HRV - 2014/1

Obrazac zahtjeva

O obrascu zahtjevaOvaj obrazac zahtjeva je službeni pravni dokument i može utjecati na Vaša prava i obveze. Molimo Vas da slijedite upute navedene u Uputama za ispunjavanje obrasca zahtjeva. Provjerite jeste li ispunili sva polja koja se odnose na Vašu situaciju te priložite sve mjerodavne dokumente.

Upozorenje: Ukoliko je Vaš zahtjev nepotpun, neće biti prihvaćen (vidi pravilo 47. Poslovnika Suda). Posebno obratite pažnju na pravilo 47. stavak 2. (a) koje glasi: „Svi podaci iz stavka 1. (d) do (f) [izjava o činjenicama, navodne povrede i podaci o ispunjavanju uvjeta dopuštenosti] navedeni u odgovarajućoj točci obrasca zahtjeva trebali bi biti dovoljni Sudu da odredi suštinu i vrstu zahtjeva bez uvida u bilo koji drugi dokument.“

B. Podnositelj zahtjeva (pravna osoba, organizacija) Ovaj odjeljak treba popuniti samo ukoliko je podnositelj zahtjeva tvrtka, nevladina organizacija, udruga ili druga pravna osoba.

1. Prezime

2. Ime

3. Datum rođenja

4. Državljanstvo

5. Adresa

6. Telefon (uključujući međunarodni pozivni broj)

7. E-mail (ukoliko ga imate)

8. Spol

muški

ženski

9. Naziv

11. Datum osnivanja društva ili upisa u sudski registar (ukoliko postoji)

12. Djelatnost

13. Adresa sjedišta

14. Telefon (uključujući međunarodni pozivni broj)

15. E-mail

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Naš brojUkoliko ste od Suda već dobili broj zahtjeva vezano uz ove pritužbe, molimo Vas da ga ovdje navedete.

10. Broj pod kojim je upisan u sudski registar (ukoliko postoji)

Kodirane naljepniceUkoliko ste od Europskog Suda za ljudska prava već primili kodirane naljepnice, molimo Vas da jednu naljepnicu ovdje zalijepite.

A. Podnositelj zahtjeva (fizička osoba)Ovaj odjeljak popunjavaju isključivo pojedinačni podnositelji zahtjeva. Ukoliko je podnositelj zahtjeva pravna osoba ili neka organizacija, prijeđite na odjeljak B.

Europski sud za ljudska prava – Obrazac zahtjeva 2/11

C. Zastupnik/zastupnici podnositelja zahtjevaUkoliko podnositelj zahtjeva nema zastupnika, prijeđete na odjeljak D.

Osoba koja nije odvjetnik/osoba zaposlena u organizaciji Odvjetnik Molimo Vas da ispunite ovaj dio obrasca ukoliko zastupate podnositelja zahtjeva, ali niste odvjetnik.

Molimo Vas da ispunite ovaj dio obrasca ukoliko zastupate podnositelja kao odvjetnik.

U polju ispod objasnite u kojem svojstvu zastupate podnositelja ili navedite vaš odnos ili službenu dužnost ukoliko zastupate organizaciju.

16. Svojstvo / odnos / službena dužnost

17. Prezime

18. Ime

19. Državljanstvo

20. Adresa

21. Telefon (uključujući međunarodni pozivni broj)

22. Telefaks

23. E-mail

24. Prezime

25. Ime

26. Državljanstvo

27. Adresa

28. Telefon (uključujući međunarodni pozivni broj)

29. Telefaks

30. E-mail

PunomoćPodnositelj zahtjeva mora opunomoćiti zastupnika da ga zastupa u ovom predmetu potpisivanjem punomoći u nastavku (vidi Uputu za ispunjavanje obrasca zahtjeva).

Ovime opunomoćujem navedenu osobu da me zastupa u postupku pred Europskim sudom za ljudska prava u svezi s mojim zahtjevom podnesenim u skladu s člankom 34. Konvencije.

31. Potpis podnositelja zahtjeva 32. Datum

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Europski sud za ljudska prava – Obrazac zahtjeva 3/11

D. Država/države protiv koje/kojih se zahtjev podnosi 33. Označite ime države/država protiv koje/kojih se zahtjev podnosi

ALB - Albanija ITA - Italija

AND - Andora LIE - Lihtenštajn

ARM - Armenija

AUT - Austrija LUX - Luksemburg

AZE - Azerbajdžan LVA - Latvija

BEL - Belgija MCO - Monako

BGR - Bugarska MDA - Republika Moldova

BIH - Bosna i Hercegovina MKD - „Bivša jugoslavenska republika Makedonija“

CHE - Švicarska MLT - Malta

CYP - Cipar MNE - Crna Gora

CZE - Češka Republika NLD - Nizozemska

DEU - Njemačka NOR - Norveška

DNK - Danska POL - Poljska

ESP - Španjolska PRT - Portugal

EST - Estonija ROU - Rumunjska

FIN - Finska RUS - Ruska Federacija

FRA - Francuska SMR - San Marino

GBR - Ujedinjena Kraljevina Velike Britanije i Sjeverne Irske SRB - Srbija

GEO - Gruzija SVK - Slovačka

GRC - Grčka SVN - Slovenija

HRV - Hrvatska SWE - Švedska

HUN - Mađarska TUR - Turska

IRL - Irska UKR - Ukrajina

ISL - Island

LTU - Litva

Europski sud za ljudska prava – Obrazac zahtjeva 4/11

Predmet zahtjevaU ovom dijelu obrasca zahtjeva (točke E., F. i G.) trebate navesti sve podatke koji se odnose na činjenice, pritužbe i ispunjavanje uvjeta vezano uz iscrpljenje domaćih pravnih lijekova kao i poštovanje roka od 6 mjeseci, sukladno članku 35. stavku 1. Konvencije (pravilo 47. stavak 2. (a)). Podnositelj može nadopuniti navedene podatke prilažući obrascu zahtjeva dodatne pojedinosti ili objašnjenja koja ne smiju biti iznijeta na više od 20 stranica (pravilo 47. stavak 2. (b)). Ovo ograničenje broja stranica ne uključuje kopije priloženih dokumenata i odluka.

E. Izjava o činjenicama 34.

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Europski sud za ljudska prava – Obrazac zahtjeva 5/11

Izjava o činjenicama (nastavak)35.

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Europski sud za ljudska prava – Obrazac zahtjeva 6/11

Izjava o činjenicama (nastavak)36.

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Europski sud za ljudska prava – Obrazac zahtjeva 7/11

F. Izjava o navodnim povredama odredaba Konvencije i/ili njenih Protokola, te odgovarajuća obrazloženja 37. Članak na koji se pozivate Objašnjenje

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Europski sud za ljudska prava – Obrazac zahtjeva 8/11

G. Molimo Vas da za svaku pritužbu potvrdite da ste iscrpili sve raspoložive domaće pravne lijekove, uključujući žalbe, te navedete datum kada je donijeta konačna domaća odluka kao i datum kada Vam je ona dostavljena, kao dokaz da je ispunjen uvjet o roku od šest mjeseci.

38. Pritužba Iskorišteni pravni lijekovi i datum konačne domaće odluke

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Europski sud za ljudska prava – Obrazac zahtjeva 9/11

39. Postoji li ili je postojao još neki pravni lijek kojim se niste poslužili? Da

Ne

40. Ukoliko je Vaš odgovor na prethodno pitanje potvrdan, molimo Vas navedite koju žalbu ili pravni lijek niste iscrpili i zašto.

H. Podaci koji se odnose na druge međunarodne postupke (ukoliko ih ima) 41. Jeste li već iznijeli neku od ovih pritužbi u nekom drugom postupku pred međunarodnim tijelima? Da

Ne

42.

43. Da

Ne

44. Ukoliko je Vaš odgovor na prethodno pitanje potvrdan, navedite broj/brojeve zahtjeva u polju ispod.

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Ukoliko je Vaš odgovor na prethodno pitanje potvrdan, molimo iznesite sažet opis postupka (podnesene pritužbe, naziv međunarodnog tijela te datum i suštinu svake eventualno donesene odluke).

Imate li Vi (podnositelj zahtjeva) trenutno, ili ste ikada prije imali, neki drugi zahtjev pred ovim Sudom?

Europski sud za ljudska prava – Obrazac zahtjeva 10/11

I. Lista priloženih dokumenataPriložite potpune i čitke preslike svih dokumenata.Dokumenti Vam neće biti vraćeni. Stoga je u Vašem interesu priložiti preslike, a ne izvornike. OBAVEZNO:

- poredajte dokumente po datumu i postupku;- označite stranice rednim brojevima;- NEMOJTE spajati dokumente spajalicama, uvezivati ih niti lijepiti.

45. U nastavku navedite dokumente vremenskim redom uz sažeti opis.

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Europski sud za ljudska prava – Obrazac zahtjeva 11/11

Dodatni komentariImate li dodatne komentare u svezi Vašeg zahtjeva?

46. Komentari

Izjava i potpis Ovime izjavljujem da su po mojoj savjesti i uvjerenju svi podaci u ovom zahtjevu točni.

47. Datum

Podnositelj/podnositelji zahtjeva ili zastupnik/zastupnici podnositelja zahtjeva moraju se potpisati u naznačenom polju.48. Potpis(i)

Osoba za kontaktUkoliko ima više podnositelja zahtjeva ili više zastupnika, molimo Vas da navedete ime i adresu jedne osobe s kojom će Sud komunicirati.

49. Ime i adresa podnositelja zahtjeva

Ispunjeni obrazac zahtjeva treba potpisati i poslati poštom na:

The Registrar European Court of Human RightsCouncil of Europe 67075 STRASBOURG CEDEXFRANCE

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Podnositelj/podnositelji

npr. 27/09/2012

zastupnik/zastupnici – označite odgovarajući kružić

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zastupnika – označite odgovarajući kružić

35: 1: 2: 3: 4: 5: 6: 7: 8: 9: 10: 11: 12: 13: 14: 15: 16: 17: 18: 19: 20: 21: 22: 23: 24: 25: 49 Name and address of applicant representative delete as appropriate: Button2: LawyerSurname: NonLawyerCapacity: LawyerFirstName: NonLawyerSurname: LawyerNationality: NonLawyerFirstNames: NonLawyerNationality: LawyerAddress: NonLawyerAddress: LawyerTelephone: LawyerFax: NonLawyerTelephone: LawyerEmail: NonLawyerFax: NonLawyerEmail: Albania: OffAndorra: OffArmenia: OffAustria: OffAzerbaijan: OffBelgium: OffBosnia and Herzegovina: OffBulgaria: OffCroatia: OffCyprus: OffCzech Republic: OffDenmark: OffEstonia: OffFinland: OffFrance: OffGeorgia: OffGermany: OffGreece: OffHungary: OffIceland: OffIreland: OffItaly: OffLatvia: OffLiechtenstein: OffLithuania: OffLuxembourg: OffMalta: OffRepublic of Moldova: OffMonaco: OffMontenegro: OffThe Netherlands: OffNorway: OffPoland: OffPortugal: OffRomania: OffRussian Federation: OffSan Marino: OffSerbia: OffSlovak Republic: OffSlovenia: OffSpain: OffSweden: OffSwitzerland: OffThe former Yugoslav Republic of Macedonia: OffTurkey: OffUkraine: OffUnited Kingdom: OffStatesBinary: 034: Remedy: InternationalBody: ApplicationNumbers: 46 Comments: DeclarationDate: ApplicantAddress: SignatureDate: Version: HRV - 2014/1OrganisationAddress: OrganisationDateOfReg: ApplicantDateOfBirth: Sex: 0Appeal: OffComplaint: OffPendingApplications: OffApplicantNationality: ApplicantTelephone: ApplicantEmail: OrganisationEmail: 38 Complaint: ComplaintInfo: 37 Article invoked: Explanation: RefNo: ApplicantFirstNames: ApplicantSurname: OrganisationID: OrganisationName: OrganisationTelephone: OrganisationActivity: 36: Text1: Molim Vas obratite pažnju da podaci koje unosite u ovaj odjeljak ne prelaze dozvoljeni broj stranica, te ukoliko je potrebno skratite tekst. Ukoliko želite dostaviti dodatne podatke postupite prema „Uputi za ispunjavanje obrasca zahtjeva“.48 signed: Off49 Correspondent: Off