Yes, please indicate if the Istanbul Protocol was requested:
I don't know what it isYesNo

Indicate if at any point in the judicial process or during the investigation, the alleged victim entered a guilty plea of the crime(s) he or she was charged with.*
I don't knowYesNo

If Yes, please explain the reasons why or the circumstances under which the alleged victim entered a guilty plea:

8. EVIDENCE

The available evidence consists of documents that can prove the reported violations (for example, major actions or parts of judicial or administrative records, expert reports, forensic reports, photographs, films, among others).

Please indicate how the documents will be sent.*
By postal mail (Do not send originals)By email (scans)Other

List or indicate the evidence that supports your request and, if possible, identify what pieces of evidence you are attaching or sending along with your request. *
If it is not possible to send the documents, you must explain why and indicate whether you can send them in the future. Documents must be in Spanish, English or French, which are the official languages of the CART.

9. TYPE OF REQUIRED ASSISTANCE

Specify the type of assistance you are asking for *
Review and analysis of the victim's recordLegal advicePublicizing the caseWriting a petitionPsychological supportPreparing a complaint to national bodiesPreparing a complaint to international bodiesOther

LEGAL TERMS

With this request for assistance, I can assure that, as a representative of the alleged victim before the CART, I have the firm conviction that the alleged victim that I represent is innocent of the charges that have been brought against him or her. I agree that in our communications with the CART the alleged victim and I will always act according to the truth, that we will not hide any element of the present or past situation of the alleged victim nor of the judicial process the alleged victim faces.

Despite advocating that any accused person should have access to a fair defense, the CART reserves itself the right to withdraw its support to any person who has failed to meet the requirements mentioned above or if elements are discovered that suggest that the alleged victim is actually guilty of the facts that were brought against him or her.

After a review of the documents that will be provided to us (see section 8.), a representative of the CART will contact you to inform you of the decision we will make concerning the present case.

Name and surname(s) of the representative of the alleged victim:*

Date:*
(day/month/year)

Signature:*