Petition form

 

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Petition form

 

To the People’s Advocate,

  1. Name and surname (capital letters) ……………………………………….., domicile (residence or another address where you can be contacted)……………………………….. ………………………………………………………. ………………………………..Telephone ………………………..

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  1. The date when you learned about the violation of your rights: ……………………………..
  2. Brief presentation of your infringed rights and/or freedoms:

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  1. The denounced administrative authority and the civil servant: ………………………………….

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  1. Brief presentation of the alleged maladministration: (you may continue on another page and attach it to the application)

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  1. The public authorities notified before:

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7.The answer received and the grounds on which you deem yourself further wronged: ……..

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  1. In sustaining the alleged facts, I submit the following documents (copies, not originals): …………

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  1. The obligatory statement that the petition is/was the object of a litigation in a court of law:

YES/NO

  1. I wish that all the information and the results shall remain confidential:

YES / No

  1. The petition is submitted:

|_| Personally

|_| By delegate

Date ……………

Signature …………………

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