Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Xxxxxxxxxx xx Applications xxx xxx Provision xx Xxxxxxxxx Xxxxxxx xx Xxxxxxx xx Xxxxxxxx Xxxx pursuant xx Xxx Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xx xxx xxxxxxx xx xxxxxxxx xxxx xxx xx xxxxxxxx xxxxxxx xxxxx xxxx, as xxxxxxx

Xxxx Xxx/Xxxxx,

Xx apologise for xxxxxxxxx xxx xxxx xxxxxxxx xxxxxxxxx xx xxxx xxxxxxx xxxxxxxxx. Xxxxxxx, xxxxxxx xx xxxx xxxxxxxxxxxxx is xxxxxxxx xxx xxx xxxxx xxxxxxxxxx xx xxxx xxxxxxxxxxx for xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xx Act xx. 209/1997. Xxxxx xxx xxx xxxx xxxxxxxxxxx; xx is xxxxxx xxxxxxxxxxx.

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X. Xxxxxx xxxxxxx xxxx xx xxx xxxxxxxx xxxx xx xxx xxxxxxxxx - x.x. xxx xxxxxx xx xxx criminal xxx xxx xxx xxxxxxxx xxxxxx xxxx, xx xxx xxxxxxxx xx x person xxx xxx died xx xxxxxxxxxxx xx xxx xxxxxxxx xxx:

1. Xxxxxxx:

2. Xxxxx name:

3. Xxxx xx xxxxx:

4. Xxxxxxxxx address:

5. Xxxx xxxxxxxx xxxxxxx (xxxxxx xx xxxxxx xxxx xxx xxxxxxxxx xxxxxxx, xxxx):

6. Xxxxx Xxxxxx:

7. X-xxxx address:

8. Nationality:

II. Xx xxx applicant xx xxxxxxxxxxx xx xxxxxxx person ("xxxxxxxxxxxxxx") xx the xxxxx xx xxxxxxxxx representation (xxx xxxxxxxx, x xxxxx xxxxx xxxxxxxxxxx xx xxx/xxx xxxxxx) xx xx the xxxxx of a xxxxx of attorney, xxxxxx fill xx xxx xxxx xx xxxx xxxxxxxxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxxxxxxx xx xxxxxxxxxx address:

If xxx xxxxxxxxxxxxxx xx xxxxxx xxx xxxxxxxxxxx xx xxxxxx xx xxx xxxxxxxxx, xxxxxx xxxx xxxxxx x xxxxxxxx xxxxxxxxxxx him/her xx xxxxxxxxx xxx xxxxxxxxx - a xxxx xx x xxxxx xx xxxxxxxx (xxx xxxxxxxxxxx representation) xx x xxxx xx xxx xxxxx xxxxxxxxxxx (xxx statutory xxxxxxxxxxxxxx) xx xxx xxxxx equivalent xxxxxxxx.

XXX. Xx xxx xxxxxxxxx xx x xxxxxxxx xx x xxxxxx xxx xxx died xx xxxxxxxxxxx xx xxx xxxxxxxxxx xxxxxxxx xxx, xxxxxx fill xx the personal xxxx of xxx xxxxxxxx:

1. Xxxxxxx:

2. Given xxxx:

3. Xxxx xx xxxxx:

4. Date of xxxxx:

5. Last xxxxxxxxx xxxxxxx:

6. Xxxxxxxxxxx:

7. Relationship xx the xxxxxxxx xx the xxxxxxxxx (x.x. father, daughter, xx xxxxxxxxxx living xx xxxxxx xxxxxxxxx)

Xx xxx xxxxxxxxx xx x survivor xx x xxxxxx xxx xxxx in consequence xx xxx xxxxxxxx xxx, xxxxxx xxxxxx x xxxx of xxx xxxxx xxxxxxxxxxx xxx xxx documents xxxxxxx that xxx xxxxxxxx xxxxxxxxx or xxx an xxxxxxxxxx xx xxxxxxx xxx xxxxxxxx (xx the xxxx of x xxxxxx-xxxxx xxxxxxxxxxxx, xxxx xxxxxxxxx xxxxxxx birth xxxxxxxxxxxx xx x xxxxx xxxxxxxx xx xxx xxxxxxxxxx xx xxxxxxx the xxxxxxxxx; xx xxx xxxx xx xxxxxxx xxxxxxx, xxxxxx attach x xxxxxxxx xxxxxxxxxxx).

Xxxxxx specify xxx xxxx xx which xxx xxxxx xxx xxxxxxxxx and, xx xxx xxxxxx xxxxxxx xxxxx xxx xxxxxxxxxxxx xx xxx crime xx a later xxxx, xxxxxx xxxx xxxxxxx the date xxx the xxxxxx xx which the xxxxxx xxxxxxx xx xxxx xxxxxxxxxxxx (e.g., xxx date xx xxx medical xxxxxx).

XX. Xxxxxx xxxxxxx xxx xxxxxxxx xxxxxxx xxxxxxxxx (x.x. xxxxxx, xxxxxx xxxxxxxxxx'x office, xxxxx) xxxxx most recently xxxxxxxxx xxxxxxxx proceedings. Xxxxx the xxxxxxxxx xxxxxx xx xxx xxxx xxxxxxx xx xxx respective xxxxxxxxxxx.

Xx xxxxxxxxx, xxxxxx xxxxxx xxx xxxxxx xxxxxxxx xx xxx xxxxxxxxxxxxxx xxxxxxxx justice xxxxxxxxx xxxxx could xxxxxxxx xxx stage xx xxx xxxxxxxxxx xxxxxxxxxxx (x.x. xxxxxxxxxx xx xxx discontinuation of xxxxxxxx prosecution, copy xx the indictment, xxxxxxxxx - final xx otherwise).

Xxxxxxxxx xx the xxxxxxxxxx xx §8 xx Xxx xx. 209/1997, xxx xxxxxx xx xxxxxxxxx xxxxxxx xxx xx xxxxxxx or xxxxxxxx xxxxxxxxx xx xxxxxxx the xxxxxx xxx xxxx xxx xx xxx xxxxx xxxxxxxx xx xxxxxxx x xxxxx xxx xxxxxxxxxxxx xxxxxxx xxx xxxxxxxx or any xxxxx xxxxxx xxxxxxxxxxx xxx the xxxx xxxxxxxx. Xx not xxxx in xxxx xxxx xx xxx xxxxxxxx xxx not xxxx identified.

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Fill xx xxxx XxXx xx xxx xxxxxxxxx is x xxxxxxxx xx xx individual who xxx died xx xxxxxxxxxxx xx xxx xxxxxxxxx xxxxx.

1. Xxx xxx x xxxxx, xxxxxx xx xxxxx xx xxx xxxxxx xxx xxxx xx xxxxxxxxxxx xx xxx xxxxxxxx xxxxxxx?

2. Xxx xxx xxxx xx x common xxxxxxxxx xxxx xxx xxxxxxxx xxxxxx xxxxx xx xxx xxxxxxxxxx xx xxx xxxxx?

3. Xxxx you a xxxxxxxxx of xxx xxxxxx xx xxx xxx xxxxxxxx obliged xx support you?

4. Xx xxx xxxxx xxxxxxx meet xxx xxxxxxxxxx xxxxxxxxx xx xxxxxxx 1 to 3? Xxxxxx give xxxxx number, if xxxxx xx xxx.

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Xxxxxxxxx xx xxx xxxxxxxxxx xx §2, xxxxxxx 2 xx Xxx xx. 209/1997, x xxxxxx xxx xx x xxxxxxxx xx x xxxxxx xxx xxxx in xxxxxxxxxxx xx a xxxxxxxx xxx xx xxxxxxxxxx xx xx a xxxxxx if xx xx she xx x parent, xxxxxx xx xxxxx of xxx deceased xxx xxxxx with xxx xx her xx xxx same xxxxxxxxx xx xx the xxxxxx was x xxxxxxxxx xx xxx xxxxxxxx xx the xxxxxxxx xxx xxxxxxxx xx xxxxxxx the xxxxxx.

Xx xxx xxxxxxxxx xx the xxxxxx xx a xxxxx xxx xxx xxxxxxxx xxxxxx xxxx, please xxxx xx items XX - XXX.

Xxxxxx attach x xxxxx-xxxxx assessment xx xxxx xxx xxxxxxxxx pursuant to Xxxxxx No. 440/2001 Xxxx. Xxx xxxxxxxxxx xxxxxxxx xxxxxx xx xxxxxxxx xxxx the xxxxxxxxx xxxxxxxxxxx xxx xxx victim's xxxxxxxxx. Xxxx medical xxxxxx xxxx xxxxxxx a xxxxx-xxxxx assessment xx xxx xxx xxxxxxxx xxx x xxxxx-xxxxx xxxxxxxxxx xx xxx xxxxxxxx xx xxx xxxxxx'x social position. Xxxxxx xxxx xx xxxx that xxxx xxx xxxxx-xxxxx xxxxxxxxxx xx xxx xxx xxxxxxxx xx xxxxxxxx xxx xxx xxxxxxxx xx Act xx. 209/1997. Xxxxxxxxx to xxx xxxxxxxxxx of §6, xxxxxxx 2 xx Act no. 209/1997, xx xxxxxxxxx xxxxxxx xxxx be xxxxxxxx xxxxxx the xxxxx xxxxxxxxxx xx xxx xxxx suffered xx at least 100 xxxxxx.

The xxxxxx xxx xxxxxx xxxx xxx financial xxxxxxx in xxx xxxxxx xx CZK 25,000 xx xx xxxxxx xxxxx xx xxx xxxxxx xxxxx xx medical xxxxxxxxx xxx xxxx xxxxxx (§7, xxxxxxx 1, xxxxxx x of Xxx Xx. 209/1997 Xxxx.). lf xxx xxxxxx to apply xxx x xxxx xxx xxxxxxx, xxxxx xx no xxxx xx fill xx xxxxx XII - XxX.

This xxxxxxxx xxx xxxxxxxx for xxxxxxxxxx, xxxxxxxx xxxxxxxxx, xxxxxxxxxxxxxx xxxxx, hiring xx xxxxxxxxx to xxxx xxx xx xxx home xx xxxx xxxxxxx treatment, xxxxxxxxx transportation xxxxx xxx., provided such xxxxx xxxx xxx xxxx xxxx by xx xxxxxxxxx company. xx xxxx xxxxxxxx xxx xxx proved xx xxxxxxxxxxx xxxxxxxx, xxx Xxxxxxxx xx Xxxxxxx xxx not xxxx xxxx xxxx xxxxxxxxxxxxx.

Xxxxxx xxxxxx xxx documents xxxxxxxxxx xxxx facts xx xxx xxxxxxxxxxx.

Xx the xxxxxxxxx xx xx xxxxxxxx, xxxxx xxxxxxxxx xxxxx include x xxxxxxxxx xxxx xxx/xxx xxxxxxxx xxxxxxxxxx xxx xxxxxxx salary xxxxxxxxx xx §351 xx. xxx. xx Xxx xx. 262/2006, xxx Xxxxx Xxxxxx Code, xx amended. xx xxx xxxxxxxxx is xxxx-xxxxxxxx, xxxx xxxxxxxx xxxxx be x xxxx xx his/her xxxx xxxxxx tax xxxxxx. xx xxx xxxxxxxxx xx x xxxxxxx xxxxxx xxx xx xxxx to xxxxx xxx/xxx xxxxxxxx xxxxxx xxxxxxxx, please xxxxxx x xxxxxxxx xxxxxxxxxx xxx xxxxxx xx xxx xxxxxxxxxx xxxxxxx. xx for xxx xxxxxx xxx xxxxxxxxx'x xxxxxx situation xxxxxx be xxxxxx, xx xxxxxxxxxxx cases xx xxxxxxxxx xxx xx xxxxxxxx.

Xx xxxxxx standing xxx xxxx xxxxxxxx xx x result xx xxx xxxxxxxx xxx xx xxxxx I xxx x victim. X xxxx not xxx xxxx compensated xxx the xxxx 1 xxxx suffered xx x xxxxxx xx xxx xxxxxxxx xxx.

X xxxxxx xxxxxx xxxx X have xxx xxxxxx xxx xxxxx for financial xxxxxxx xx xxx xxxxxxx xxxxx xxx xxxxxxxxxxxx xxx xxx xxxx suffered as x xxxxxx of xxx xxxxxxxx act xx any xxxxxxx xxxxx xxxx xxx Xxxxx Republic.

I acknowledge xxxx xxxxxxxxx xx §12 xx Xxx Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxx xxx victims xx xxxxxxxx xxxx xxx xx xxxxxxxx xxxxxxx xxxxx xxxx, xx xxxxxxx, X xx xxxxxxx to xxxxxxxxx xxx Ministry xx Xxxxxxx any xxxxxx received xx xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx, up xx xxx xxxxxx xx xxx financial xxxxxxx, xxxxxx xxxx xxxxx xxxx the xxxx xx xxxxxxxxx xxx funding xxxxxxx. X xxxx xxxxxxxxxxx xxxx, xxxxx the xxxxx xx xxx xxxx-xxxx xxxxxx, I xxx xxxx xx xxxxxxxxxxx xxxxxx xxx Xxxxxxxx of Justice xx xxxxx xxx xxxxx'x xxxxx xxx xxx return xx xxx xxxxxxxx support, xxxxxx xxxx x xxxxxx be well xxxxxxxx xx my xxxxxx xxxxxxxx, xxx xxxxx extent xx xxxx xxxxxxxx and xxx xxxxxx xx xxxxxxxxxxxx xxxxxxxx.

X xxxx xxxxxxxxxxx xxxx xxxxxxxxxxx xxxxxx xxxxx xx xxxxxxxxxx information xx xxxxxxxxxxx xxxxxxxxxxx for xxx purposes xx xxxxxxxxxxxxx xxxxxxx xxxxxxxx xxx represent xx xxxxxxx pursuant xx §21, section 1, xxxxxx c) of Xxx xx. 200/1990 Xxxx., xx xxxxxxxx xx xxxxxxx.

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Xxxxxxxxx xx xxx xxxxxxxxx xx xxx/xxx xxxxxxxxxxxxxx

- Xxxx xxxxxxx xx xxx xxxxxxxxxxx xxx xxx xxxxxxxxx of xxxxxxxxx xxxxxxx xxxxxxxx to Xxx No. 209/1997, xxx Xxxxxxxx of Xxxxxxx xxxxx xxxxxxx xxxxxxx and xxxxxx xx x xxxxxx xxxxxx. Xxxxxxxxxxxx, the Xxxxxxxx xxxxx xxxxxxxx xx xxxxxxxxxxxxx with xxx police or x xxxxxxx authority xx per the xxxxxxxx xxxxxxx xx xxx xxxx. Xxxxxx xxxxx months xxxx xxx date xx xxx xxxxxxx xx xxx xxxxxxxxxxx xxx xxxxxxxxxx xx the xxxxxxxxx documents, the Xxxxxxxx shall xxxxxx xxxxxxx xxx xxxxxxx xx xxxxxx the xxxxxxxxx of xxx xxxxxxx xxx xxxx xxxxxxx xxx been xxxxxxxx.

- Xxx applicant xxxxx be xxxxxxxxxx x xxxxxx as xxx Xxx Xx. 209/1997 Xxxx. xxxx xx xx/xxx xxx xxxxxxxx xxxxxx xxxx xx x result xx xxx xxxxxxxxxx xx x xxxxx. X xxxxxxxxx but xxx xxx ohly xxxxxxxxx for xxx xxxxxx'x xxxxxxx xx xxxxxxxx xxxxxxx shall xx xxx xxxxxx xx the point-based xxxxxxxxxx xx the xxx xxxxxxxx (not xxx weakening xx xxxxxx position), xxxxx xxxx be at xxxxx 100 points. Xxxxxxxxx of x xxxxxx xxx xxx xxxx xx consequence xx x xxxxx xxxxx xx considered xx be x xxxxxx if the xxxxxxxx xx a xxxxxx, xxxxxx or xxxxx xx xxx xxxxxxxx and xxx xxxxxxxx shared a xxxxxxxxx xxxx the xxxxxxxx xx xxx xxxx of his/her xxxxx xx if xxx xxxxxxxx supported xx was xxxxxxxx xx xxxxxxx the xxxxxxxx.

- Xxx Xx. 209/1997 Xxxx. xx xxx xxxxxxxxx of xxxxxxxxx support xx xxxxxxx xx xxxxxxxx xxxx xxxxxxxxxx a xxxxxxxxxx xxxx xx 1 xxxx xxxx xxx xxxx xx xxxxx xxx victim xxxxxxx of xxx xxxx xxxxxx xx xxx xxxxx. Xx xxxx xxxx xxxx xxx xxxxxxxx with xxx xxxx of xxx xxxxxxxxxx xx xxx xxxxx, xxx xxxxxx shall xxxxxxx xxxxxxxx xx xxx xxxx xx xxxxx xx/xxx xxxxxxx xx xxx xxxxxxxxxxxx. The Xxxxxxxx xx Xxxxxxx xxxxxx xxxx an xxxxxxxxxxx for xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xxxxxxx xxxxx xxx xxxxx xx xxx xxxxxxxxxxxxxx xxxxxx.

- Xxxxxxxxx xxxxxxx xx xxxxxxx xxx xx a xxxxxx xxx xxx suffered xxxxxx xxxx as x result xx xxx xxxxxxxxxx of x crime xxx xx xx xxx xxxx xx a xxxx xxx xxxxxxxxx xx XXX 25,000 xx an xxxxxx xxxxx to xxxx xxxxxx xx the xxxxx xx xxxxxxx xxxxxxxxx xx xxxxxx xx xxx xxxxxx, xxxxxxx xx any xxxxxx previously xxxx xx xxx xxxxxx xx xxxxxxxxxxxx xxx xxx xxxx incurred. Xxx xxxxx amount xx xxxx support xxxx xxx xxxxxx XXX 150,000. If, xxxxx the xxxxxxxxx xx xxxxxxx, xxx xxxxxx xxxxxx xxxx xxx harm suffered xxxxxxx the amount xxxxxxxx, xxx victim xxx xxxxxxx xxxxxxxxxx xxxxxxx xx xx xxx xxxxxx of XXX 150,000 xx xx/xxx applies xxx xx xxxxxx xxx xxxxxxxxxxxxxx period xx xxxx (x.x., 1 xxxx xxxx xxx xxxx xx xxxxx xxx victim learned xx xxx harm xxxxxx xx xxx xxxxx); xx such xxxx, any xxxxxxx xxxxxxx xxxx will xx taken xxxx xxxxxxx.

- An xxxxxxxxxx xxx xx x xxxxxxxx xx x xxxxxx xxx xxx xxxx xx x xxxxxx xx xxx xxxxxxxxxx xx x xxxxx (x xxxxxx, xxxxxx xx xxxxx xx xxx xxxxxxxx xxxxxx xx a xxxxxx xxxxxxxxx with xxx xxxxxxxx xx xxx xxxx of xxx/xxx xxxxx xx xxxxxxxxx xx xx xxxxxxxx to xx xxxxxxxxx xx xxx xxxxxxxx) shall xx xxxxxxxx xxxx x xxxx sum xxxxxxxxx xx XXX 150,000. Xxx xxxxx xxxxxx xxxxxxxx xx financial xxxxxxx xxxxx not xxxxxx XXX 450,000; xxxxxx xxx xxxxxx xx xxxxxxx xxxxxx xxxxx, xxx amount xxxxxxxx xxx xxxxxx xxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxx Xx. 209/1997 Xxxx. xxxx xxx replace the xxxxxxxxx xx xxx xxxxxxxxx xxxxxxxxx xx xxxxxxxxx xx motor xxxxxxxx related xx xxxxxxxxxx xxxxxxxxx xxxxxxxxx. Xx matters xxxxxxx xx xxxxxxx accidents, xxxxxxxxxxxx for xxxxxxxxx xxxxxxxx xxxxxx xxxx xx xxxxxxxx xx xxx xxxxxxxx xxxxxxxxx xxxx xxxxxxxxx insurance. Xxxx xx xxxxxxxx xxxxx, xx view xx exceptional xxxxxxxxxxxxx, xxx xx xxxxxxxxxxx xxx xxx xxxxxxxxx xx financial xxxxxxx xx xxxxx xxxx xxx Xxxxxxxx of Xxxxxxx.

- Xxxxxx xxxx xx mind that xxx available xxxxxxxxx xxx xxxxxxxxxxxxx xxxxxxxx xxx xxx xxxxxxxxxx xxxxx xxxx be xxxxxxxx xx xxx xxxxxxxxxxx. If xxx xxxxxxxxx xxxxx to xx xx, xxx Xxxxxxxx xx Xxxxxxx xxxxxx xxxxxxxx process xxx xxxxxxxxxxx. Should xxx xxxxxxxxx fail xx deliver xxx xxxx xxxxxxxxx xxx xxxxxxxxxxxxx xxxx xxxxxx x xxxxxxxxxxxxx deadline, xxxx fact xxx xxxxxxx x xxxxxxxx xx xxxxxxxx any xxxxxxx xx per Xxx No. 209/1997 Xxxx. Xxxx shall xxx, xxxxxxx, xxxxxxxxx xxx xxxxxx of xxxxxxx xxxxxxxxxxx.

- Xxxxxx xxxx xx xxxx xxxx xxx xxxxxxxxx xxxxx be obliged xx xxxxxx xxx xxxxxxxxx amount received xx compensation xxx xxxx (from the xxxxxxxx, xxxxxxxx xxx.) xx the account xx the Xxxxxxxx xx Xxxxxxx xx xx xxx amount xx xxx xxxxxxx xxxxxxxx. Xxxx xxxxxxxxxx xxxx xxx apply xx xx/xxx has xxx xxxxxxxx xxx xxxxxxxxxxxx. Xx so xxxxxxxxx xx the xxxxxx xx xx xxxxxxxxxxx, the Xxxxxxxx xx Xxxxxxx xxx xxxxx xxx xxxxx'x xxxxx xx claim xxx xxxxxx of xxx xxxxxxxxx support xxxxxxxx xxxxx xxx xxxxx xx xxx xxxx-xxxx xxxx, xxxxxxxx xxxx x xxxxxx xx justified by xxx xxxxxx'x xxxxxx xxxxxxxx, xxx xxxxx xxxxxx of the xxxx xxxxxxxx and xxx xxxxxx xx xxxxxxxxxxxx xxxx xx xxx xxxxxx.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, xx x xxxxxxxx, v xxxxxx xx nachádzate, xxx xxxxxx Xxx xxxxxxxxx xxxxxxxxxxxx otázkami. V xxxxxx rýchleho xxxxxxxxx Xxxxx xxxxxxxx x xxxxxxxxxxx peňažnej pomoci xxxxxxx trestnej xxxxxxxx xxxľx xxxxxx č. 209/1997 Zb., xx xxxx xxxxxxxxx xxxxx xxxxxxxxx nevyhnutné. Xxxxxxxx Xxx za xxxxxxxxxx, ktorú xx xxxxx xxxxxx.

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X. Xxxxxx, xxxxxxx xxxxxxľxx xxxxxx xxxxx o xxxxxxxľxxx - xxxxx xxxxxxxxx xxxx, ktorej xxôxxxxxx xxxx na xxxxxx, xxxxx xxxxx xxxxxxxxxx xx xxxxx, ktorá x xôxxxxxx trestného xxxx zomrela:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx narodenia:

4. Xxxxxx xxxxxxxx xxxxxx:

5. Xxxxxxxxxxxxxx adresa (x xxxxxxx, že xx xxxx od xxxxxx xxxxxxxx xxxxxxxx):

6. Xxxxxxx:

7. X-Xxxx:

8. Xxxxxxxxxx:

XX. Ak xxxxxxxľx xxxxxxxxx xxx xxxxx (xxxxxxxx) na xxxxxxx zákonného xxxxxxxxxx (xxxx. xxxxxxxx xxxxx xxxxxx xxxxxxx) xxxxx xx xxxxxxx dohody x plnej xxxx, xxxxxxx xxxxx x xxxxxxxxxx:

1. Xxxxxxxxxx:

2. Meno:

3. Xxxxxxxxxxxxxx xxxxxx:

Xx xxxxxxx xx inú xxxxx, xxxx xx xxxxxxx xxxxxxxxxx, xxxxx zastúpenie xxxxxxx. Xxxxx x xxxxxxxx xxxxxxxx xxxxx xxxxx xxxx (pri xxxxxxxx xxxxxxxxx) xxxxx xxxxx xxxxxxx listu (x xxxxxxx xxxxxxxxx xxxxxxxxxx) alebo xxx xxxxxxx xxxxxxx.

XXX. Ak xxxxxxxľ xxxxx xxxxx xxxxxxxxx xx osobe, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xxxxxxx, xxxxxx, xx xxxxx x xxxxxxx xxxxx:

1. Priezvisko:

2. Xxxx:

3. Xxxxx narodenia:

4. Xxxxx xxxxxx:

5. Posledné xxxxxxxx:

7. Xxxxxxxxxx:

8. X xxxx xxxxxx bola xxxxxxx xxxxx x xôxxxxxx xxxxxxxxx xxxx k xxxxx žiadateľa (xxxx, xxxxx, xxxxx xxxxxx x xxxxxxxxx domácnosti):

Ak xx žiadateľ xxxxxx xxxxxxxxxx xx xxxxx, xxxxx v xôxxxxxx xxxxxxxxx xxxx zomrela, x xxxxxxxx xx xxxx priložiť xxxxx xxxxxxxx xxxxx a xxxxxxx, xxxxx xxxxxxxxx xxxxxxxxxx, xx xxxxxx xxxxx vyživovala pozostalú xxxxx xxxxx mala xxxxxxxxx xx xxxxxxxxx (xx xxxxxx rodič - dieťa xôxxx x xxxxx xxxx xxxxx rozhodnutie xxxx x xxxxxxxxxxx xxxxxxxxxx, xxx xxxxxxxx takou xxxxxxxx bude xxxxxxx xxxx x xxx.)

XX. Xxxxxx, xx xxxxxxx xxxxxxxx peňažnú xxxxx xxxxxxxxxxxxxxx pošty alebo xxxxxxxx na peňažný xxxx; x xxxxx xxxxxxx láskavo xxxxxxx xxxxx Vášho xxxx.

X. Xxxxxx xxxxx, xxxx xx obeť dozvedela x xxxxx xxôxxxxxxx xxxxxxxx xxxxx.

Xxxxxx dátum xxxxxxxxx xxxxxxxxx činu x xx xx xxxx x xxxxx xxx xxôxxxxxxx dozvedela xx xxxxôx, xxxxxx xxxx x xxx (xxxxxxxxx x lekárskej xxxxxx - xxxxx xxx vystavenia).

VI. Xxxxxxx xxxxx činný x xxxxxxxx xxxxxx (xxxxxxxxx xxxxx, xxxxxx zastupitelstvo, xxx), ktorý xxxxxxxxx xxxxx konanie o xxxxxxxx xxxx. Uveďte xx xxxxxxx xxxxxx, xxx xxxxxx prebieha xxxxxxxxxxxx.

Xx máte x xxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxx činného x xxxxxxxx xxxxxx, ktoré xxxx xxxxxxxxx x xxx, x akom xxxxxx xx vec xxxxxxxx (xxxx. xxxxxxxxx x xxxxxxxx xxxxxxxxx xxxxxxxx, xxxx xxxxxxxx, xxxxxxxx - x xxxxxxxxxxxxx), xxxxxxxx xx x žiadosti.

VII. Xxxxxx, xxxx xxôxxxxx xxx xxxxxxxxx nárok xx xxxxxxx xxxxx xx xxxxxxxľx xxxxx inej xxxxx, xxxxx zodpovedá xx škodu.

Podľa xxxxxxxxxxx §8 zákona č. 209/1997 (Xx)., xxxxxxxx xxxxx xx xôxx xxxxxx xxxxx xx xxxxxxxx x prihliadnutím xx xx, xx xxxx xxxxxxx xxxxxx xxxxxxx xxxxxxxxxxx na xxxxxxxxxx xxxxxx xx xxxxxxx xxxxx od xxxxxxxľx alebo xxxx xxxxx, xxxxx zodpovedá xx xxxxx. Xxxxx xxx xxxxxxxxxxx, xx xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

Xxx VIII. Vyplňte, xx xxxxxxxľ xx xxxxxxxxxx xx xxxxx, xxxxx v dôsledku xxxxxxxxx činu zomrela.

VIII. Xxxxxx, xx ste xxxxxxx xxxxxx, xxxxx xxľxx podmienky xxxxxxx x §2 odst. 2 zákona č. 209/1997 Zb., prípadne xxľxx xxôx xxľxx xxxxx podmienky, xx xx Vám xxxxx xxxxxxxxxxx známe.

1. Xxxx xxx xxxxxxx, xxxxxxxx xxxxx dieťaťom osoby, xxxxx xxxxxxx x xôxxxxxx trestného xxxx?

2. Xxxx xxx s xxxxxx trestného činu xxxx xxxxxxxxx xxxxxxxxx xxxx x spoločnej xxxxxxxxxx?

3. Xxxxxxxxxxx Xxx xxxx xxxxxxxxx xxxx xxxxxx, xx xxxx x xxxx xxxxxxx?

4. Xxľxxxx další xxxxx xxxxxxxxxxx podmienky 1 xx 3? Uveďte xxx xxxxx, xx Xxx xx xxxxx.

Xxxľx xxxxxxxxxxx §2 xxxx. 2 xxxxxx x. 209/1997 Zb. xx xx xxxx xxxxxxxx xxxxx pozostalá po xxxxx, ktorá v xôxxxxxx xxxxxxxxx xxxx xxxxxxx, ak xx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx v xxxx xxxx smrti x xxx xxxx x xxxxxxxxxx xxxxx xxxxx, xxxxxx xxxxxx xxxxxxxxxx xxxxx xxx xxxxxxx xxxxxxxxxx xxxxxx.

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Xxxx XX. xx XXX. Xxxxxxx, xx xx žiadateľ xxxx xxxxxx xxxxxxxxx xxxx x xxxx xx xxôxxxxxx ujma xx zdraví.

IX. Xxxxxx xxxxx, xxxx sa xxxxxxxx xxxxxxxx, xxxxxxxxxx xxxx xx xxxxxxxx xxxxxxxx neschopnosť.

X. Xxxxxxx xxxxx xxxxxxxx xxxxxxxxxxx xx xxxxxx činí:

K xxxxxxxx xx musí xxxxxxxx xxxxxx ohodnotenie xx xxxxxx xxxľx xxxxxxxx č. 440/2001 Zb., xxxxx xxxxxxxľ xxxxx xx xxxxxx, ktorý xx xxxxxxxxx. Xxxxx lekársky xxxxxxx xxxx obsahovať xxxxxx xxxxxxxxxx vytrpenej xxxxxxx x bodové xxxxxxxxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx. Xxxxxxxxxxx, že xxx xxxxx xxxxxx č. 209/1997 Zb. je xxxxxxxxxx xxx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxxľx xxxxxxxxxxx §6 xxxx. 2 xxxxxx x. 209/1997 Xx. xxxxxxx xxxxxxxxx' xxxxxxx pomoc, xx bodové ohodnotenie xxxxxxxxx xxxxxxx nedosiahne xxxxxxxx 100 xxxxx.

XX. Xxxxxx, či xxxxxxx x poskytnutie xxxxxxxx xxxxxx xx výške xxxxxxxxx čiastky 25&xxxx;000.- Xx alebo xx xxxxxxxx xxxxx ušlého xxxxxxx a nákladov xx xxxxxxxx.

Xxxľx ustanovenia §7 xxxx. 1 xxxx. x) xxxxxx x. 209/1997 Xx. xx žiadosť obete xxxxx xxxxxxxxx xxxxxxx xxxxx vo výške xxxxxxxxx sumy 25 000.- Xx, xxxxx xx xxxxx xxxxxxxxxxxxxx xxxxxxxxxxx xxxxxxxx xx liečenie x xxxxxx xxxxxxx. Xx sa xxxxxxxxxx xxxxxx x xxxxxxx xxxxx xx výške xxxxxxxxx čiastky, xxxxxxxx xx xxxxxxxxx xxxx XXX. - XIV. xxxxx xxxxxxxxx.

XXX. Xxxxxxx xxxxxxx x liečením xxxxxx:

Xxx x náklady xx xxxxx, xxxxxxxxxxxx xxxôxxx, xxxxxxx na xxxxxxxxxxxxx, xxxxxxxxx xxxxxx xxxxx xx pomoc x xxxxxxxxxx či xxxxxxxxxx, zvýšené náklady xx dopravu, x xxx. pod podmienkou, xx tieto xxxxxxx xxxxxxxxx xxxxxxxxx. Tu xxxxxxx xxxxxxx xx xxxxx xxxxxxx, xxxx xx xx xxxxxxxxxxxx xxxxxxxxxxxxxx nebude xxxx xxxx xxxxxľ.

XXXX. Xxxxxxx xxxxxxxxx xxxxxx xxxxxxxľx xxxx a xx xxxxxx xxxx xx xxxxxx xxôxxxxxxx xxxxxxxx xxxxx.

X xxxxxxxx xxxxxxxx xxxxxxx, ktoré potvrdzujú xxxxxxx xxxxxxxxxxx.

X xxxxxxx, xx žiadateľ je x xxxxxxxxxxxxxx pomere, xôxxx o xxxxxxxxxx xxxxxxxxxxxxľx x xxxxxxxxxx xxxxxxx podľa §351 x xxxx. zákona x. 262/2006 Xx., xxxxxxxx xxxxx, v xxxxx neskorších xxxxxxxxx. Xx je žiadateľ xxxxxx xxxxxxxxxx zárobkovo xxxxxx, takou listinou xxxx napríklad opis xxxxxxxxxx daňového xxxxxxxxx. Xx žiadateľ xxxxxx xxxxxxxx xôxxxxxx, xxxxxxxx, xxxxx xôxx xxxxxxx xxxxxxxx xxxxxxxx xxxxxxxx, xxxx potvrdenie x xxxxx xxxxxxxxxx xôxxxxxx. X prípade, že x xxxxxxxx xxxxxxxxx xôxxxx nemožno xxxxxxx xxxxxxxxx xxxxxx xxxxxxxľx, x xxxxxxx xxxxxxx xx možné xxxxxxxx xxxxxxxxxx x nich xxxxxxx vyhlásením.

XIV. Xxxxxx xxxxx xxxxxxxxxxxx dávok (xxxxxxxxxxx xôxxxxxx) x xxxx, odkedy xxx xxxxxxxľ xxxxxx, či xxxxxxx xx xxxxxx xxxx xx xxxxxx, xxôxxxxxxx xxxxxxxx činom.

K xxxxxxxx priložte potvrdenie xxxxxxxxxxxxľx alebo poisťovne x výške nemocenských xxxxx. X xxxxxxx, xx x xôxxxxxx xxxxx xx zdraví xxôxxxxxxx xxxxxxxx xxxxx Xxx xxxxxxxx invalidný xôxxxxxx, xxxxxx x xxxxxxx jeho xxxxx.

Xxxx xxxxxxxxx pomery xx xxxx, xx xxxxxxxx xxxxx, xxxxxxx xxx xxx(x) xxxxxx, xx moja xxxxxxxx xxxxxxxx xxxxxxxx. Xxxxx, xxxxx xx xxxxx xxôxxxxx, xxxxxľ xxxxxx xxxxxxxx.

Xxxxxx xxxxxxxxxx, že xxxxx na xxxxxxx xxxxx xx xxxxxxx xxxxx xx xxxxxxxxxxx xxxx xxôxxxxxxx xxxxxxxx xxxxx som xxxxxxxxxx(x) x xxxxxxx xxxx xxxxx xxx x Xxxxxx (Xxxxxxxxxx) republike.

Beriem xx xxxxxxx, xx xx podľa xxx. §12 zákona x. 209/1997 Xx., x xxxxxxxxxx peňažnej xxxxxx xxxxxxx trestnej xxxxxxxx x o xxxxx x x doplnení xxxxxxxxxx xxxxxxx, x xxxxx xxxxxxxxxx predpisov, xxxxxx xxxxxxxxx xx xxxxxxx rokov xxx xxx, keď mi xxxxxxxx xxxxx, xxxxxxx xx účet Xxxxxxxxxxxx xxxxxxxxxxxxxx čiastky, xxxxx xxx xxxxxx(x) ako xxxxxxx škody, x xx až xx xxxxx xxxxxxxxxxx pomoci. Xxxxxxx x xxx xxxxxx xx xxxxxxx, xx xx xxxxxxxx xxxxxxxxxx päťročnej xxxx xôxxx xxxxxxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx, aby sa x xxxx xxxxx xxxxxx xxxxx xx xxxxxxxx xxxxxxxxxxx pomoci, xx xxxx xxxxxxxx xxxxxxxx xxxx xxxx xxxxxx xxôxxxxxxxx, xxxxxxx xxxxx xxxxx, ktorú xx spôsobili a xxxxx xxxxxxx, xxxxx xxx xxxxxx(x).

Xxxxxx xxxx xx xxxxxxx, xx xxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxx xxxxxxxxx xxxxx xx jeho zatajením xx xxxxxx xxxxxxxx xxxxxxxxxxxx výhody, xx xôxxx dopustiť xxxxxxxxxx xxxľx §21 xxxx. 1 písm. c) xxxxxx č. 200/1990 Xx., o priestupkoch, x xxxxx xxxxxxxxxx xxxxxxxxx.

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xxxxxx žiadateľa xxxxx xxxxxxxx

- Xxxxxxxxxxxx spravodlivosti Xxxxx republiky xx xxxxxxx xxxxxxxx o xxxxxxxxxxx xxxxxxxx xxxxxx xxxľx xxxxxx č. 209/1997 Zb. xxxxxxx xxx xxxxxx x xxxxx poradové xxxxx. Xxxxx bude xxxxxxxxxx xx xxxxxxx xx xx xxxx xxxxxxxx xxxxxx xxxľx xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xx xxxxx xxxxxxxx xx xxxxxx žiadosti x xxxxxxxxxx xxxxxxxxxx xxxxxxxx xxx pomoc xxxxxxxx xxxxx žiadateľovi xxxxxx xôxxxx, prečo xxxxx xxxxxxx xxxxxxxx.

- X xxxxxx xxxxxx č. 209/1997 Zb. xxxx xxxxxxxľ xxxxxxxxxx za xxxx xxx x prípade, xx mu x xôxxxxxx trestného xxxx xxxx xxôxxxxxx xxxxxxxxxx xxxxxxx. Xxxxxxxxxxx, nie xxxx xxxxxxxxxxxx xxxxxxxxxx xx xxxxxxxxx xxxxxxxx xxxxxx takej xxxxx xx xxxxx bodového xxxxxxxxxxx xxxxxxx (xxx xxxx xxxxxxxx spoločenského xxxxxxxxxx) xxxxxxxxxxxx aspoň 100 xxxxx. Xx xxxx xx považuje xx osoba xxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx trestného xxxx xxxxxxx, xx xxxx xxxxxxx, xxxxxxxx xxxxx dieťaťom xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx x ním žila x domácnosti, xxxxx xxxxx, ktorej zomretý xxxxxxxxxx xxxxx bol xxxxxxx poskytovať xxxxxx.

- Xxxxx č. 209/1997 Zb. x xxxxxxxxxx xxxxxxxxx xxxxxx xxxxxxx trestnej xxxxxxxx xxxxxxxxx xxxxxxxxxxx (xxxxxxxx) xxxx 1 roka xxx dňa, keď xx xxxx xxxxxxxxx x škode xxôxxxxxxx xxxxxxxx xxxxx. Ak xxxxx dňom xx xxx je xxx xxxxxxxxx xxxxxxxxx xxxx, xxxx xxxxxxxx xxxxxxx, xxxx xx to xxxxx. Ministerstvo xxxxxxxxxxxxxx xxxôxx xxxxxxxx xxxxxxxxxx x poskytnutie xxxxxxxx xxxxxx, xxxxx xx xxxxxxxx xx xxxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx xx xx xxxxxxx xxxxx, xxxxxx x xôxxxxxx xxxxxxxxx činu xxxxxxx xxxxx xx xxxxxx, xxxxxxxx v xxxxxxxxx xxxx 25&xxxx;000.- Xx xxxxx xx xxxxx, xxxxx predstavuje xxxxxxxxxx xxxxxx xx xxxxxxx, preukázané xxxxxxx xxxxxxx s xxxxxxxx, xxxxxxx x xxxxx xxxxxxxx čiastok, ktoré xxxx z titulu xxxxxxx xxxxx xx xxxxxxx; xxxxx xx xxxxxx súčte xxxxxx xxxxxxxxxx xxxx 150 000.- Xx. Xx xxxx - xx xxx, xxx xxx xxxxxxxx xxxxx - xxxxxxxx, xx xxx vzniknutá xxxxx je vyššia xxx xx, xxxxx xxxx xxxxxxxxx xx xxxxxxxxxxx xxxxxx, xx xxx žiadosť v xxxxxx xxxxxxxxxx týmto xxxxxxx xxx xxxxx xxxxxxxxx pomoc opäť, x xx až xx xxxxxxxxxx xxxxx 150&xxxx;000.- Xx; xxxxxx xx prihliadne xx xxxxxxx, xxxxx xx xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, xxxxx je xxxxxxxxxx po xxxxx, xxxxx v xôxxxxxx xxxxxxxxx činu xxxxxxx (xx xxxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx x ním xxxx x xxxxxxxxxx, xxxxx xxx xxxxxxx xxxxxxxxxx, xx xxx xxxxxxx xxxxxxxxxx xxxxxx), xx xxxxxxxx xxxxxxx xxxxx x xxxxxxxxx xxxx 150&xxxx;000.- Kč; xxxxx xx xxxxxx xxxxx xxxxxx xxxxxxxxxx xxxx 450&xxxx;000.- Xx, x xx xx xxxxx xxxxx viac xxx xxx osoby, xxxxxxxxxxx xxxxxxx sa xxx xxxxxx xxxxx xxxxxxxxx kráti.

- Xxxxx č. 209/1997 Zb. xxxxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxxxxxxxxx vykonávateľa xxxxxxxxxx vozidiel, xx xxxxx xxxxäxxxx povinné xxxxxxx poistenie xxxxxxxxxxxxx. Xxxxx xx potrebné x xxxxxxxxxxxxxx dopravných xxxôx žiadať subjekt, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, x xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxx x xxxxxx xxxxxxxxxxx xxxxxxxxx x xxxxxxxxxxxxx xx xxxxxxxxx xxxxxxxxx xxxxxxxxx xx xxxxx xxxxxx xxxxxxxxxxxx xxxxxxxxxxxxxx x poskytnutie xxxxxxxx xxxxxx.

- Pripomíname, že xx nevyhnutné xxxxxxxx xxxxxx xxxxxxxx xxxxxxx x xxxxxxxxxx, na xxxxx xxxxxxxxxx xxx xxxxxxxxxxxx xxxxxxxxx. Xx xxx xxxxxxxľ neučiní, xxxxxxxxxxxx spravodlivosti xxxôxx xxxxxxx xxxxxxx. Ak xxxxxx potvrdenia x xxxxxxx ani xxxxxxxxx xxxxxx, táto xxxxxxxxxx xôxx xxx xôxxxxx xxxxxxxxxxxxx xxxxxxxx pomoci xxxľx xxxxxx č. 209/1997 Zb. Xx však nevylučuje xxxxxxx xxxxx xxxx xxxxxxx.

- Xxxxxxxxxxxx, xx xx bude xxxxxxxľxxx xxxxxxxxxx xxxxxxx xxxxx, xxxxxxxľ xx xx xxxxxxx xxxxx odo xxx poskytnutia pomoci xxxxxxx na xxxx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxx, xxxxx xxxxxx ako xxxxxxx xxxxx (xx xxxxxxxľx, xxxxxxxxx x xxx.) xx xx xxxxx xxxxxxxxxxx pomoci. Xxxx xxxxxxxxx xxxx, xx xx škodu xxxxxxxxxx. Xx základe xxxxxxxx xxxxx xx xxxxxxxxxxxx xxxxxxxxxxxxxx môže x mene xxxxx xx uplynutí xxxxxxxxxx xäxxxxxxx xxxx vzdať xxxxx xx xxxxxxxx xxxxxxxxxxx peňažnej xxxxxx. Xx xxxxxx xxxxxx xxôxxxxxxx xxxxxxxx xxxxxxxx xxxxx, xxxxxxx xxxxx xxxxx, xxxxx xxx xxôxxxxxx, x výška xxxxxxx, xxxxx xxxx xxxxxxx.