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Profile Information

Title

First Name

Middle Name(s)

Last Name

Sex

Male Female Other

Date of Birth

Nationality

Occupation

Marital Status

Phone Number

Alternate Phone Number

E-mail Address

Physical and Mailing Addresses

Physical Location Information

District

Ward

Settlement

Village

Next of Kin

First Name

Middle Name(s)

Last Name

Relationship

Phone Number

E-mail Address

Address

Some Background Information

Have your ever brought a case to the NHRC?

Yes No

Please indicate if the NHRC should be aware of any special conditions (medical, physical) which may limit your participation/ participation of those involved in the proceedings:

In what capacity are you filing the complaint?

Are you filing the complaint on behalf of a victim other than yourself?

Yes No

If you are submitting the complaint on behalf of someone, please indicate the following

Your relationship to that person(s)

Has the person(s) agreed to be represented by you?

Yes No

Please explain why you are representing the person(s):

Profile Information of the victim of the human rights violation

Title

First Name

Middle Name(s)

Last Name

Gender

Male Female Other

Phone Number

Alternate Phone Number

E-mail Address

Physical Address

Nature of Complaint

Complaint Type(s)

Civil and Political Rights Economic, Social and Cultural Rights Group/Collective Rights Others

Respondent (the complaint is against whom?)

Respondent Name

Respondent First Name

Respondent Middle Name(s)

Respondent Last Name

Gender

Male Female Other

Phone Number

E-mail Address

Address

Incident Location

District

Ward

Settlement

Witness Details

Incident Details

Summary of complaint (please include all relevant details and dates, in order of occurrence)

Supporting documents provided (attach files):

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Steps taken to date (please tell us if you have reported this matter to any authorities and what actions have been taken by those authorities. You must also tell us if your complaint relates to any matter before a court of law or public authorities. Please state the claims made, when they were made and what the outcome was):

What do you want the NHRC to do for you (remedy)?

Request for confidentiality

Please note that if your complaint complies with the Commission’s admissibility criteria, it will be shared with the respondent to give them an opportunity to respond to the allegations of violations. Please state whether you would like to request that your identity or specific information in the complaint be kept confidential.

Yes No

Submitted Successfully

Complaint details have been successfully saved.

Case ID:

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National Human Rights Commission

The Gambia

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Profile Information

Physical and Mailing Addresses

Physical Location Information

Next of Kin

Some Background Information

In what capacity are you filing the complaint?

If you are submitting the complaint on behalf of someone, please indicate the following

Profile Information of the victim of the human rights violation

Nature of Complaint

Incident Location

Witness Details

Incident Details

Request for confidentiality

Submitted Successfully

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