Complaint Form

Name*
Date Of Birth
Date Format: MM slash DD slash YYYY
Place Of Birth
Religion
Nationality / Citizenship
Passport / Identity Card Number (If available)
Gender
Marital Status / Children
Profession
Ethnic background, religious affiliation, social group (if relevant)
Present Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mailing address for confidential correspondence (if other than present address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
I hereby, confirm I have been subjected to inhumane treatment by the Authorities
If yes, then please specify the exact period
I was subjected to following torture and mistreatment (separate using comma ",")
I am aware of the names of the perpetrators, they are: (Separate using comma ",")
*
I am not aware of the names the perpetrators.
*
I confirm I have provided consent for this information to be shared with the relevant authorities and I give permissio to MAAR –Movement Against AstrocIties and Repression to take matters forward on my behalf with relevant authorities.
MAAR- Movement Against Atrocities & Repression Maar-Movement Postfach 1144, Dennliweg 31a CH-4900, Langenthal, Switzerland

Information of the relative of Victim ( if the relative is filling on behalf of victim )
Family Name
Email*
First Name
Date Of Birth
Date Format: MM slash DD slash YYYY
Place Of Birth
Citizenship / Nationality, Religion
Passport / Identity Card Number (If available)
Marital Status / Children
Profession
I hereby, confirm I have been subjected to inhumane treatment by the Authorities
If yes, then please specify the exact period
From To
I was subjected to following torture and mistreatment (separate using comma ",")
I am aware of the names of the perpetrators, they are: (Separate using comma ",")
*
I am not aware of the names the perpetrators.
*
I confirm I have provided consent for this information to be shared with the relevant authorities and I give permissio to MAAR –Movement Against AstrocIties and Repression to take matters forward on my behalf with relevant authorities.
MAAR- Movement Against Atrocities & Repression Maar-Movement Postfach 1144, Dennliweg 31a CH-4900, Langenthal, Switzerland