特别报告员的示范调查表

一般性信息

特别报告员在下述情形中采取行动:

(a) 与死刑有关的违反生命权行为。在不公平审判后强迫死刑,或在上诉权和要求赦免或减刑的权利受侵犯时,特别报告员会出面干预。报告员还会在罪犯为未成年、智力迟钝者或精神病患者、孕妇或产妇的情况下进行干预;

(b) 死亡威胁和迫在眉睫的法外处决,且其由国家官员、准军事集团、与政府合作或获政府宽容的个人或团体,以及可能与上述各类有关的身份未明人士造成;

(c) 由于拷打、疏忽或使用武力,或拘留条件威胁生命而导致监禁期内死亡;

(d) 由于执法人员,或由于行为直接或间接遵从国家的人员使用武力而造成死亡,而使用武力又不符合绝对需要或相称的标准;

(e) 由于国家安全部队、准军事集团、敢死队或与政府合作或获政府宽容的其他私人力量的袭击而死亡;

(f) 发生武装冲突期间违反人道主义法侵犯生命权,特别是平民的生命权;

(g) 将人员驱逐到威胁其生命的国家;

(h) 种族灭绝;

(I) 不履行调查侵犯生命权的指控并将应对此负责者绳之以法的义务;

(j) 不履行向侵犯生命权的受害者提供充分赔偿的义务。

地址:

关于法外处决、即审即决或任意处决的报告可以递送至以下地址:

Special Rapporteur on Extrajudicial, Summary, or Arbitrary Executions
(任何对法外处决、即审即决或任意处决问题特别报告员)
c/o OHCHR-UNOG, 1211 Geneva 10, Switzerland(瑞士日内瓦)
传真:+41 22 917 90 06

或者发送电子邮件至:
urgent-action@ohchr.org

注意:如果问卷中所填信息应予以保密,请在相关条目旁边标注“保密(CONFIDENTIAL)”二字。如果填写空间不够,请另附纸。

I. 相关人士身份:
Identity of the person concerned:

注意:如果涉及多人,请为每个人分别填写问卷
Note: if more than one person is concerned, please fill out separate questionnaires for each person

1. 姓 Family name:.........................................................................................................................................

2. 名 First name:...........................................................................................................................................

3. 性别 Sex: __ 男 male __ 女 female

4. 生日或年龄 Birth date or age:.......................................................................................................................

5. 国籍 Nationality(ies):...................................................................................................................................

6. 婚姻状况(单身,已婚等)Civil status (single, married, etc.):

7. 身份证件 Identity document:........................................ ................................................................................

号码 Nr.:........................................................................................................................................................

签发者 Issued by:...........................................................................................................................................

签发日期 Date of issue:....................................................................................................................................

8. 职业或从事的活动(例如工会,政治、宗教、人道主义/团结/人权活动等)
Profession and/or activity (e.g. trade union, political, religious, humanitarian/solidarity/human rights, etc.) .......................................................................................................................................................

9. 常用地址 Address of usual residence:......................................................................................................

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10. 是否与其他案件/人物有联系?请具体指明:
Is there a link to other cases/ persons? Please specify:

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II. 与事件相关的信息:
Information regarding the incident:
 

1. 日期 Date:................................................................................................................................................

2. 地点 Place:................................................................................................................................................

3. 时间 Time:................................................................................................................................................
 

4. 事件性质:请描述事件的情形,包括下列几类
The nature of the incident: Please describe the circumstances of the incident, including the following categories:

(a) 死刑,或公正审判保证,请详述(不公平的法律或程序、指控、最终上诉、处决迫在眉睫等等。)
death penalty, or fair trial guarantees, please detail (unfair laws or proceedings, charges, eventual appeals, execution is imminent, etc.)

(b) 有紧迫的生命权遭侵犯之虞(死亡威胁、即将遭到驱逐而导致生命陷入危险等),请详述。
imminent violation of the right to life is feared (death threats, imminent expulsion or refoulement leading to a life-threatening situation, etc.), please detail.

(c) 其他(拘禁期间死亡,武装冲突期间死亡,由于执法人员滥用武力致死,由于国家安全部队、准军事集团或私人武装的袭击而死亡,不履行调查义务等等):
others (death in custody, death during an armed conflict, death due to excessive use of force by law enforcement officials, death due to attacks by security forces of State, paramilitary or private forces, breach of obligation to investigate, etc.): ............................................................................

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(a) 如果认定犯罪者为国家公务人员,请详细区分(军方,警察,穿制服或平民服装的相关人员,安全部门人员,供职部门,职位和职能等等)。同时指出为什么认定他们应为此负责。请尽可能精确:
if the perpetrators are believed to be State agents, please specify (military, police, persons in uniform or civilian clothes, agents of security services, unit to which they belong, rank and functions, etc.) and indicate why they are believed to be responsible; be as precise as possible: ..................................................................................................................................

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(b) 如果无法辨认其国家公务人员身份,你为什么认为政府当局或与之相关的人员应为此事负责?
if an identification as State agents is not possible, why do you believe that Government authorities, or persons linked to them, are responsible for the incident?

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(c) 如有人可为此事作证,请写出其姓名。如果证人希望匿名,请指明他们是否是亲戚、路人等;如果有证据,请详细说明:
if there are witnesses to the incident, indicate their names. If they wish to remain anonymous, indicate if they are relatives, by-passers, etc.; if there is evidence, please specify:

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IV. 受害者或其亲属采取的步骤:
Steps taken by the victim or his/her family:

 

(a) 请指出是否已经提出投诉,在何时何人提出,提交至哪个机关
Indicate if complaints have been filed, when, by whom, and before which organ

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(b) 采取的其他措施 Other steps taken:

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V. 当局采取的措施:
Steps taken by the authorities:

 

(a) 指出是否有国家当局开展的调查;如果是,是何种调查?调查的进展和状况;还采取了哪些措施(例如尸检)?
Indicate whether or not there have been investigations by the State authorities; if so, what kind of investigations? Progress and status of these investigations; which other measures have been taken (e.g. autopsy)?

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(b) 在由受害者或其家人提交投诉的案件中,相关机关如何处置投诉?那些程序的结果如何?
in case of complaints by the victim or its family, how have the organs dealt with them? What is the outcome of those proceedings?

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VI. 提交案件者的身份
Identity of the person submitting the case

 

1. 姓 Family name:.........................................................................................................................................

2. 名 First name(s):........................................................................................................................................ 

3. 状况:个人、组织、非政府组织、跨政府机构、政府。请指明:
Status: individual, group, non-governmental organization, inter-governmental agency, Government. Please specify:

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4. 地址(电话、传真、电子邮件):
Address (telephone, fax, e-mail):

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5. 请说明是否希望保密身份:
Please state whether you want your identity to be kept confidential: ..........................................................

日期 Date:
 

填写者签名 Signature of author: