சித்திரவதைக்கான ஐ. நா. குழு - விண்ணப்ப படிவம்

சித்திரவதைக்கான ஐ. நா. குழு - விண்ணப்ப படிவம்

The Committee against Torture

Date: ................................................

submitted for consideration under the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment

I. Information concerning the author of the communication

Name ................................................ First name(s)................................................

Nationality ......................................... .Profession ....................................................

Date and place of birth..............................................................................................

Present address
...........................................................................................................................................................................................................................................................................................


Address for exchange of confidential correspondence (if other than present address)
...........................................................................................................................................................................................................................................................................................
...........................................................................................................................................................................................................................................................................................

Submitting the communication as:

(a) Victim of the violation or violations set forth below ..................... [ ]
(b) Appointed representative/legal counsel of the alleged victim(s)............................. [ ]
© Other ................................................ ........................................ [ ]



If box © is marked, the author should explain:

(i) In what capacity he is acting on behalf of the victim(s) (e.g. family relationship or other personal links with the alleged victim(s)):
...........................................................................................................................................................................................................................................................................................
(ii) Why the victim(s) is (are) unable to submit the communication himself (themselves):
...........................................................................................................................................................................................................................................................................................

An unrelated third party having no link to the victim(s) cannot submit a communication on his (their) behalf.

II. Information concerning the alleged victim(s)(if other than author)

Name................................................ Firstname(s) ........................................................
Nationality......................................... .Profession ..........................................................
Date and place of birth ..................................................................................................
Present address or whereabouts ........................................................................ ..............................................................................................................................................................................................................................................................................

III. State concerned/articles violated/domestic remedies

Name of the State party (country) to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment against which the communication is directed:
..............................................................................................................................................................................................................................................................................

Articles of the Convention against Torture allegedly violated:
..............................................................................................................................................................................................................................................................................
Steps taken by or on behalf of the alleged victim(s) to exhaust domestic remedies-recourse to the courts or other public authorities, when and with what results (if possible, enclose copies of all relevant judicial or administrative decisions):
..............................................................................................................................................................................................................................................................................


If domestic remedies have not been exhausted, explain why:
..............................................................................................................................................................................................................................................................................

IV. Other international procedures

Has the same matter been submitted for examination under another procedure of international investigation or settlement (e.g. the Inter-American Commission on Human Rights, the European Commission on Human Rights)? If so, when and with what results?
.............................................................................................................................................................................................................................................................................

V. Facts of the claim

Detailed description of the facts of the alleged violation or violations (including relevant dates)*

..............................................................................................................................................................................................................................................................................

Author's signature:
....................... ......................


பற்றிய விபரங்களை எத்தனை பக்கங்களிலும் விபரிக்கலாம்
தகவல் அனுப்ப வேண்டிய விலாசம்

The Committee against Torture
Office of the High Commissioner for Human Rights
United Nations Office
1211 Geneva
Switzerland