Complaint Form

Your Email (required)

Name of Victim

Address of the Victim

National Identity Card Number

District

Telephone No (if any)

Age

Female / Male

Female Male

Name of complainant

Name of complainant

Address of complainant

Complainant Email

Relationship to alleged victim?

Please state the institution against which the complaint is being made (Department, Corporation, an Institution)

Names, Designation and addresses of the officer alleged to be responsible for the alleged rights violation.

Please provide details of alleged violations (If the space provided is not enough, please attach additional document/s below)

What is the relief you seek regarding the current complaint?

Documentary evidence

Name of the Court / Tribunal/ Commission

Date of which complaint was made

What was the outcome/present status of that complaint?