ModelComplaintForm.docVIP

Model Complaint Form For communications under: Optional Protocol to the International Covenant on Civil and Political Rights Convention against Torture, or International Convention on the Elimination of Racial Discrimination Please indicate which of the above procedures you are invoking: ……… Date: …………. I. Information on the complainant: Name: ……… First name(s): …………. Nationality: ……… Date and place of birth: …………. Address for correspondence on this complaint: ……….. Submitting the communication: on his/her own behalf: ……….. on behalf of another person: ………