Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Xxxxxxxxxx xx Xxxxxxxxxxxx xxx xxx Xxxxxxxxx of Xxxxxxxxx Xxxxxxx to Xxxxxxx of Xxxxxxxx Xxxx xxxxxxxx xx Xxx Xx. 209/1997 Xxxx., xx the xxxxxxxxx xx fulancial xxxxxxx xx the xxxxxxx xx xxxxxxxx xxxx xxx xx xxxxxxxx certain other xxxx, xx xxxxxxx

Xxxx Xxx/Xxxxx,

Xx apologise xxx xxxxxxxxx xxx with xxxxxxxx xxxxxxxxx xx xxxx current situation. Xxxxxxx, filling xx xxxx xxxxxxxxxxxxx xx xxxxxxxx xxx xxx xxxxx assessment xx xxxx xxxxxxxxxxx for xxx xxxxxxxxx xx xxxxxxxxx support xxxxxxxx xx Xxx no. 209/1997. Xxxxx you xxx xxxx xxxxxxxxxxx; xx xx xxxxxx xxxxxxxxxxx.

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X. Xxxxxx legibly xxxx in xxx xxxxxxxx data of xxx xxxxxxxxx - x.x. the victim xx xxx xxxxxxxx xxx xxx xxx xxxxxxxx xxxxxx harm, xx xxx xxxxxxxx xx x person xxx xxx xxxx xx xxxxxxxxxxx of xxx xxxxxxxx act:

1. Xxxxxxx:

2. Given name:

3. Xxxx xx birth:

4. Xxxxxxxxx xxxxxxx:

5. Xxxx xxxxxxxx address (xxxxxx xx diffen from xxx permanent xxxxxxx, xxxx):

6. Xxxxx Xxxxxx:

7. X-xxxx xxxxxxx:

8. Nationality:

II. Xx the xxxxxxxxx xx xxxxxxxxxxx xx xxxxxxx xxxxxx ("xxxxxxxxxxxxxx") xx xxx basis xx statutory xxxxxxxxxxxxxx (xxx xxxxxxxx, x xxxxx child xxxxxxxxxxx xx xxx/xxx xxxxxx) xx on the xxxxx xx a xxxxx xx attorney, xxxxxx xxxx xx xxx xxxx xx xxxx representative:

1. Surname:

2. Xxxxx xxxx:

3. Permanent xx registered address:

If xxx representative is xxxxxx xxx xxxxxxxxxxx xx xxxxxx xx xxx xxxxxxxxx, xxxxxx xxxx submit x xxxxxxxx xxxxxxxxxxx him/her xx xxxxxxxxx the xxxxxxxxx - x xxxx xx x xxxxx xx xxxxxxxx (xxx xxxxxxxxxxx xxxxxxxxxxxxxx) xx x xxxx xx xxx xxxxx xxxxxxxxxxx (xxx statutory xxxxxxxxxxxxxx) xx xxx xxxxx xxxxxxxxxx document.

III. Xx the xxxxxxxxx xx a xxxxxxxx xx x person xxx xxx xxxx xx xxxxxxxxxxx xx xxx respective xxxxxxxx xxx, xxxxxx xxxx xx xxx xxxxxxxx xxxx xx xxx xxxxxxxx:

1. Surname:

2. Xxxxx xxxx:

3. Xxxx xx xxxxx:

4. Xxxx xx xxxxx:

5. Xxxx permanent xxxxxxx:

6. Xxxxxxxxxxx:

7. Xxxxxxxxxxxx xx the deceased xx xxx xxxxxxxxx (x.x. xxxxxx, daughter, xx xxxxxxxxxx living xx xxxxxx xxxxxxxxx)

Xx xxx xxxxxxxxx is x xxxxxxxx of x xxxxxx who xxxx xx xxxxxxxxxxx xx the criminal xxx, xxxxxx attach x copy xx xxx death certificate xxx any documents xxxxxxx xxxx xxx xxxxxxxx xxxxxxxxx xx xxx xx obligation xx xxxxxxx xxx xxxxxxxx (xx xxx xxxx xx a xxxxxx-xxxxx xxxxxxxxxxxx, xxxx xxxxxxxxx include xxxxx xxxxxxxxxxxx or x xxxxx decision on xxx xxxxxxxxxx xx xxxxxxx xxx xxxxxxxxx; xx xxx case xx married couples, xxxxxx attach x xxxxxxxx xxxxxxxxxxx).

Xxxxxx xxxxxxx xxx xxxx xx which xxx xxxxx xxx xxxxxxxxx xxx, xx xxx victim learned xxxxx xxx consequences xx xxx xxxxx xx a later xxxx, xxxxxx xxxx xxxxxxx the xxxx xxx xxx manner xx which xxx xxxxxx xxxxxxx of xxxx xxxxxxxxxxxx (e.g., xxx xxxx xx xxx xxxxxxx xxxxxx).

XX. Xxxxxx xxxxxxx the xxxxxxxx xxxxxxx xxxxxxxxx (x.x. xxxxxx, xxxxxx xxxxxxxxxx'x xxxxxx, xxxxx) xxxxx xxxx xxxxxxxx xxxxxxxxx xxxxxxxx xxxxxxxxxxx. Xxxxx the xxxxxxxxx xxxxxx of xxx xxxx related to xxx respective xxxxxxxxxxx.

Xx xxxxxxxxx, xxxxxx xxxxxx xxx latest decision xx the xxxxxxxxxxxxxx xxxxxxxx xxxxxxx xxxxxxxxx xxxxx xxxxx indicate xxx stage of xxx respective xxxxxxxxxxx (x.x. resolution xx xxx xxxxxxxxxxxxxxx xx xxxxxxxx xxxxxxxxxxx, xxxx xx xxx xxxxxxxxxx, xxxxxxxxx - xxxxx xx xxxxxxxxx).

According xx the xxxxxxxxxx xx §8 xx Xxx no. 209/1997, xxx amount xx xxxxxxxxx xxxxxxx may xx xxxxxxx xx xxxxxxxx xxxxxxxxx on xxxxxxx the xxxxxx xxx xxxx xxx xx xxx xxxxx xxxxxxxx xx enforce x xxxxx for xxxxxxxxxxxx xxxxxxx the xxxxxxxx xx xxx xxxxx xxxxxx responsible xxx xxx harm xxxxxxxx. Do xxx xxxx xx xxxx xxxx xx xxx xxxxxxxx xxx xxx xxxx identified.

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Fill in xxxx XxXx xx xxx applicant is x xxxxxxxx of xx xxxxxxxxxx who xxx xxxx xx xxxxxxxxxxx xx the xxxxxxxxx xxxxx.

1. Xxx xxx x xxxxx, xxxxxx xx xxxxx xx the xxxxxx who died xx consequence xx xxx criminal xxxxxxx?

2. Xxx you live xx a common xxxxxxxxx xxxx xxx xxxxxxxx xxxxxx prior xx xxx commitment xx xxx xxxxx?

3. Xxxx you a xxxxxxxxx xx the xxxxxx xx was xxx deceased xxxxxxx xx support xxx?

4. Xx any xxxxx xxxxxxx xxxx the xxxxxxxxxx xxxxxxxxx in xxxxxxx 1 to 3? Xxxxxx give xxxxx xxxxxx, if xxxxx to xxx.

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Xxxxxxxxx xx xxx xxxxxxxxxx xx §2, xxxxxxx 2 xx Act xx. 209/1997, x xxxxxx who xx x xxxxxxxx xx x xxxxxx who xxxx xx xxxxxxxxxxx xx a criminal xxx xx considered xx xx x xxxxxx xx xx xx xxx xx x xxxxxx, spouse xx child of xxx deceased and xxxxx with xxx xx her in xxx same xxxxxxxxx xx xx xxx xxxxxx xxx a xxxxxxxxx of xxx xxxxxxxx xx xxx xxxxxxxx was xxxxxxxx xx xxxxxxx xxx xxxxxx.

Xx xxx xxxxxxxxx xx xxx xxxxxx xx x crime xxx xxx xxxxxxxx xxxxxx xxxx, xxxxxx xxxx xx xxxxx XX - XXX.

Xxxxxx xxxxxx x xxxxx-xxxxx xxxxxxxxxx xx xxxx xxx xxxxxxxxx xxxxxxxx to Xxxxxx No. 440/2001 Xxxx. Xxx respective xxxxxxxx xxxxxx xx xxxxxxxx xxxx xxx xxxxxxxxx xxxxxxxxxxx for xxx victim's treatment. Xxxx medical xxxxxx xxxx xxxxxxx x xxxxx-xxxxx xxxxxxxxxx xx xxx xxx suffered xxx x xxxxx-xxxxx xxxxxxxxxx of xxx xxxxxxxx xx the xxxxxx'x xxxxxx position. Xxxxxx bear xx xxxx that only xxx point-based xxxxxxxxxx xx xxx xxx xxxxxxxx xx xxxxxxxx xxx xxx purposes xx Xxx xx. 209/1997. Xxxxxxxxx xx xxx xxxxxxxxxx xx §6, xxxxxxx 2 xx Xxx no. 209/1997, xx xxxxxxxxx xxxxxxx xxxx xx xxxxxxxx xxxxxx the xxxxx assessment xx xxx xxxx suffered xx xx xxxxx 100 xxxxxx.

Xxx xxxxxx xxx obtain xxxx xxx financial xxxxxxx xx the xxxxxx of XXX 25,000 xx xx xxxxxx xxxxx xx xxx xxxxxx xxxxx xx xxxxxxx xxxxxxxxx xxx xxxx xxxxxx (§7, xxxxxxx 1, xxxxxx a xx Xxx No. 209/1997 Xxxx.). xx xxx xxxxxx xx xxxxx xxx a xxxx xxx xxxxxxx, xxxxx xx xx xxxx xx fill in xxxxx XXX - XxX.

Xxxx xxxxxxxx xxx expenses xxx xxxxxxxxxx, xxxxxxxx xxxxxxxxx, xxxxxxxxxxxxxx costs, xxxxxx xx xxxxxxxxx to xxxx out in xxx home or xxxx medical treatment, xxxxxxxxx xxxxxxxxxxxxxx xxxxx xxx., xxxxxxxx xxxx xxxxx xxxx not xxxx xxxx by xx insurance xxxxxxx. xx xxxx xxxxxxxx xxx xxx xxxxxx xx xxxxxxxxxxx xxxxxxxx, xxx Xxxxxxxx xx Xxxxxxx xxx xxx xxxx xxxx xxxx xxxxxxxxxxxxx.

Please attach xxx documents xxxxxxxxxx xxxx facts to xxx application.

If xxx xxxxxxxxx is an xxxxxxxx, xxxxx xxxxxxxxx xxxxx xxxxxxx x xxxxxxxxx xxxx xxx/xxx xxxxxxxx describing xxx xxxxxxx xxxxxx according xx §351 et. xxx. xx Act xx. 262/2006, xxx Xxxxx Xxxxxx Xxxx, xx xxxxxxx. xx xxx applicant is xxxx-xxxxxxxx, xxxx document xxxxx be x xxxx of xxx/xxx xxxx xxxxxx xxx xxxxxx. xx the xxxxxxxxx is a xxxxxxx xxxxxx who xx able to xxxxx xxx/xxx xxxxxxxx xxxxxx xxxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxx the xxxxxx xx xxx retirement xxxxxxx. lf xxx xxx xxxxxx the xxxxxxxxx'x income situation xxxxxx be xxxxxx, xx xxxxxxxxxxx cases xx xxxxxxxxx xxx xx attached.

Xx xxxxxx xxxxxxxx xxx xxxx xxxxxxxx xx x xxxxxx xx xxx xxxxxxxx xxx xx which X xxx x victim. X xxxx not xxx xxxx xxxxxxxxxxx xxx the xxxx 1 xxxx xxxxxxxx xx a xxxxxx xx the xxxxxxxx xxx.

X xxxxxx xxxxxx xxxx I xxxx xxx lodged xxx xxxxx for xxxxxxxxx xxxxxxx or xxx xxxxxxx xxxxx xxx xxxxxxxxxxxx for xxx xxxx suffered xx x result xx xxx xxxxxxxx xxx xx any country xxxxx than xxx Xxxxx Republic.

I xxxxxxxxxxx xxxx xxxxxxxxx xx §12 xx Act Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx support xxx xxx victims xx xxxxxxxx xxxx xxx xx xxxxxxxx xxxxxxx xxxxx xxxx, xx xxxxxxx, X xx xxxxxxx xx xxxxxxxxx xxx Ministry xx Xxxxxxx xxx xxxxxx received as xxxxxxxxxxxx for xxx xxxx xxxxxxxx, up xx xxx xxxxxx xx xxx xxxxxxxxx xxxxxxx, xxxxxx xxxx xxxxx from xxx xxxx xx xxxxxxxxx xxx funding xxxxxxx. X xxxx xxxxxxxxxxx xxxx, after xxx xxxxx xx xxx xxxx-xxxx period, X xxx xxxx xx xxxxxxxxxxx asking xxx Xxxxxxxx xx Justice xx xxxxx the xxxxx'x xxxxx for xxx return xx xxx xxxxxxxx support, xxxxxx xxxx x xxxxxx xx xxxx xxxxxxxx xx xx xxxxxx standing, xxx xxxxx xxxxxx of xxxx xxxxxxxx xxx xxx xxxxxx of xxxxxxxxxxxx xxxxxxxx.

X also xxxxxxxxxxx xxxx consciously xxxxxx false or xxxxxxxxxx information xx xxxxxxxxxxx xxxxxxxxxxx xxx xxx purposes of xxxxxxxxxxxxx xxxxxxx xxxxxxxx xxx xxxxxxxxx xx xxxxxxx xxxxxxxx xx §21, xxxxxxx 1, xxxxxx x) xx Xxx xx. 200/1990 Xxxx., xx offences xx amended.

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Signature xx xxx xxxxxxxxx or xxx/xxx xxxxxxxxxxxxxx

- Xxxx xxxxxxx xx the xxxxxxxxxxx xxx xxx xxxxxxxxx of xxxxxxxxx xxxxxxx pursuant xx Xxx Xx. 209/1997, xxx Ministry xx Xxxxxxx xxxxx xxxxxxx xxxxxxx xxx xxxxxx xx x xxxxxx xxxxxx. Xxxxxxxxxxxx, xxx Xxxxxxxx xxxxx xxxxxxxx xx investigation xxxx xxx police xx x similar xxxxxxxxx xx xxx the xxxxxxxx xxxxxxx of xxx xxxx. Xxxxxx xxxxx months xxxx xxx date xx xxx receipt xx xxx xxxxxxxxxxx xxx xxxxxxxxxx xx xxx xxxxxxxxx documents, xxx Xxxxxxxx xxxxx either xxxxxxx xxx xxxxxxx xx inform the xxxxxxxxx xx the xxxxxxx xxx such xxxxxxx xxx xxxx xxxxxxxx.

- The xxxxxxxxx xxxxx xx xxxxxxxxxx x xxxxxx as xxx Act No. 209/1997 Xxxx. xxxx xx xx/xxx has xxxxxxxx xxxxxx xxxx xx x result xx the xxxxxxxxxx xx x xxxxx. X xxxxxxxxx but xxx xxx ohly xxxxxxxxx xxx xxx xxxxxx'x xxxxxxx xx xxxxxxxx xxxxxxx xxxxx xx xxx xxxxxx xx the xxxxx-xxxxx xxxxxxxxxx xx xxx xxx xxxxxxxx (xxx xxx xxxxxxxxx xx xxxxxx xxxxxxxx), which xxxx xx xx xxxxx 100 xxxxxx. Xxxxxxxxx xx x xxxxxx xxx has xxxx xx xxxxxxxxxxx xx a xxxxx xxxxx be xxxxxxxxxx xx xx x xxxxxx xx xxx xxxxxxxx is a xxxxxx, xxxxxx or xxxxx of xxx xxxxxxxx and the xxxxxxxx shared a xxxxxxxxx xxxx xxx xxxxxxxx xx the xxxx xx xxx/xxx xxxxx xx if xxx xxxxxxxx xxxxxxxxx xx was xxxxxxxx xx xxxxxxx xxx xxxxxxxx.

- Xxx Xx. 209/1997 Xxxx. on xxx provision of xxxxxxxxx xxxxxxx xx xxxxxxx xx xxxxxxxx xxxx xxxxxxxxxx a xxxxxxxxxx xxxx of 1 year xxxx xxx date xx xxxxx xxx xxxxxx xxxxxxx xx xxx xxxx xxxxxx by xxx xxxxx. If xxxx date xxxx xxx coincide xxxx xxx xxxx xx xxx xxxxxxxxxx of xxx xxxxx, the xxxxxx xxxxx xxxxxxx xxxxxxxx xx xxx xxxx xx xxxxx xx/xxx xxxxxxx of xxx xxxxxxxxxxxx. Xxx Xxxxxxxx xx Xxxxxxx xxxxxx meet an xxxxxxxxxxx for xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx anytime xxxxx the xxxxx xx xxx abovementioned xxxxxx.

- Financial support xx xxxxxxx xxx xx x victim xxx xxx xxxxxxxx xxxxxx harm as x xxxxxx of xxx commitment xx x xxxxx may xx xx xxx xxxx xx x xxxx xxx xxxxxxxxx xx CZK 25,000 xx xx xxxxxx xxxxx xx lost xxxxxx xx the xxxxx of xxxxxxx xxxxxxxxx xx xxxxxx xx the xxxxxx, xxxxxxx xx xxx xxxxxx xxxxxxxxxx xxxx xx xxx xxxxxx xx xxxxxxxxxxxx xxx xxx harm xxxxxxxx. Xxx xxxxx xxxxxx xx xxxx xxxxxxx xxxx xxx xxxxxx XXX 150,000. If, xxxxx xxx provision xx xxxxxxx, the xxxxxx xxxxxx xxxx xxx xxxx xxxxxxxx xxxxxxx xxx xxxxxx xxxxxxxx, the victim xxx receive xxxxxxxxxx xxxxxxx up xx xxx amount xx XXX 150,000 xx xx/xxx xxxxxxx for xx xxxxxx the xxxxxxxxxxxxxx period xx xxxx (x.x., 1 xxxx xxxx the xxxx xx xxxxx xxx xxxxxx xxxxxxx xx xxx xxxx xxxxxx xx xxx xxxxx); xx xxxx xxxx, any xxxxxxx xxxxxxx xxxx xxxx xx xxxxx xxxx xxxxxxx.

- Xx xxxxxxxxxx xxx xx x xxxxxxxx of x xxxxxx xxx has xxxx as x xxxxxx of the xxxxxxxxxx xx x xxxxx (x parent, xxxxxx or xxxxx xx xxx xxxxxxxx xxxxxx xx a xxxxxx xxxxxxxxx xxxx xxx xxxxxxxx at xxx xxxx xx xxx/xxx xxxxx xx xxxxxxxxx xx or xxxxxxxx xx be xxxxxxxxx by the xxxxxxxx) shall be xxxxxxxx xxxx x xxxx xxx amounting xx XXX 150,000. Xxx total xxxxxx xxxxxxxx as financial xxxxxxx xxxxx not xxxxxx XXX 450,000; xxxxxx xxx xxxxxx xx xxxxxxx xxxxxx xxxxx, xxx xxxxxx xxxxxxxx xxx xxxxxx xxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxx No. 209/1997 Xxxx. xxxx xxx xxxxxxx xxx xxxxxxxxx xx the xxxxxxxxx xxxxxxxxx xx xxxxxxxxx xx xxxxx xxxxxxxx xxxxxxx xx xxxxxxxxxx liability insurance. Xx xxxxxxx related xx traffic xxxxxxxxx, xxxxxxxxxxxx xxx insurance xxxxxxxx should xxxx xx xxxxxxxx xx xxx xxxxxxxx providing xxxx xxxxxxxxx xxxxxxxxx. Xxxx in xxxxxxxx xxxxx, xx xxxx xx exceptional xxxxxxxxxxxxx, xxx xx xxxxxxxxxxx xxx xxx provision xx xxxxxxxxx xxxxxxx xx filed xxxx xxx Xxxxxxxx xx Xxxxxxx.

- Xxxxxx bear xx mind xxxx xxx xxxxxxxxx documents xxx confirmations xxxxxxxx xxx xxx xxxxxxxxxx xxxxx xxxx xx xxxxxxxx xx xxx xxxxxxxxxxx. If xxx xxxxxxxxx fails xx xx xx, xxx Xxxxxxxx xx Xxxxxxx xxxxxx properly process xxx xxxxxxxxxxx. Xxxxxx xxx xxxxxxxxx xxxx xx xxxxxxx any xxxx documents xxx xxxxxxxxxxxxx xxxx xxxxxx x xxxxxxxxxxxxx xxxxxxxx, xxxx xxxx xxx xxxxxxx x xxxxxxxx xx xxxxxxxx any xxxxxxx xx xxx Xxx No. 209/1997 Xxxx. This xxxxx xxx, xxxxxxx, xxxxxxxxx xxx filing xx xxxxxxx application.

- Xxxxxx xxxx xx xxxx xxxx the xxxxxxxxx xxxxx xx obliged xx return xxx xxxxxxxxx xxxxxx received xx xxxxxxxxxxxx for xxxx (xxxx the xxxxxxxx, xxxxxxxx xxx.) xx xxx xxxxxxx xx xxx Ministry xx Xxxxxxx up xx xxx amount xx xxx xxxxxxx xxxxxxxx. Xxxx obligation xxxx xxx xxxxx xx he/she xxx xxx xxxxxxxx any xxxxxxxxxxxx. If xx xxxxxxxxx by xxx xxxxxx xx xx xxxxxxxxxxx, xxx Ministry xx Xxxxxxx may xxxxx the xxxxx'x xxxxx xx claim xxx return xx xxx financial xxxxxxx xxxxxxxx xxxxx xxx xxxxx of xxx xxxx-xxxx xxxx, xxxxxxxx xxxx x xxxxxx xx xxxxxxxxx by xxx victim's social xxxxxxxx, xxx xxxxx xxxxxx xx xxx xxxx xxxxxxxx xxx xxx xxxxxx xx xxxxxxxxxxxx xxxx to xxx victim.

Vážený xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, že v xxxxxxxx, x xxxxxx xx nachádzate, sme xxxxxx Xxx xxxxxxxxx xxxxxxxxxxxx xxxxxxxx. V xxxxxx xxxxxxxx xxxxxxxxx Xxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx xxxxxxx trestnej činnosti xxxľx zákona č. 209/1997 Zb., xx xxxx xxxxxxxxx xxxxx xxxxxxxxx nevyhnutné. Xxxxxxxx Vám za xxxxxxxxxx, xxxxx xx xxxxx xxxxxx.

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X. Xxxxxx, xxxxxxx xxxxxxľxx osobné xxxxx x žiadateľovi - obeti xxxxxxxxx xxxx, xxxxxx xxôxxxxxx xxxx xx xxxxxx, xxxxx osobe xxxxxxxxxx xx xxxxx, xxxxx x dôsledku trestného xxxx xxxxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Xxxxxx xxxxxxxx pobytu:

5. Xxxxxxxxxxxxxx xxxxxx (v xxxxxxx, xx sa xxxx xx adresy xxxxxxxx bydliska):

6. Xxxxxxx:

7. X-Xxxx:

8. Občianstvo:

II. Ak xxxxxxxľx xxxxxxxxx xxx xxxxx (zástupca) xx xxxxxxx xxxxxxxxx xxxxxxxxxx (xxxx. xxxxxxxx xxxxx xxxxxx xxxxxxx) xxxxx xx základe xxxxxx x xxxxx xxxx, xxxxxxx údaje x xxxxxxxxxx:

1. Priezvisko:

2. Xxxx:

3. Xxxxxxxxxxxxxx xxxxxx:

Xx žiadate xx inú xxxxx, xxxx sa xxxxxxx xxxxxxxxxx, ktorá xxxxxxxxxx xxxxxxx. Preto x xxxxxxxx xxxxxxxx kópiu xxxxx xxxx (pri xxxxxxxx xxxxxxxxx) xxxxx xxxxx rodného xxxxx (x prípade xxxxxxxxx xxxxxxxxxx) xxxxx xxx xxxxxxx xxxxxxx.

XXX. Xx xxxxxxxľ xxxxx xxxxx xxxxxxxxx po osobe, xxxxx x xôxxxxxx xxxxxxxxx xxxx zomrela, xxxxxxx, xxxxxx, xx xxxxx x xxxxxxx xxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Dátum xxxxxx:

5. Posledné xxxxxxxx:

7. Xxxxxxxxxx:

8. X akom xxxxxx xxxx zomretá xxxxx v xôxxxxxx xxxxxxxxx xxxx k xxxxx žiadateľa (xxxx, xxxxx, osoba žijúca x spoločnej domácnosti):

Ak xx xxxxxxxľ xxxxxx xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx zomrela, x xxxxxxxx xx xxxx xxxxxxxx xxxxx xxxxxxxx listu x xxxxxxx, xxxxx xxxxxxxxx xxxxxxxxxx, xx xxxxxx xxxxx xxxxxxxxxx pozostalú xxxxx xxxxx mala xxxxxxxxx xx xxxxxxxxx (xx xxxxxx rodič - dieťa pôjde x rodný xxxx xxxxx rozhodnutie súdu x xxxxxxxxxxx xxxxxxxxxx, xxx manželov xxxxx xxxxxxxx bude xxxxxxx xxxx x pod.)

IV. Xxxxxx, xx xxxxxxx xxxxxxxx xxxxxxx pomoc xxxxxxxxxxxxxxx pošty xxxxx xxxxxxxx xx xxxxxxx xxxx; x xxxxx xxxxxxx láskavo xxxxxxx xxxxx Xxxxx xxxx.

X. Xxxxxx dátum, xxxx xx xxxx xxxxxxxxx x xxxxx spôsobenej xxxxxxxx činom.

Uveďte dátum xxxxxxxxx xxxxxxxxx xxxx x ak sa xxxx x xxxxx xxx xxôxxxxxxx dozvedela xx xxxxôx, xxxxxx xxxx a ako (xxxxxxxxx x lekárskej xxxxxx - xxxxx xxx xxxxxxxxxx).

XX. Xxxxxxx xxxxx činný x xxxxxxxx konaní (xxxxxxxxx xxxxx, štátne xxxxxxxxxxxxxx, xxx), xxxxx xxxxxxxxx xxxxx konanie x xxxxxxxx čine. Xxxxxx xx spisovú xxxxxx, xxx xxxxxx xxxxxxxx xxxxxxxxxxxx.

Xx máte x xxxxxxxxxx posledné xxxxxxxxxxx xxxxxx xxxxxxx x xxxxxxxx xxxxxx, xxxxx xxxx predstavu o xxx, x akom xxxxxx xx vec xxxxxxxx (napr. xxxxxxxxx x xxxxxxxx xxxxxxxxx xxxxxxxx, xxxx obžaloby, xxxxxxxx - i xxxxxxxxxxxxx), pripojte xx x žiadosti.

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

Podľa xxxxxxxxxxx §8 xxxxxx č. 209/1997 (Zb)., xxxxxxxx xxxxx xx xôxx xxxxxx alebo xx xxxxxxxx s prihliadnutím xx to, xx xxxx xxxxxxx xxxxxx xxxxxxx xxxxxxxxxxx xx xxxxxxxxxx xxxxxx na xxxxxxx xxxxx od xxxxxxxľx alebo inej xxxxx, xxxxx zodpovedá xx škodu. Tento xxx nevyplňujte, xx xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

Xxx VIII. Xxxxxxx, xx xxxxxxxľ xx xxxxxxxxxx po osobe, xxxxx v dôsledku xxxxxxxxx činu xxxxxxx.

XXXX. Xxxxxx, či ste xxxxxxx osobou, xxxxx xxľxx xxxxxxxxx uvedené x §2 odst. 2 xxxxxx x. 209/1997 Zb., prípadne xxľxx xxôx xxľxx xxxxx xxxxxxxxx, ak xx Xxx tieto xxxxxxxxxxx xxxxx.

1. Xxxx xxx xxxxxxx, xxxxxxxx xxxxx dieťaťom xxxxx, xxxxx xxxxxxx x xôxxxxxx xxxxxxxxx činu?

2. Xxxx ste x xxxxxx xxxxxxxxx činu xxxx xxxxxxxxx xxxxxxxxx xxxx x spoločnej xxxxxxxxxx?

3. Xxxxxxxxxxx Xxx xxxx xxxxxxxxx xxxx xxxxxx, či bola x xxxx povinná?

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

Podľa xxxxxxxxxxx §2 xxxx. 2 xxxxxx x. 209/1997 Xx. sa xx xxxx xxxxxxxx xxxxx xxxxxxxxx po xxxxx, xxxxx v xôxxxxxx xxxxxxxxx činu xxxxxxx, xx xx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx a xxxxxxx x čase xxxx xxxxx x xxx xxxx x xxxxxxxxxx alebo osoba, xxxxxx nebohý xxxxxxxxxx xxxxx xxx xxxxxxx xxxxxxxxxx xxxxxx.

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Xxxx IX. xx XXX. Xxxxxxx, xx xx žiadateľ xxxx xxxxxx xxxxxxxxx xxxx a xxxx xx xxôxxxxxx xxxx xx xxxxxx.

XX. Uveďte xxxxx, kedy xx xxxxxxxx xxxxxxxx, xxxxxxxxxx xxxx xx xxxxxxxx xxxxxxxx xxxxxxxxxxx.

X. Celková xxxxx bodového xxxxxxxxxxx xx xxxxxx xxxx:

X xxxxxxxx sa musí xxxxxxxx bodové xxxxxxxxxxx xx bolesť xxxľx xxxxxxxx č. 440/2001 Zb., ktoré xxxxxxxľ xxxxx xx xxxxxx, xxxxx xx xxxxxxxxx. Xxxxx lekársky xxxxxxx xxxx obsahovať xxxxxx hodnotenie vytrpenej xxxxxxx a xxxxxx xxxxxxxxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx. Xxxxxxxxxxx, že xxx xxxxx xxxxxx č. 209/1997 Zb. je xxxxxxxxxx xxx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxxľx xxxxxxxxxxx §6 odst. 2 xxxxxx x. 209/1997 Zb. nemožno xxxxxxxxx' xxxxxxx pomoc, xx xxxxxx xxxxxxxxxxx xxxxxxxxx bolesti nedosiahne xxxxxxxx 100 xxxxx.

XX. Xxxxxx, či xxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx xx xxxxx xxxxxxxxx čiastky 25 000.- Xx xxxxx či xxxxxxxx výšku xxxxxx xxxxxxx x nákladov xx xxxxxxxx.

Xxxľx xxxxxxxxxxx §7 xxxx. 1 xxxx. x) xxxxxx x. 209/1997 Xx. xx xxxxxxx xxxxx xxxxx poskytnúť peňažnú xxxxx vo výške xxxxxxxxx xxxx 25&xxxx;000.- Xx, alebo vo xxxxx xxxxxxxxxxxxxx preukázaným xxxxxxxx xx xxxxxxxx x xxxxxx xxxxxxx. Xx sa xxxxxxxxxx xxxxxx x xxxxxxx xxxxx xx xxxxx xxxxxxxxx xxxxxxx, nemusíte xx vyplňovať body XXX. - XXX. xxxxx xxxxxxxxx.

XXX. Xxxxxxx xxxxxxx x xxxxxxxx xxxxxx:

Xxx x náklady xx xxxxx, zdravotnícke xxxôxxx, náklady na xxxxxxxxxxxxx, xxxxxxxxx cudzej xxxxx na xxxxx x xxxxxxxxxx či xxxxxxxxxx, zvýšené náklady xx xxxxxxx, x xxx. pod podmienkou, xx xxxxx xxxxxxx xxxxxxxxx xxxxxxxxx. Xx xxxxxxx xxxxxxx xx xxxxx doložiť, inak xx ne xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxx xxxx xxxx zreteľ.

XIII. Xxxxxxx xxxxxxxxx pomery xxxxxxxľx xxxx a xx xxxxxx xxxx xx xxxxxx spôsobenej trestným xxxxx.

X xxxxxxxx xxxxxxxx xxxxxxx, ktoré xxxxxxxxxx xxxxxxx skutočnosti.

V xxxxxxx, xx žiadateľ je x zamestnaneckom xxxxxx, xôxxx x xxxxxxxxxx xxxxxxxxxxxxľx o xxxxxxxxxx xxxxxxx podľa §351 x xxxx. xxxxxx x. 262/2006 Xx., xxxxxxxx xxxxx, x xxxxx xxxxxxxxxx xxxxxxxxx. Xx je xxxxxxxľ xxxxxx samostatne xxxxxxxxx xxxxxx, takou xxxxxxxx xxxx xxxxxxxxx xxxx xxxxxxxxxx daňového xxxxxxxxx. Xx xxxxxxxľ xxxxxx xxxxxxxx dôchodok, xxxxxxxx, xxxxx xôxx xxxxxxx xxxxxxxx xxxxxxxx xxxxxxxx, xxxx xxxxxxxxxx o xxxxx starobného xôxxxxxx. X xxxxxxx, xx x xxxxxxxx xxxxxxxxx xôxxxx nemožno xxxxxxx xxxxxxxxx xxxxxx xxxxxxxľx, x xxxxxxx xxxxxxx xx xxxxx xxxxxxxx xxxxxxxxxx x xxxx xxxxxxx xxxxxxxxxx.

XXX. Uveďte xxxxx xxxxxxxxxxxx xxxxx (xxxxxxxxxxx dôchodku) a xxxx, xxxxxx ich xxxxxxxľ xxxxxx, xx xxxxxxx po vzniku xxxx xx xxxxxx, xxôxxxxxxx xxxxxxxx xxxxx.

X xxxxxxxx xxxxxxxx potvrdenie xxxxxxxxxxxxľx xxxxx xxxxxxxxx x výške xxxxxxxxxxxx xxxxx. V xxxxxxx, xx x xôxxxxxx xxxxx na zdraví xxôxxxxxxx xxxxxxxx činom Xxx priznali invalidný xôxxxxxx, uveďte a xxxxxxx xxxx xxxxx.

Xxxx xxxxxxxxx pomery xx xxxx, xx xxxxxxxx činom, xxxxxxx xxx xxx(x) xxxxxx, xx xxxx sociálna xxxxxxxx zhoršila. Xxxxx, xxxxx xx xxxxx xxôxxxxx, dosiaľ xxxxxx xxxxxxxx.

Xxxxxx xxxxxxxxxx, že xxxxx na xxxxxxx xxxxx xx xxxxxxx xxxxx xx xxxxxxxxxxx xxxx xxôxxxxxxx trestným xxxxx som neuplatnil(a) x xxxxxxx xxxx xxxxx ako v Xxxxxx (Slovenskej) xxxxxxxxx.

Xxxxxx xx xxxxxxx, xx xx xxxľx ust. §12 xxxxxx x. 209/1997 Xx., x xxxxxxxxxx peňažnej xxxxxx xxxxxxx trestnej činnosti x x zmene x o xxxxxxxx xxxxxxxxxx xxxxxxx, x xxxxx xxxxxxxxxx xxxxxxxxx, xxxxxx xxxxxxxxx xx xxxxxxx rokov xxx xxx, xxx mi xxxxxxxx xxxxx, xxxxxxx xx xxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx čiastky, xxxxx xxx dostal(a) xxx xxxxxxx škody, x xx xx xx xxxxx xxxxxxxxxxx xxxxxx. Xxxxxxx s xxx xxxxxx na xxxxxxx, xx xx xxxxxxxx xxxxxxxxxx xäxxxxxxx xxxx xôxxx xxxxxxxx Ministerstvo xxxxxxxxxxxxxx, aby xx x xxxx xxxxx xxxxxx práva xx xxxxxxxx poskytnutej xxxxxx, xx xxxx sociálna xxxxxxxx xxxx taký xxxxxx xxôxxxxxxxx, xxxxxxx xxxxx xxxxx, ktorú xx xxôxxxxxx x 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 xxxxxxxx priestupku xxxľx §21 xxxx. 1 xxxx. x) xxxxxx č. 200/1990 Xx., x xxxxxxxxxxxx, x znení xxxxxxxxxx xxxxxxxxx.

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xxxxxx xxxxxxxľx xxxxx xxxxxxxx

- Ministerstvo xxxxxxxxxxxxxx Xxxxx republiky xx xxxxxxx xxxxxxxx x xxxxxxxxxxx peňažnej pomoci xxxľx zákona č. 209/1997 Zb. xxxxxxx xxx xxxxxx x xxxxx xxxxxxxx xxxxx. Xxxxx bude xxxxxxxxxx xx xxxxxxx xx xx xxxx xxxxxxxx xxxxxx xxxľx xxxxxxxxxxx xxxxxxxxx prípadu. Xx xxxxx xxxxxxxx xx xxxxxx xxxxxxxx x xxxxxxxxxx xxxxxxxxxx xxxxxxxx xxx xxxxx xxxxxxxx xxxxx žiadateľovi xxxxxx dôvody, xxxxx xxxxx nemožno xxxxxxxx.

- X xxxxxx zákona č. 209/1997 Zb. xxxx žiadateľ xxxxxxxxxx xx xxxx xxx x xxxxxxx, xx xx v xôxxxxxx xxxxxxxxx činu xxxx spôsobené xxxxxxxxxx xxxxxxx. Nevyhnutnou, xxx xxxx xxxxxxxxxxxx xxxxxxxxxx xx xxxxxxxxx xxxxxxxx xxxxxx xxxxx obeti xx xxxxx bodového xxxxxxxxxxx xxxxxxx (nie xxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx) xxxxxxxxxxxx aspoň 100 xxxxx. Xx xxxx xx považuje xx osoba pozostalá xx xxxxx, xxxxx x dôsledku xxxxxxxxx xxxx zomrela, ak xxxx rodičom, xxxxxxxx xxxxx dieťaťom xxxxxxxxx x zároveň x xxxx xxxx smrti x xxx žila x xxxxxxxxxx, alebo xxxxx, xxxxxx zomretý xxxxxxxxxx alebo bol xxxxxxx poskytovať výživu.

- Xxxxx č. 209/1997 Zb. o xxxxxxxxxx xxxxxxxxx pomoci xxxxxxx xxxxxxxx xxxxxxxx xxxxxxxxx prekluzívnu (xxxxxxxx) xxxx 1 roka xxx xxx, xxx xx xxxx dozvedela x xxxxx xxôxxxxxxx xxxxxxxx xxxxx. Ak xxxxx xxxx už xxx je deň xxxxxxxxx xxxxxxxxx činu, xxxx xxxxxxxx xxxxxxx, xxxx xx to xxxxx. Ministerstvo spravodlivosti xxxôxx xxxxxxxx xxxxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx, xxxxx mu xxxxxxxx po xxxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx xx na xxxxxxx xxxxx, xxxxxx x xôxxxxxx xxxxxxxxx činu xxxxxxx škoda xx xxxxxx, xxxxxxxx x xxxxxxxxx xxxx 25&xxxx;000.- Xx xxxxx xx xxxxx, xxxxx xxxxxxxxxxx xxxxxxxxxx stratu xx xxxxxxx, xxxxxxxxxx xxxxxxx xxxxxxx s xxxxxxxx, xxxxxxx o xxxxx xxxxxxxx čiastok, ktoré xxxx z xxxxxx xxxxxxx škody xx xxxxxxx; pomoc xx xxxxxx súčte xxxxxx xxxxxxxxxx xxxx 150 000.- Xx. Xx obeť - po xxx, xxx xxx poskytli xxxxx - preukáže, xx xxx xxxxxxxxx xxxxx je xxxxxx xxx tá, xxxxx xxxx xxxxxxxxx xx xxxxxxxxxxx pomoci, na xxx žiadosť x xxxxxx xxxxxxxxxx xxxxx xxxxxxx xxx xxxxx xxxxxxxxx xxxxx opäť, x to xx xx xxxxxxxxxx výšky 150&xxxx;000.- Kč; pričom xx xxxxxxxxxx xx xxxxxxx, xxxxx už xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, xxxxx xx xxxxxxxxxx po xxxxx, xxxxx v xôxxxxxx xxxxxxxxx xxxx zomrela (xx xxxx rodičom, xxxxxxxx alebo dieťaťom xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx x xxx xxxx v xxxxxxxxxx, xxxxx jej zomretý xxxxxxxxxx, xx xxx xxxxxxx xxxxxxxxxx xxxxxx), xx poskytne peňažná xxxxx v xxxxxxxxx xxxx 150&xxxx;000.- Xx; xxxxx vo xxxxxx xxxxx nesmie presiahnuť xxxx 450 000.- Xx, x xx xx xxxxx xxxxx viac xxx xxx xxxxx, xxxxxxxxxxx xxxxxxx sa xxx xxxxxx xxxxx xxxxxxxxx kráti.

- Xxxxx č. 209/1997 Zb. xxxxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxxxxxxxxx xxxxxxxxxxľx xxxxxxxxxx xxxxxxxx, xx xxxxx xxxxäxxxx xxxxxxx xxxxxxx xxxxxxxxx xxxxxxxxxxxxx. Xxxxx xx potrebné x xxxxxxxxxxxxxx xxxxxxxxxx xxxôx žiadať xxxxxxx, xxxxx xxxxxxxx poistenie xxxxxxxxxxxxx, x xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxx x celkom xxxxxxxxxxx xxxxxxxxx x xxxxxxxxxxxxx xx xxxxxxxxx xxxxxxxxx xxxxxxxxx je xxxxx xxxxxx xxxxxxxxxxxx spravodlivosti x xxxxxxxxxxx peňažnej xxxxxx.

- Xxxxxxxxxxx, xx xx xxxxxxxxxx priložiť xxxxxx xxxxxxxx xxxxxxx x xxxxxxxxxx, na xxxxx odkazujeme xxx xxxxxxxxxxxx xxxxxxxxx. Xx xxx xxxxxxxľ xxxxxxx, xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx xxxxxxx žiadosť. Ak xxxxxx xxxxxxxxxx a xxxxxxx xxx xxxxxxxxx xxxxxx, xxxx xxxxxxxxxx xôxx byť xôxxxxx xxxxxxxxxxxxx xxxxxxxx xxxxxx xxxľx zákona č. 209/1997 Zb. Xx xxxx xxxxxxxxxx xxxxxxx xxxxx xxxx xxxxxxx.

- Xxxxxxxxxxxx, xx xx bude xxxxxxxľxxx xxxxxxxxxx peňažná xxxxx, xxxxxxxľ xx do xxxxxxx xxxxx odo xxx xxxxxxxxxxx pomoci xxxxxxx na xxxx xxxxxxxxxxxx spravodlivosti sumy, xxxxx xxxxxx xxx xxxxxxx xxxxx (od xxxxxxxľx, poisťovne x xxx.) xx xx xxxxx xxxxxxxxxxx pomoci. Xxxx xxxxxxxxx xxxx, xx xx xxxxx xxxxxxxxxx. Xx xxxxxxx xxxxxxxx obete xx xxxxxxxxxxxx spravodlivosti xôxx x xxxx xxxxx xx xxxxxxxx stanovenej xäxxxxxxx xxxx xxxxx xxxxx xx vrátenie xxxxxxxxxxx xxxxxxxx pomoci. Xx xxxxxx xxxxxx xxôxxxxxxx xxxxxxxx situácia xxxxx, xxxxxxx výška xxxxx, xxxxx jej xxôxxxxxx, a xxxxx xxxxxxx, xxxxx xxxx xxxxxxx.