Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Xxxxxxxxxx xx Applications xxx xxx Provision xx Xxxxxxxxx Support to Xxxxxxx xx Xxxxxxxx Xxxx xxxxxxxx xx Xxx No. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xx xxx xxxxxxx of criminal xxxx xxx xx xxxxxxxx xxxxxxx xxxxx xxxx, xx xxxxxxx

Xxxx Xxx/Xxxxx,

Xx xxxxxxxxx for xxxxxxxxx xxx with xxxxxxxx xxxxxxxxx in xxxx xxxxxxx xxxxxxxxx. Xxxxxxx, xxxxxxx xx xxxx questionnaire xx xxxxxxxx xxx xxx xxxxx xxxxxxxxxx of xxxx xxxxxxxxxxx for xxx provision xx xxxxxxxxx xxxxxxx pursuant xx Xxx no. 209/1997. Xxxxx you xxx xxxx xxxxxxxxxxx; xx xx highly xxxxxxxxxxx.

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X. Please legibly xxxx xx xxx xxxxxxxx xxxx xx xxx xxxxxxxxx - x.x. the xxxxxx xx xxx xxxxxxxx xxx xxx has xxxxxxxx xxxxxx xxxx, xx xxx xxxxxxxx xx a xxxxxx xxx has xxxx xx xxxxxxxxxxx of xxx xxxxxxxx act:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxx xx birth:

4. Xxxxxxxxx address:

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

6. Xxxxx Xxxxxx:

7. X-xxxx xxxxxxx:

8. Xxxxxxxxxxx:

XX. Xx xxx xxxxxxxxx xx xxxxxxxxxxx xx xxxxxxx person ("xxxxxxxxxxxxxx") xx the basis xx xxxxxxxxx representation (xxx xxxxxxxx, x xxxxx xxxxx xxxxxxxxxxx xx xxx/xxx parent) xx xx the xxxxx xx x xxxxx of xxxxxxxx, xxxxxx xxxx xx xxx xxxx xx xxxx xxxxxxxxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Permanent xx registered xxxxxxx:

Xx xxx representative is xxxxxx the xxxxxxxxxxx xx xxxxxx xx xxx applicant, xxxxxx xxxx xxxxxx x xxxxxxxx xxxxxxxxxxx xxx/xxx xx xxxxxxxxx xxx xxxxxxxxx - x xxxx xx a xxxxx of xxxxxxxx (xxx contractual xxxxxxxxxxxxxx) xx x xxxx xx xxx birth xxxxxxxxxxx (for statutory xxxxxxxxxxxxxx) xx any xxxxx xxxxxxxxxx xxxxxxxx.

XXX. Xx xxx xxxxxxxxx xx x survivor xx a xxxxxx xxx xxx died xx xxxxxxxxxxx xx xxx respective criminal xxx, xxxxxx xxxx xx xxx xxxxxxxx xxxx xx xxx xxxxxxxx:

1. Xxxxxxx:

2. Given xxxx:

3. Xxxx xx xxxxx:

4. Xxxx xx xxxxx:

5. Last xxxxxxxxx xxxxxxx:

6. Nationality:

7. Xxxxxxxxxxxx xx the deceased xx xxx xxxxxxxxx (x.x. father, xxxxxxxx, xx individual living xx common xxxxxxxxx)

Xx xxx applicant xx x xxxxxxxx of x person xxx xxxx xx consequence xx the criminal xxx, xxxxxx xxxxxx x xxxx of xxx death xxxxxxxxxxx xxx xxx xxxxxxxxx xxxxxxx xxxx xxx xxxxxxxx xxxxxxxxx or xxx xx xxxxxxxxxx xx support xxx xxxxxxxx (in xxx xxxx xx x xxxxxx-xxxxx relationship, xxxx xxxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxx or x xxxxx xxxxxxxx xx xxx xxxxxxxxxx to xxxxxxx xxx dependent; xx the xxxx xx xxxxxxx couples, xxxxxx xxxxxx x xxxxxxxx certificate).

Xxxxxx specify the xxxx xx which xxx xxxxx was xxxxxxxxx xxx, xx xxx xxxxxx xxxxxxx xxxxx xxx consequences xx xxx xxxxx xx x xxxxx xxxx, please also xxxxxxx xxx date xxx xxx xxxxxx xx which the xxxxxx xxxxxxx xx xxxx xxxxxxxxxxxx (x.x., xxx xxxx of xxx medical xxxxxx).

XX. Xxxxxx xxxxxxx xxx xxxxxxxx xxxxxxx authority (x.x. xxxxxx, public xxxxxxxxxx'x xxxxxx, xxxxx) xxxxx xxxx xxxxxxxx xxxxxxxxx xxxxxxxx xxxxxxxxxxx. Xxxxx xxx xxxxxxxxx xxxxxx xx xxx xxxx xxxxxxx xx xxx xxxxxxxxxx xxxxxxxxxxx.

Xx xxxxxxxxx, xxxxxx xxxxxx xxx latest xxxxxxxx xx xxx xxxxxxxxxxxxxx xxxxxxxx xxxxxxx authority xxxxx xxxxx xxxxxxxx xxx stage of xxx xxxxxxxxxx xxxxxxxxxxx (x.x. xxxxxxxxxx on xxx xxxxxxxxxxxxxxx xx xxxxxxxx prosecution, xxxx xx xxx indictment, xxxxxxxxx - final xx xxxxxxxxx).

Xxxxxxxxx xx xxx xxxxxxxxxx xx §8 of Xxx xx. 209/1997, xxx xxxxxx xx xxxxxxxxx support may xx reduced xx xxxxxxxx xxxxxxxxx on xxxxxxx the victim xxx made use xx all xxxxx xxxxxxxx to xxxxxxx x xxxxx xxx xxxxxxxxxxxx against the xxxxxxxx or xxx xxxxx person xxxxxxxxxxx xxx the xxxx xxxxxxxx. Xx not xxxx xx xxxx xxxx if xxx xxxxxxxx xxx xxx xxxx xxxxxxxxxx.

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Xxxx in xxxx XxXx xx xxx applicant xx x xxxxxxxx of xx xxxxxxxxxx xxx xxx xxxx xx xxxxxxxxxxx xx the xxxxxxxxx xxxxx.

1. Xxx xxx x xxxxx, xxxxxx xx xxxxx xx xxx xxxxxx who died xx xxxxxxxxxxx of xxx criminal xxxxxxx?

2. Xxx xxx xxxx xx a xxxxxx xxxxxxxxx xxxx the xxxxxxxx person xxxxx xx the commitment xx xxx xxxxx?

3. Xxxx you x xxxxxxxxx xx xxx xxxxxx xx was xxx xxxxxxxx xxxxxxx xx xxxxxxx you?

4. Xx xxx xxxxx xxxxxxx xxxx xxx xxxxxxxxxx xxxxxxxxx in xxxxxxx 1 to 3? Please xxxx xxxxx xxxxxx, if xxxxx xx xxx.

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Xxxxxxxxx xx xxx xxxxxxxxxx xx §2, section 2 xx Xxx xx. 209/1997, x xxxxxx xxx xx x xxxxxxxx xx x xxxxxx who xxxx xx consequence xx x xxxxxxxx xxx xx xxxxxxxxxx xx be x xxxxxx xx xx xx xxx is x xxxxxx, xxxxxx xx child xx xxx xxxxxxxx xxx xxxxx xxxx xxx xx xxx xx xxx xxxx xxxxxxxxx xx if the xxxxxx was a xxxxxxxxx xx xxx xxxxxxxx xx xxx xxxxxxxx xxx required xx xxxxxxx the xxxxxx.

Xx xxx xxxxxxxxx xx xxx xxxxxx xx a crime xxx xxx xxxxxxxx xxxxxx harm, please xxxx in items XX - XIV.

Please attach x xxxxx-xxxxx xxxxxxxxxx xx xxxx xxx xxxxxxxxx xxxxxxxx xx Xxxxxx Xx. 440/2001 Xxxx. Xxx xxxxxxxxxx xxxxxxxx xxxxxx xx xxxxxxxx xxxx xxx xxxxxxxxx responsible xxx xxx xxxxxx'x xxxxxxxxx. Xxxx xxxxxxx xxxxxx xxxx contain x xxxxx-xxxxx assessment xx xxx xxx xxxxxxxx xxx a xxxxx-xxxxx xxxxxxxxxx of xxx xxxxxxxx xx xxx xxxxxx'x social xxxxxxxx. Xxxxxx xxxx in xxxx xxxx xxxx xxx point-based assessment xx the pam xxxxxxxx is xxxxxxxx xxx xxx xxxxxxxx xx Act no. 209/1997. Xxxxxxxxx xx xxx provisions of §6, xxxxxxx 2 xx Xxx no. 209/1997, xx financial xxxxxxx will be xxxxxxxx unless xxx xxxxx xxxxxxxxxx xx xxx xxxx suffered xx xx least 100 xxxxxx.

Xxx xxxxxx may xxxxxx xxxx sum xxxxxxxxx xxxxxxx xx xxx xxxxxx of CZK 25,000 xx xx xxxxxx xxxxx xx xxx xxxxxx xxxxx xx medical treatment xxx lost income (§7, xxxxxxx 1, xxxxxx x xx Xxx Xx. 209/1997 Xxxx.). xx you xxxxxx to apply xxx x xxxx xxx xxxxxxx, xxxxx xx xx need xx fill in xxxxx XII - XxX.

Xxxx includes xxx xxxxxxxx xxx xxxxxxxxxx, sanitary xxxxxxxxx, xxxxxxxxxxxxxx xxxxx, xxxxxx xx xxxxxxxxx to xxxx xxx in xxx xxxx or xxxx xxxxxxx xxxxxxxxx, xxxxxxxxx xxxxxxxxxxxxxx xxxxx xxx., xxxxxxxx such xxxxx have xxx xxxx paid xx xx insurance xxxxxxx. xx such expenses xxx xxx xxxxxx xx xxxxxxxxxxx xxxxxxxx, xxx Xxxxxxxx of Xxxxxxx xxx xxx xxxx them into xxxxxxxxxxxxx.

Xxxxxx xxxxxx xxx documents xxxxxxxxxx xxxx facts to xxx xxxxxxxxxxx.

Xx xxx xxxxxxxxx is xx xxxxxxxx, xxxxx xxxxxxxxx xxxxx include a xxxxxxxxx xxxx xxx/xxx xxxxxxxx xxxxxxxxxx xxx xxxxxxx salary xxxxxxxxx xx §351 et. xxx. of Xxx xx. 262/2006, xxx Xxxxx Xxxxxx Xxxx, xx xxxxxxx. lf xxx xxxxxxxxx xx xxxx-xxxxxxxx, such xxxxxxxx xxxxx xx x xxxx of his/her xxxx xxxxxx tax xxxxxx. xx xxx xxxxxxxxx is x xxxxxxx xxxxxx xxx xx able xx xxxxx xxx/xxx xxxxxxxx xxxxxx xxxxxxxx, please xxxxxx x document xxxxxxxxxx xxx xxxxxx xx xxx xxxxxxxxxx xxxxxxx. xx xxx xxx xxxxxx xxx xxxxxxxxx'x xxxxxx xxxxxxxxx xxxxxx be xxxxxx, xx exceptional xxxxx xx affidavit xxx xx xxxxxxxx.

Xx xxxxxx standing has xxxx xxxxxxxx as x xxxxxx xx xxx xxxxxxxx xxx xx xxxxx X xxx a xxxxxx. X xxxx not xxx xxxx xxxxxxxxxxx xxx xxx harm 1 have suffered xx x xxxxxx xx xxx xxxxxxxx xxx.

X xxxxxx xxxxxx xxxx X have xxx lodged any xxxxx xxx financial xxxxxxx xx any xxxxxxx xxxxx xxx xxxxxxxxxxxx xxx the xxxx xxxxxxxx as x result xx xxx xxxxxxxx xxx xx xxx country xxxxx xxxx the Xxxxx Xxxxxxxx.

X acknowledge xxxx according xx §12 xx Xxx Xx. 209/1997 Coll., xx xxx provision xx financial xxxxxxx xxx the xxxxxxx xx xxxxxxxx xxxx xxx xx xxxxxxxx xxxxxxx other xxxx, xx xxxxxxx, X xx xxxxxxx xx xxxxxxxxx xxx Xxxxxxxx xx Xxxxxxx xxx xxxxxx xxxxxxxx as xxxxxxxxxxxx xxx the xxxx xxxxxxxx, xx xx xxx xxxxxx xx xxx xxxxxxxxx xxxxxxx, xxxxxx xxxx xxxxx from xxx xxxx of receiving xxx funding xxxxxxx. X xxxx xxxxxxxxxxx xxxx, xxxxx the xxxxx xx xxx xxxx-xxxx xxxxxx, X xxx xxxx an xxxxxxxxxxx xxxxxx xxx Xxxxxxxx xx Xxxxxxx xx xxxxx the xxxxx'x xxxxx xxx xxx xxxxxx xx xxx provided xxxxxxx, xxxxxx such x xxxxxx xx xxxx xxxxxxxx by my xxxxxx standing, the xxxxx extent xx xxxx xxxxxxxx xxx xxx xxxxxx xx xxxxxxxxxxxx received.

I also xxxxxxxxxxx xxxx xxxxxxxxxxx xxxxxx xxxxx xx xxxxxxxxxx xxxxxxxxxxx xx xxxxxxxxxxx information xxx xxx purposes xx xxxxxxxxxxxxx xxxxxxx xxxxxxxx xxx represent xx xxxxxxx xxxxxxxx xx §21, xxxxxxx 1, xxxxxx x) of Xxx no. 200/1990 Xxxx., xx xxxxxxxx xx amended.

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Signature xx xxx xxxxxxxxx xx xxx/xxx xxxxxxxxxxxxxx

- Xxxx xxxxxxx of xxx xxxxxxxxxxx xxx xxx xxxxxxxxx xx financial xxxxxxx xxxxxxxx xx Xxx Xx. 209/1997, xxx Ministry of Xxxxxxx xxxxx xxxxxxx xxxxxxx xxx assign xx x xxxxxx xxxxxx. Subsequently, xxx Xxxxxxxx shall xxxxxxxx xx investigation xxxx xxx xxxxxx xx x similar xxxxxxxxx xx xxx the xxxxxxxx xxxxxxx xx xxx xxxx. Within xxxxx months xxxx xxx xxxx of xxx xxxxxxx of xxx xxxxxxxxxxx xxx xxxxxxxxxx xx xxx xxxxxxxxx documents, the Xxxxxxxx xxxxx xxxxxx xxxxxxx the support xx xxxxxx xxx xxxxxxxxx xx xxx xxxxxxx why xxxx xxxxxxx xxx xxxx xxxxxxxx.

- Xxx applicant xxxxx xx considered x victim xx xxx Act Xx. 209/1997 Xxxx. xxxx xx he/she xxx xxxxxxxx bodily harm xx a xxxxxx xx xxx xxxxxxxxxx xx a xxxxx. X xxxxxxxxx but xxx xxx xxxx xxxxxxxxx xxx the xxxxxx'x xxxxxxx of xxxxxxxx support xxxxx xx the xxxxxx xx the point-based xxxxxxxxxx xx xxx xxx suffercd (xxx xxx xxxxxxxxx of xxxxxx xxxxxxxx), xxxxx xxxx xx xx xxxxx 100 points. Xxxxxxxxx of x xxxxxx xxx has xxxx xx consequence xx x xxxxx xxxxx xx considered xx xx x xxxxxx if xxx xxxxxxxx is x xxxxxx, xxxxxx xx xxxxx xx xxx xxxxxxxx and xxx xxxxxxxx xxxxxx x xxxxxxxxx xxxx xxx xxxxxxxx xx the xxxx xx xxx/xxx xxxxx or xx xxx xxxxxxxx xxxxxxxxx xx was xxxxxxxx xx support xxx xxxxxxxx.

- Xxx Xx. 209/1997 Xxxx. xx xxx provision xx xxxxxxxxx xxxxxxx xx xxxxxxx of criminal xxxx xxxxxxxxxx x xxxxxxxxxx xxxx of 1 year xxxx xxx xxxx xx xxxxx xxx xxxxxx xxxxxxx xx the xxxx caused by xxx xxxxx. Xx xxxx date does xxx coincide with xxx xxxx of xxx xxxxxxxxxx of xxx crime, xxx xxxxxx xxxxx xxxxxxx xxxxxxxx xx xxx xxxx on xxxxx xx/xxx xxxxxxx of xxx consequences. The Xxxxxxxx xx Justice xxxxxx meet an xxxxxxxxxxx xxx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xxxxxxx xxxxx the lapse xx xxx xxxxxxxxxxxxxx xxxxxx.

- Xxxxxxxxx xxxxxxx xx xxxxxxx for xx x xxxxxx xxx xxx xxxxxxxx xxxxxx xxxx xx x xxxxxx of xxx xxxxxxxxxx xx x xxxxx may xx in xxx xxxx xx x xxxx xxx amounting xx XXX 25,000 xx xx xxxxxx xxxxx to lost xxxxxx xx xxx xxxxx xx medical xxxxxxxxx xx xxxxxx xx the xxxxxx, xxxxxxx xx xxx xxxxxx xxxxxxxxxx xxxx xx xxx victim xx xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx. Xxx total xxxxxx xx such support xxxx xxx exceed XXX 150,000. Xx, xxxxx xxx xxxxxxxxx xx support, xxx xxxxxx xxxxxx xxxx xxx xxxx xxxxxxxx xxxxxxx xxx amount xxxxxxxx, the xxxxxx xxx xxxxxxx xxxxxxxxxx xxxxxxx xx to xxx amount xx XXX 150,000 xx xx/xxx applies for xx xxxxxx xxx xxxxxxxxxxxxxx period xx xxxx (x.x., 1 xxxx xxxx xxx xxxx on xxxxx xxx xxxxxx learned xx xxx xxxx xxxxxx by xxx xxxxx); xx xxxx xxxx, xxx xxxxxxx xxxxxxx paid will xx xxxxx xxxx xxxxxxx.

- Xx individual xxx xx x xxxxxxxx of x xxxxxx xxx xxx xxxx xx x xxxxxx xx xxx xxxxxxxxxx of a xxxxx (x xxxxxx, xxxxxx xx child xx the xxxxxxxx xxxxxx xx x xxxxxx xxxxxxxxx with xxx xxxxxxxx at xxx xxxx xx xxx/xxx xxxxx xx xxxxxxxxx xx xx xxxxxxxx to xx xxxxxxxxx by the xxxxxxxx) xxxxx be xxxxxxxx with a xxxx sum xxxxxxxxx xx CZK 150,000. Xxx total xxxxxx xxxxxxxx xx xxxxxxxxx xxxxxxx xxxxx not xxxxxx XXX 450,000; xxxxxx xxx xxxxxx xx xxxxxxx xxxxxx xxxxx, the amount xxxxxxxx per victim xxxxx be xxxxxxx xxxxxxxxxxx.

- Xxx Xx. 209/1997 Xxxx. xxxx xxx xxxxxxx xxx xxxxxxxxx xx xxx xxxxxxxxx liability xx xxxxxxxxx xx xxxxx xxxxxxxx xxxxxxx xx xxxxxxxxxx xxxxxxxxx xxxxxxxxx. Xx matters xxxxxxx xx xxxxxxx accidents, xxxxxxxxxxxx for insurance xxxxxxxx should xxxx xx xxxxxxxx xx xxx insurers xxxxxxxxx xxxx xxxxxxxxx xxxxxxxxx. Xxxx xx isolated xxxxx, xx view xx xxxxxxxxxxx xxxxxxxxxxxxx, xxx xx xxxxxxxxxxx xxx xxx provision xx xxxxxxxxx support xx xxxxx xxxx xxx Xxxxxxxx xx Xxxxxxx.

- Xxxxxx xxxx xx xxxx that xxx available xxxxxxxxx xxx confirmations required xxx xxx xxxxxxxxxx xxxxx xxxx xx xxxxxxxx xx xxx xxxxxxxxxxx. Xx xxx xxxxxxxxx xxxxx xx xx xx, the Xxxxxxxx of Justice xxxxxx xxxxxxxx xxxxxxx xxx xxxxxxxxxxx. Xxxxxx xxx applicant xxxx xx xxxxxxx xxx xxxx documents xxx xxxxxxxxxxxxx xxxx xxxxxx x supplementary xxxxxxxx, xxxx xxxx xxx xxxxxxx a xxxxxxxx xx withhold xxx xxxxxxx xx xxx Xxx Xx. 209/1997 Xxxx. Xxxx xxxxx xxx, xxxxxxx, xxxxxxxxx xxx xxxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxxxxx xxxx xx xxxx xxxx xxx xxxxxxxxx xxxxx be xxxxxxx xx return xxx xxxxxxxxx amount received xx compensation xxx xxxx (from xxx xxxxxxxx, xxxxxxxx xxx.) xx xxx xxxxxxx xx the Xxxxxxxx xx Xxxxxxx up xx xxx xxxxxx xx the xxxxxxx xxxxxxxx. Xxxx xxxxxxxxxx xxxx xxx xxxxx xx xx/xxx has xxx received any xxxxxxxxxxxx. If so xxxxxxxxx xx xxx xxxxxx in xx xxxxxxxxxxx, the Xxxxxxxx xx Xxxxxxx may xxxxx xxx state's xxxxx to claim xxx xxxxxx xx xxx xxxxxxxxx xxxxxxx xxxxxxxx after xxx xxxxx of xxx xxxx-xxxx xxxx, xxxxxxxx xxxx x xxxxxx xx xxxxxxxxx by xxx xxxxxx'x xxxxxx xxxxxxxx, xxx xxxxx xxxxxx xx xxx xxxx xxxxxxxx and xxx amount of xxxxxxxxxxxx xxxx xx xxx xxxxxx.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, xx x xxxxxxxx, x xxxxxx xx xxxxxxxxxx, sme xxxxxx Xxx xxxxxxxxx xxxxxxxxxxxx otázkami. V xxxxxx xxxxxxxx xxxxxxxxx Xxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx xxxxxxx trestnej xxxxxxxx xxxľx xxxxxx č. 209/1997 Zb., xx xxxx xxxxxxxxx xxxxx xxxxxxxxx xxxxxxxxxx. Xxxxxxxx Xxx xx xxxxxxxxxx, xxxxx si xxxxx ceníme.

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I. Prosím, xxxxxxx čitateľne xxxxxx xxxxx o xxxxxxxľxxx - xxxxx trestného xxxx, xxxxxx spôsobili xxxx xx zdraví, xxxxx xxxxx xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx:

1. Priezvisko:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Xxxxxx xxxxxxxx xxxxxx:

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

6. Xxxxxxx:

7. X-Xxxx:

8. Xxxxxxxxxx:

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

1. Xxxxxxxxxx:

2. Meno:

3. Xxxxxxxxxxxxxx xxxxxx:

Xx xxxxxxx xx xxx xxxxx, xxxx sa xxxxxxx xxxxxxxxxx, ktorá zastúpenie xxxxxxx. Xxxxx x xxxxxxxx priložte xxxxx xxxxx xxxx (xxx xxxxxxxx xxxxxxxxx) xxxxx xxxxx xxxxxxx xxxxx (x xxxxxxx xxxxxxxxx xxxxxxxxxx) xxxxx xxx xxxxxxx listinu.

III. Xx xxxxxxxľ alebo osoba xxxxxxxxx xx osobe, xxxxx x xôxxxxxx xxxxxxxxx činu xxxxxxx, xxxxxxx, xxxxxx, xx xxxxx x umretej xxxxx:

1. Priezvisko:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Dátum xxxxxx:

5. Xxxxxxxx xxxxxxxx:

7. Xxxxxxxxxx:

8. X xxxx xxxxxx bola zomretá xxxxx v xôxxxxxx xxxxxxxxx xxxx k xxxxx xxxxxxxľx (otec, xxxxx, xxxxx xxxxxx x xxxxxxxxx xxxxxxxxxx):

Xx xx xxxxxxxľ xxxxxx xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, x xxxxxxxx sa xxxx xxxxxxxx kópia xxxxxxxx listu x xxxxxxx, ktoré dokladajú xxxxxxxxxx, že xxxxxx xxxxx vyživovala xxxxxxxxx xxxxx xxxxx mala xxxxxxxxx xx vyživovať (xx vzťahu xxxxx - dieťa xôxxx x xxxxx xxxx xxxxx xxxxxxxxxxx súdu x xxxxxxxxxxx xxxxxxxxxx, xxx xxxxxxxx xxxxx xxxxxxxx bude xxxxxxx xxxx x xxx.)

XX. Xxxxxx, či xxxxxxx xxxxxxxx xxxxxxx pomoc xxxxxxxxxxxxxxx xxxxx alebo xxxxxxxx xx xxxxxxx xxxx; x xxxxx xxxxxxx xxxxxxx xxxxxxx xxxxx Xxxxx xxxx.

X. Xxxxxx xxxxx, kedy xx obeť xxxxxxxxx x xxxxx xxôxxxxxxx xxxxxxxx činom.

Uveďte xxxxx xxxxxxxxx xxxxxxxxx xxxx x xx xx xxxx x škode xxx xxôxxxxxxx xxxxxxxxx xx xxxxôx, xxxxxx xxxx x ako (xxxxxxxxx x lekárskej xxxxxx - dátum xxx xxxxxxxxxx).

XX. Xxxxxxx xxxxx xxxxx x xxxxxxxx xxxxxx (xxxxxxxxx xxxxx, xxxxxx xxxxxxxxxxxxxx, xxx), ktorý naposledy xxxxx xxxxxxx o xxxxxxxx xxxx. Xxxxxx xx spisovú značku, xxx xxxxxx prebieha xxxxxxxxxxxx.

Xx xxxx k xxxxxxxxxx posledné xxxxxxxxxxx xxxxxx činného v xxxxxxxx konaní, xxxxx xxxx xxxxxxxxx x xxx, v xxxx xxxxxx xx xxx xxxxxxxx (napr. xxxxxxxxx x xxxxxxxx xxxxxxxxx xxxxxxxx, xxxx obžaloby, xxxxxxxx - x xxxxxxxxxxxxx), xxxxxxxx ho x xxxxxxxx.

XXX. Uveďte, xxxx xxôxxxxx ste xxxxxxxxx xxxxx na xxxxxxx xxxxx xx xxxxxxxľx xxxxx xxxx xxxxx, xxxxx xxxxxxxxx xx škodu.

Podľa xxxxxxxxxxx §8 zákona č. 209/1997 (Xx)., xxxxxxxx xxxxx xx xôxx xxxxxx alebo xx xxxxxxxx x xxxxxxxxxxxxx xx xx, xx xxxx xxxxxxx všetky xxxxxxx xxxxxxxxxxx xx xxxxxxxxxx nároku xx xxxxxxx škody xx xxxxxxxľx xxxxx xxxx xxxxx, xxxxx xxxxxxxxx xx škodu. Xxxxx xxx xxxxxxxxxxx, xx xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

Xxx XXXX. Xxxxxxx, xx žiadateľ xx xxxxxxxxxx po osobe, xxxxx x xôxxxxxx xxxxxxxxx činu xxxxxxx.

XXXX. Xxxxxx, xx xxx xxxxxxx xxxxxx, xxxxx xxľxx xxxxxxxxx xxxxxxx x §2 xxxx. 2 zákona č. 209/1997 Xx., xxxxxxxx xxľxx osôb xxľxx xxxxx xxxxxxxxx, xx xx Vám tieto xxxxxxxxxxx xxxxx.

1. Xxxx xxx xxxxxxx, manželom xxxxx xxxxxxxx xxxxx, xxxxx zomrela x xôxxxxxx trestného xxxx?

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

3. Xxxxxxxxxxx Xxx xxxx trestného xxxx xxxxxx, xx bola x xxxx xxxxxxx?

4. Xxľxxxx xxxxx osoby xxxxxxxxxxx xxxxxxxxx 1 xx 3? Uveďte xxx xxxxx, ak Xxx je xxxxx.

Xxxľx xxxxxxxxxxx §2 odst. 2 xxxxxx x. 209/1997 Zb. sa xx obeť xxxxxxxx xxxxx pozostalá xx xxxxx, ktorá x xôxxxxxx xxxxxxxxx činu xxxxxxx, xx je xxxxxxx, manželom alebo xxxxxxxx xxxxxxxxx x xxxxxxx v xxxx xxxx xxxxx x xxx xxxx x xxxxxxxxxx alebo osoba, xxxxxx xxxxxx xxxxxxxxxx xxxxx xxx xxxxxxx xxxxxxxxxx výživu.

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Body IX. xx XXX. Xxxxxxx, xx xx žiadateľ xxxx xxxxxx xxxxxxxxx xxxx x bola xx spôsobená xxxx xx xxxxxx.

XX. Xxxxxx xxxxx, xxxx xx xxxxxxxx liečenie, xxxxxxxxxx xxxx xx xxxxxxxx xxxxxxxx xxxxxxxxxxx.

X. Xxxxxxx xxxxx xxxxxxxx xxxxxxxxxxx xx xxxxxx xxxx:

X xxxxxxxx xx musí xxxxxxxx xxxxxx xxxxxxxxxxx xx bolesť xxxľx xxxxxxxx č. 440/2001 Zb., xxxxx xxxxxxxľ získa od xxxxxx, xxxxx ho xxxxxxxxx. Xxxxx xxxxxxxx xxxxxxx xxxx obsahovať xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxxx x bodové xxxxxxxxxx sťaženia spoločenského xxxxxxxxxx. Pripomíname, xx xxx účely zákona č. 209/1997 Zb. xx xxxxxxxxxx xxx xxxxxx ohodnotenie xxxxxxxxx xxxxxxx. Xxxľx xxxxxxxxxxx §6 xxxx. 2 xxxxxx x. 209/1997 Xx. nemožno xxxxxxxxx' peňažnú xxxxx, xx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx xxxxxxxxxx xxxxxxxx 100 xxxxx.

XX. Xxxxxx, xx xxxxxxx x poskytnutie peňažnej xxxxxx xx xxxxx xxxxxxxxx čiastky 25 000.- Xx xxxxx xx xxxxxxxx xxxxx xxxxxx xxxxxxx x xxxxxxxx xx liečenie.

Podľa xxxxxxxxxxx §7 xxxx. 1 xxxx. a) xxxxxx x. 209/1997 Zb. xx xxxxxxx xxxxx xxxxx xxxxxxxxx peňažnú xxxxx xx xxxxx xxxxxxxxx xxxx 25 000.- Xx, alebo vo xxxxx zodpovedajúcej preukázaným xxxxxxxx xx xxxxxxxx x xxxxxx zárobku. Xx sa xxxxxxxxxx xxxxxx o xxxxxxx xxxxx vo xxxxx xxxxxxxxx xxxxxxx, nemusíte xx xxxxxxxxx body XXX. - XXX. xxxxx xxxxxxxxx.

XXX. Náklady xxxxxxx x liečením xxxxxx:

Xxx o xxxxxxx xx xxxxx, xxxxxxxxxxxx xxxôxxx, náklady na xxxxxxxxxxxxx, pribranie xxxxxx xxxxx xx xxxxx x domácnosti či xxxxxxxxxx, zvýšené xxxxxxx xx xxxxxxx, a xxx. xxx podmienkou, xx xxxxx xxxxxxx xxxxxxxxx pojsťovňa. Tu xxxxxxx xxxxxxx xx xxxxx doložiť, xxxx xx xx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxx xxxx xxxx zreteľ.

XIII. Xxxxxxx xxxxxxxxx pomery xxxxxxxľx xxxx x po xxxxxx xxxx na xxxxxx xxôxxxxxxx xxxxxxxx xxxxx.

X žiadosti xxxxxxxx xxxxxxx, xxxxx xxxxxxxxxx xxxxxxx xxxxxxxxxxx.

X xxxxxxx, xx žiadateľ je x zamestnaneckom xxxxxx, xôxxx x xxxxxxxxxx xxxxxxxxxxxxľx x xxxxxxxxxx xxxxxxx podľa §351 x nasl. zákona x. 262/2006 Zb., xxxxxxxx práce, x xxxxx xxxxxxxxxx xxxxxxxxx. Xx xx xxxxxxxľ xxxxxx xxxxxxxxxx zárobkovo xxxxxx, xxxxx listinou xxxx xxxxxxxxx xxxx xxxxxxxxxx xxxxxxxx xxxxxxxxx. Xx xxxxxxxľ xxxxxx xxxxxxxx dôchodok, xxxxxxxx, xxxxx môže xxxxxxx xxxxxxxx xxxxxxxx situáciu, xxxx xxxxxxxxxx x xxxxx xxxxxxxxxx xôxxxxxx. X prípade, že x nejakého xxxxxxxxx xôxxxx xxxxxxx xxxxxxx xxxxxxxxx pomery xxxxxxxľx, x xxxxxxx xxxxxxx xx možné nahradiť xxxxxxxxxx x nich xxxxxxx xxxxxxxxxx.

XXX. Xxxxxx xxxxx nemocenských xxxxx (xxxxxxxxxxx xôxxxxxx) x xxxx, xxxxxx xxx xxxxxxxľ poberá, či xxxxxxx xx xxxxxx xxxx na zdraví, xxôxxxxxxx trestným xxxxx.

X xxxxxxxx xxxxxxxx xxxxxxxxxx xxxxxxxxxxxxľx xxxxx xxxxxxxxx x xxxxx xxxxxxxxxxxx xxxxx. V xxxxxxx, xx v xôxxxxxx xxxxx na xxxxxx xxôxxxxxxx xxxxxxxx xxxxx Xxx priznali xxxxxxxxx xôxxxxxx, xxxxxx x xxxxxxx jeho xxxxx.

Xxxx xxxxxxxxx pomery xx xxxx, že xxxxxxxx činom, xxxxxxx xxx xxx(x) obeťou, xx moja sociálna xxxxxxxx xxxxxxxx. Xxxxx, xxxxx mi takto xxôxxxxx, xxxxxľ nebola xxxxxxxx.

Xxxxxx xxxxxxxxxx, xx xxxxx na xxxxxxx xxxxx xx xxxxxxx xxxxx xx xxxxxxxxxxx xxxx xxôxxxxxxx trestným xxxxx xxx neuplatnil(a) x žiadnom inom xxxxx xxx v Xxxxxx (Xxxxxxxxxx) republike.

Beriem xx vedomie, že xx podľa xxx. §12 xxxxxx x. 209/1997 Zb., o xxxxxxxxxx peňažnej xxxxxx xxxxxxx xxxxxxxx činnosti x x zmene x x doplnení xxxxxxxxxx xxxxxxx, x xxxxx xxxxxxxxxx predpisov, xxxxxx xxxxxxxxx do xxxxxxx rokov xxx xxx, xxx xx xxxxxxxx xxxxx, odviesť xx účet Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxx, xxxxx xxx xxxxxx(x) xxx xxxxxxx xxxxx, x xx xx do xxxxx poskytnutej xxxxxx. Xxxxxxx x tým xxxxxx xx xxxxxxx, xx xx uplynutí xxxxxxxxxx xäxxxxxxx xxxx xôxxx xxxxxxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx, xxx sa x mene xxxxx xxxxxx práva xx xxxxxxxx poskytnutej xxxxxx, xx xxxx xxxxxxxx xxxxxxxx xxxx xxxx xxxxxx xxôxxxxxxxx, celková xxxxx xxxxx, ktorú xx xxôxxxxxx x xxxxx xxxxxxx, xxxxx xxx xxxxxx(x).

Xxxxxx tiež xx xxxxxxx, xx xxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxx xxxxxxxxx xxxxx xx xxxx xxxxxxxxx xx xxxxxx xxxxxxxx xxxxxxxxxxxx xxxxxx, xx xôxxx xxxxxxxx xxxxxxxxxx xxxľx §21 xxxx. 1 xxxx. x) xxxxxx x. 200/1990 Xx., o priestupkoch, x xxxxx xxxxxxxxxx xxxxxxxxx.

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xxxxxx xxxxxxxľx xxxxx xxxxxxxx

- Xxxxxxxxxxxx xxxxxxxxxxxxxx Xxxxx xxxxxxxxx xx xxxxxxx žiadosti o xxxxxxxxxxx xxxxxxxx xxxxxx xxxľx xxxxxx č. 209/1997 Zb. xxxxxxx jej xxxxxx x xxxxx xxxxxxxx xxxxx. Xxxxx xxxx xxxxxxxxxx xx xxxxxxx xx na inom xxxxxxxx xxxxxx podľa xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xx xxxxx mesiacov xx xxxxxx žiadosti x xxxxxxxxxx xxxxxxxxxx xxxxxxxx xxx xxxxx xxxxxxxx xxxxx xxxxxxxľxxx xxxxxx xôxxxx, prečo xxxxx nemožno poskynúť.

- X xxxxxx xxxxxx č. 209/1997 Zb. xxxx xxxxxxxľ xxxxxxxxxx xx obeť xxx x prípade, xx mu v xôxxxxxx xxxxxxxxx xxxx xxxx spôsobené xxxxxxxxxx xxxxxxx. Xxxxxxxxxxx, nie xxxx xxxxxxxxxxxx podmienkou xx xxxxxxxxx peňažnej xxxxxx takej xxxxx xx xxxxx xxxxxxxx xxxxxxxxxxx xxxxxxx (xxx xxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx) xxxxxxxxxxxx xxxxx 100 bodov. Za xxxx sa xxxxxxxx xx xxxxx pozostalá xx obeti, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xx xxxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx x xxxx jeho smrti x xxx žila x xxxxxxxxxx, alebo xxxxx, xxxxxx zomretý xxxxxxxxxx xxxxx bol xxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx č. 209/1997 Zb. o xxxxxxxxxx peňažitej xxxxxx xxxxxxx xxxxxxxx činnosti xxxxxxxxx xxxxxxxxxxx (xxxxxxxx) xxxx 1 roka xxx xxx, xxx xx obeť xxxxxxxxx x škode xxôxxxxxxx xxxxxxxx činom. Xx xxxxx xxxx xx xxx xx xxx xxxxxxxxx xxxxxxxxx xxxx, xxxx xxxxxxxx okamžik, xxxx xx xx xxxxx. Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx xxxxxxxx žiadostiam x poskytnutie xxxxxxxx xxxxxx, xxxxx xx xxxxxxxx xx xxxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx xx xx žiadosť xxxxx, xxxxxx v xôxxxxxx xxxxxxxxx xxxx xxxxxxx xxxxx na xxxxxx, poskytne x xxxxxxxxx sume 25 000.- Xx xxxxx vo xxxxx, ktorá predstavuje xxxxxxxxxx xxxxxx xx xxxxxxx, preukázané xxxxxxx xxxxxxx s xxxxxxxx, xxxxxxx x xxxxx xxxxxxxx xxxxxxx, ktoré xxxx z titulu xxxxxxx škody už xxxxxxx; xxxxx vo xxxxxx xxxxx nesmie xxxxxxxxxx sumu 150&xxxx;000.- Xx. Xx obeť - xx tom, xxx xxx xxxxxxxx xxxxx - xxxxxxxx, xx xxx xxxxxxxxx xxxxx je xxxxxx xxx xx, xxxxx xxxx podkladom xx xxxxxxxxxxx pomoci, xx xxx žiadosť x xxxxxx stanovenej xxxxx xxxxxxx jej možno xxxxxxxxx pomoc opäť, x xx xx xx maximálnej xxxxx 150&xxxx;000.- Kč; xxxxxx xx prihliadne xx xxxxxxx, xxxxx xx xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, xxxxx xx xxxxxxxxxx xx obeti, xxxxx x xôxxxxxx xxxxxxxxx činu xxxxxxx (xx xxxx rodičom, xxxxxxxx xxxxx dieťaťom xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx s xxx xxxx x xxxxxxxxxx, xxxxx jej xxxxxxx xxxxxxxxxx, či bol xxxxxxx poskytovať xxxxxx), xx xxxxxxxx xxxxxxx xxxxx v xxxxxxxxx xxxx 150&xxxx;000.- Xx; xxxxx xx svojom xxxxx nesmie xxxxxxxxxx xxxx 450 000.- Xx, x ak je xxxxx obetí viac xxx xxx xxxxx, xxxxxxxxxxx xxxxxxx xx xxx xxxxxx xxxxx xxxxxxxxx xxxxx.

- Xxxxx č. 209/1997 Zb. xxxxxxxxxxxx inštitút xxxxxxxxxxx zodpovednosti xxxxxxxxxxľx xxxxxxxxxx xxxxxxxx, xx xxxxx xxxxäxxxx xxxxxxx xxxxxxx xxxxxxxxx zodpovednosti. Xxxxx xx potrebné x xxxxxxxxxxxxxx dopravných xxxôx žiadať subjekt, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, o xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxx x xxxxxx xxxxxxxxxxx xxxxxxxxx x xxxxxxxxxxxxx xx xxxxxxxxx výnimočné xxxxxxxxx xx xxxxx xxxxxx ministerstvo xxxxxxxxxxxxxx x poskytnutie xxxxxxxx xxxxxx.

- Xxxxxxxxxxx, xx xx xxxxxxxxxx xxxxxxxx xxxxxx xxxxxxxx xxxxxxx x xxxxxxxxxx, xx xxxxx odkazujeme pri xxxxxxxxxxxx xxxxxxxxx. Xx xxx xxxxxxxľ neučiní, xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx xxxxxxx žiadosť. Ak xxxxxx xxxxxxxxxx a xxxxxxx xxx xxxxxxxxx xxxxxx, xxxx xxxxxxxxxx xôxx xxx dôvodom xxxxxxxxxxxxx peňažnej xxxxxx xxxľx zákona č. 209/1997 Zb. Xx xxxx xxxxxxxxxx xxxxxxx xxxxx novú xxxxxxx.

- Upozorňujeme, xx xx xxxx žiadateľovi xxxxxxxxxx xxxxxxx pomoc, xxxxxxxľ je xx xxxxxxx rokov xxx xxx xxxxxxxxxxx pomoci xxxxxxx na účet xxxxxxxxxxxx spravodlivosti xxxx, xxxxx xxxxxx ako xxxxxxx xxxxx (xx xxxxxxxľx, poisťovne x xxx.) xx do xxxxx poskytnutej xxxxxx. Xxxx xxxxxxxxx xxxx, xx xx xxxxx xxxxxxxxxx. Xx xxxxxxx xxxxxxxx obete sa xxxxxxxxxxxx xxxxxxxxxxxxxx môže x mene štátu xx xxxxxxxx xxxxxxxxxx xäxxxxxxx doby xxxxx xxxxx xx vrátenie xxxxxxxxxxx xxxxxxxx pomoci. Xx takýto postup xxôxxxxxxx xxxxxxxx xxxxxxxx xxxxx, xxxxxxx xxxxx xxxxx, ktorú xxx xxôxxxxxx, x xxxxx xxxxxxx, xxxxx xxxx xxxxxxx.