INFORMATION ABOUT THE VICTIM 
    First Name  
    Last Name   
    Name in arabic   
    Current status  
    Primary address   
    Country of residence  
    Situation of the victim's family  
    Situation of the victim's family  
    Document related to the victim
     Birthdate  
     Birthdate  MaleFemale
    Nationality  
     Birthdate  
     Other relevant details about the victim  

    Political activism, writing, blogging, past arrests, etc...

     

    INFORMATION ABOUT THE SOURCE
    Source first name
    Source last name
    Source phone number
    Relation of the source to the victim
    Email
    Email - confirm
    Do you have any concerns with the use of this information in ADHRB's work with the media?

     

    TYPE OF VIOLATION
    Type of violation Arbitrary detentionTortureDisappearanceSummary executionOther
    What actions have been taken

    Legal, contact with government, NGOs, media, etc...

     

    IN CASE OF ARREST OR DETENTION
    Date of arrest
    Place of arrest (address, city, province)
    Place of arrest (country)
    Identity of arresting forces
    Description of arrest
    Where is the victim detained now?
    Describe any legal procedures

     

    IN CASE OF TORTURE
    Description of torture
    Location and dates of torture
    If he was forced to make false confessions, were they used as evidence in court? When? Which court?
    Medical report

     

    IN CASE OF DISAPPEARANCE
    Date of disappearance
    Date of last contact with the victim
    Place of last contact with the victim
    Describe disappearance Location, forces, how it was carried out.
    Are there any ideas where the victim may be detained?
    Describe the execution
    Were there any legal actions taken?

    Autopsy, investigation, etc...

     

    Comments or suggestions about this questionnaire