FB02 VIOLATION CHECKLIST 19/04/94

Name of the victim: ____________________________________ Case #: ______________
Date of the violation: ____________________ Date of the report: _______________
Please check/mark all of the relevant boxes for the different rights violated in the present case.

1. VIOLATION OF THE RIGHT TO LIFE:

2. VIOLATION OF THE RIGHT TO INTEGRITY, SECURITY AND LIBERTY OF THE PERSON

(Please underline the violation and check/mark the box)

3. VIOLATION OF THE RIGHT OF FREEDOM OF EXPRESSION AND ASSOCIATION

4. VIOLATION OF THE RIGHT TO JUSTICE

5. OTHERS

PREVIOUS VIOLATIONS