Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx the Xxxxxxxxxx xx Xxxxxxxxxxxx xxx xxx Provision of Xxxxxxxxx Xxxxxxx xx Xxxxxxx xx Criminal Xxxx pursuant to Xxx No. 209/1997 Xxxx., xx xxx xxxxxxxxx of xxxxxxxxx xxxxxxx xx xxx xxxxxxx xx xxxxxxxx xxxx and on xxxxxxxx certain xxxxx xxxx, xx amended

Dear Xxx/Xxxxx,

Xx xxxxxxxxx for xxxxxxxxx xxx with xxxxxxxx xxxxxxxxx xx xxxx xxxxxxx situation. Xxxxxxx, xxxxxxx in xxxx xxxxxxxxxxxxx is xxxxxxxx xxx the xxxxx assessment of xxxx application for xxx xxxxxxxxx of xxxxxxxxx xxxxxxx xxxxxxxx xx Xxx xx. 209/1997. Xxxxx you xxx xxxx cooperation; xx is xxxxxx xxxxxxxxxxx.

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X. Xxxxxx xxxxxxx xxxx in the xxxxxxxx xxxx xx xxx xxxxxxxxx - x.x. the victim xx xxx xxxxxxxx xxx who has xxxxxxxx xxxxxx harm, xx the xxxxxxxx xx a xxxxxx xxx xxx xxxx xx xxxxxxxxxxx xx xxx criminal xxx:

1. Xxxxxxx:

2. Given xxxx:

3. Xxxx xx xxxxx:

4. Xxxxxxxxx xxxxxxx:

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

6. Xxxxx Xxxxxx:

7. X-xxxx address:

8. Xxxxxxxxxxx:

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

1. Surname:

2. Xxxxx xxxx:

3. Xxxxxxxxx xx xxxxxxxxxx xxxxxxx:

Xx xxx xxxxxxxxxxxxxx is xxxxxx xxx xxxxxxxxxxx xx xxxxxx xx xxx xxxxxxxxx, xxxxxx xxxx xxxxxx x xxxxxxxx xxxxxxxxxxx xxx/xxx xx xxxxxxxxx the xxxxxxxxx - a xxxx of x xxxxx xx xxxxxxxx (xxx xxxxxxxxxxx xxxxxxxxxxxxxx) xx x xxxx xx the xxxxx xxxxxxxxxxx (xxx xxxxxxxxx xxxxxxxxxxxxxx) xx any xxxxx xxxxxxxxxx xxxxxxxx.

XXX. Xx xxx xxxxxxxxx xx x xxxxxxxx xx x person xxx has xxxx xx xxxxxxxxxxx xx xxx xxxxxxxxxx criminal xxx, xxxxxx fill xx xxx xxxxxxxx xxxx of xxx xxxxxxxx:

1. Xxxxxxx:

2. Given xxxx:

3. Xxxx of xxxxx:

4. Date xx xxxxx:

5. Xxxx xxxxxxxxx xxxxxxx:

6. Xxxxxxxxxxx:

7. Relationship xx the xxxxxxxx xx the xxxxxxxxx (x.x. father, xxxxxxxx, xx individual living xx common household)

If xxx xxxxxxxxx is x xxxxxxxx of x person who xxxx xx xxxxxxxxxxx xx the criminal xxx, xxxxxx xxxxxx x xxxx xx xxx xxxxx xxxxxxxxxxx xxx any xxxxxxxxx xxxxxxx that the xxxxxxxx xxxxxxxxx xx xxx xx xxxxxxxxxx xx support the xxxxxxxx (in xxx xxxx xx x xxxxxx-xxxxx xxxxxxxxxxxx, such xxxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxx xx x xxxxx xxxxxxxx on xxx xxxxxxxxxx to xxxxxxx xxx xxxxxxxxx; xx the case xx xxxxxxx xxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxxx).

Xxxxxx xxxxxxx the xxxx xx xxxxx xxx xxxxx xxx xxxxxxxxx and, if xxx xxxxxx xxxxxxx xxxxx the xxxxxxxxxxxx xx xxx xxxxx xx x xxxxx xxxx, xxxxxx xxxx xxxxxxx xxx date xxx xxx xxxxxx xx xxxxx the xxxxxx learned xx xxxx consequences (x.x., xxx xxxx of xxx xxxxxxx xxxxxx).

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

If xxxxxxxxx, xxxxxx xxxxxx xxx latest xxxxxxxx xx xxx abovementioned xxxxxxxx justice authority xxxxx could xxxxxxxx xxx xxxxx of xxx xxxxxxxxxx proceedings (x.x. xxxxxxxxxx on xxx xxxxxxxxxxxxxxx xx xxxxxxxx prosecution, copy xx xxx xxxxxxxxxx, xxxxxxxxx - xxxxx xx otherwise).

Xxxxxxxxx xx xxx xxxxxxxxxx xx §8 xx Xxx no. 209/1997, xxx xxxxxx xx xxxxxxxxx xxxxxxx xxx xx xxxxxxx xx xxxxxxxx depending xx xxxxxxx the victim xxx xxxx use xx xxx xxxxx xxxxxxxx xx xxxxxxx x xxxxx xxx xxxxxxxxxxxx xxxxxxx xxx xxxxxxxx or any xxxxx xxxxxx xxxxxxxxxxx xxx xxx xxxx xxxxxxxx. Xx xxx xxxx xx xxxx xxxx xx xxx xxxxxxxx has not xxxx xxxxxxxxxx.

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Xxxx xx xxxx XxXx if xxx applicant is x xxxxxxxx of xx individual xxx xxx died xx xxxxxxxxxxx of xxx xxxxxxxxx crime.

1. Xxx xxx x xxxxx, spouse xx xxxxx of the xxxxxx xxx xxxx xx consequence of xxx xxxxxxxx offence?

2. Xxx you xxxx xx x xxxxxx xxxxxxxxx with xxx xxxxxxxx person xxxxx xx xxx xxxxxxxxxx xx xxx crime?

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

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

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According xx xxx provisions xx §2, xxxxxxx 2 of Xxx xx. 209/1997, x xxxxxx xxx is x xxxxxxxx xx x victim xxx xxxx xx consequence xx a xxxxxxxx xxx xx xxxxxxxxxx xx xx x xxxxxx if he xx she xx x xxxxxx, xxxxxx xx xxxxx xx xxx xxxxxxxx and xxxxx with him xx her xx xxx same household xx xx xxx xxxxxx xxx x xxxxxxxxx xx xxx xxxxxxxx xx xxx xxxxxxxx was xxxxxxxx xx xxxxxxx the xxxxxx.

Xx xxx xxxxxxxxx xx xxx victim xx x xxxxx xxx xxx xxxxxxxx xxxxxx xxxx, xxxxxx xxxx in xxxxx XX - XIV.

Please xxxxxx x xxxxx-xxxxx assessment xx xxxx and xxxxxxxxx xxxxxxxx xx Xxxxxx Xx. 440/2001 Xxxx. Xxx xxxxxxxxxx xxxxxxxx xxxxxx be xxxxxxxx from xxx xxxxxxxxx xxxxxxxxxxx for xxx xxxxxx'x xxxxxxxxx. Xxxx xxxxxxx xxxxxx xxxx xxxxxxx a xxxxx-xxxxx xxxxxxxxxx of xxx pam xxxxxxxx xxx x point-based xxxxxxxxxx xx xxx xxxxxxxx of the xxxxxx'x social position. Xxxxxx xxxx xx xxxx xxxx xxxx xxx xxxxx-xxxxx assessment xx xxx xxx xxxxxxxx xx relevant xxx xxx xxxxxxxx xx Xxx xx. 209/1997. Xxxxxxxxx xx xxx xxxxxxxxxx of §6, xxxxxxx 2 xx Xxx xx. 209/1997, xx xxxxxxxxx xxxxxxx xxxx xx xxxxxxxx xxxxxx the xxxxx assessment xx xxx xxxx suffered xx xx xxxxx 100 points.

Xxx xxxxxx xxx obtain xxxx xxx financial xxxxxxx in the xxxxxx xx XXX 25,000 xx xx xxxxxx equal to xxx proved xxxxx xx xxxxxxx treatment xxx xxxx xxxxxx (§7, section 1, xxxxxx x xx Xxx Xx. 209/1997 Xxxx.). xx you xxxxxx xx xxxxx xxx x lump xxx payment, there xx no need xx xxxx xx xxxxx XXX - XxX.

Xxxx xxxxxxxx xxx xxxxxxxx xxx xxxxxxxxxx, sanitary xxxxxxxxx, xxxxxxxxxxxxxx costs, xxxxxx xx assistant xx xxxx xxx xx xxx xxxx xx xxxx xxxxxxx treatment, xxxxxxxxx transportation costs xxx., xxxxxxxx xxxx xxxxx xxxx xxx xxxx xxxx by xx insurance company. xx xxxx expenses xxx xxx xxxxxx xx documentary evidence, xxx Xxxxxxxx of Xxxxxxx may xxx xxxx xxxx into xxxxxxxxxxxxx.

Xxxxxx xxxxxx xxx documents confirming xxxx xxxxx xx xxx application.

If xxx xxxxxxxxx xx xx xxxxxxxx, xxxxx documents xxxxx xxxxxxx a xxxxxxxxx xxxx his/her xxxxxxxx describing the xxxxxxx xxxxxx xxxxxxxxx xx §351 xx. xxx. xx Act xx. 262/2006, xxx Xxxxx Xxxxxx Code, xx xxxxxxx. xx xxx xxxxxxxxx xx xxxx-xxxxxxxx, xxxx xxxxxxxx xxxxx xx x xxxx xx xxx/xxx xxxx xxxxxx xxx xxxxxx. lf the xxxxxxxxx xx x xxxxxxx xxxxxx who xx xxxx to xxxxx xxx/xxx xxxxxxxx xxxxxx xxxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxx the xxxxxx xx xxx xxxxxxxxxx xxxxxxx. xx xxx xxx xxxxxx xxx xxxxxxxxx'x xxxxxx xxxxxxxxx xxxxxx xx proven, xx exceptional xxxxx xx xxxxxxxxx xxx xx attached.

Xx xxxxxx xxxxxxxx xxx xxxx xxxxxxxx xx x result of xxx xxxxxxxx xxx xx which I xxx x xxxxxx. X xxxx xxx xxx xxxx compensated xxx xxx xxxx 1 xxxx xxxxxxxx xx a xxxxxx xx xxx criminal xxx.

X hereby xxxxxx xxxx I have xxx xxxxxx xxx xxxxx for xxxxxxxxx xxxxxxx xx xxx xxxxxxx xxxxx xxx xxxxxxxxxxxx for the xxxx suffered xx x xxxxxx xx xxx criminal xxx xx any xxxxxxx xxxxx than the Xxxxx Republic.

I xxxxxxxxxxx xxxx according xx §12 xx Xxx Xx. 209/1997 Coll., xx xxx xxxxxxxxx xx financial xxxxxxx xxx the xxxxxxx xx xxxxxxxx xxxx xxx on xxxxxxxx xxxxxxx xxxxx xxxx, xx xxxxxxx, X xx xxxxxxx to xxxxxxxxx xxx Ministry xx Xxxxxxx any xxxxxx xxxxxxxx xx xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx, xx xx the amount xx the xxxxxxxxx xxxxxxx, xxxxxx xxxx xxxxx xxxx xxx xxxx xx receiving xxx funding xxxxxxx. X also xxxxxxxxxxx xxxx, xxxxx the xxxxx xx xxx xxxx-xxxx period, I xxx xxxx xx xxxxxxxxxxx asking xxx Xxxxxxxx xx Justice xx xxxxx xxx xxxxx'x claim for xxx xxxxxx of xxx xxxxxxxx xxxxxxx, xxxxxx xxxx a xxxxxx xx xxxx xxxxxxxx xx my xxxxxx xxxxxxxx, the xxxxx xxxxxx of xxxx xxxxxxxx and xxx amount xx xxxxxxxxxxxx xxxxxxxx.

X xxxx xxxxxxxxxxx xxxx xxxxxxxxxxx xxxxxx false xx xxxxxxxxxx information or xxxxxxxxxxx information for xxx xxxxxxxx xx xxxxxxxxxxxxx xxxxxxx xxxxxxxx xxx represent an xxxxxxx pursuant xx §21, section 1, xxxxxx x) xx Xxx xx. 200/1990 Xxxx., xx xxxxxxxx xx xxxxxxx.

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Xxxxxxxxx xx xxx applicant or xxx/xxx xxxxxxxxxxxxxx

- Xxxx xxxxxxx xx xxx xxxxxxxxxxx for xxx xxxxxxxxx of xxxxxxxxx xxxxxxx xxxxxxxx xx Xxx Xx. 209/1997, xxx Ministry xx Xxxxxxx shall confirm xxxxxxx and assign xx x serial xxxxxx. Xxxxxxxxxxxx, the Xxxxxxxx xxxxx xxxxxxxx xx investigation xxxx xxx police or x xxxxxxx xxxxxxxxx xx xxx the xxxxxxxx xxxxxxx xx xxx xxxx. Xxxxxx xxxxx xxxxxx xxxx xxx date xx xxx xxxxxxx xx xxx application xxx xxxxxxxxxx xx the xxxxxxxxx documents, xxx Xxxxxxxx xxxxx xxxxxx xxxxxxx xxx xxxxxxx xx inform xxx xxxxxxxxx xx the xxxxxxx xxx xxxx xxxxxxx xxx xxxx xxxxxxxx.

- Xxx applicant xxxxx xx xxxxxxxxxx x xxxxxx xx xxx Act Xx. 209/1997 Xxxx. xxxx xx he/she has xxxxxxxx bodily harm xx x result xx the xxxxxxxxxx xx x crime. X xxxxxxxxx xxx xxx the xxxx xxxxxxxxx for xxx xxxxxx'x receipt xx xxxxxxxx xxxxxxx xxxxx xx the xxxxxx xx xxx point-based xxxxxxxxxx of the xxx xxxxxxxx (not xxx weakening xx xxxxxx xxxxxxxx), xxxxx xxxx xx xx xxxxx 100 xxxxxx. Xxxxxxxxx xx a xxxxxx who has xxxx xx consequence xx a crime xxxxx xx considered xx xx x xxxxxx xx xxx xxxxxxxx is x xxxxxx, spouse or xxxxx xx the xxxxxxxx xxx the xxxxxxxx shared a xxxxxxxxx with xxx xxxxxxxx at xxx xxxx of xxx/xxx xxxxx xx if xxx xxxxxxxx xxxxxxxxx xx xxx xxxxxxxx xx xxxxxxx xxx xxxxxxxx.

- Xxx Xx. 209/1997 Xxxx. xx xxx provision xx xxxxxxxxx xxxxxxx xx xxxxxxx xx xxxxxxxx xxxx stipulates x xxxxxxxxxx xxxx xx 1 year xxxx xxx date on xxxxx xxx xxxxxx xxxxxxx xx xxx xxxx xxxxxx xx xxx xxxxx. If xxxx date xxxx xxx xxxxxxxx with xxx date xx xxx xxxxxxxxxx xx xxx xxxxx, xxx xxxxxx xxxxx xxxxxxx xxxxxxxx xx xxx xxxx on xxxxx xx/xxx learned of xxx xxxxxxxxxxxx. The Xxxxxxxx xx Justice xxxxxx meet xx xxxxxxxxxxx xxx the xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xxxxxxx xxxxx the xxxxx xx the abovementioned xxxxxx.

- Xxxxxxxxx support xx xxxxxxx xxx xx x xxxxxx xxx xxx xxxxxxxx xxxxxx harm xx x xxxxxx xx xxx commitment xx x xxxxx may xx xx xxx xxxx xx x xxxx xxx amounting xx XXX 25,000 xx xx xxxxxx xxxxx to lost xxxxxx xx the xxxxx xx medical xxxxxxxxx xx proved xx the xxxxxx, xxxxxxx xx xxx xxxxxx xxxxxxxxxx paid xx xxx xxxxxx xx compensation for xxx xxxx xxxxxxxx. Xxx xxxxx xxxxxx xx xxxx xxxxxxx xxxx not exceed XXX 150,000. Xx, xxxxx xxx xxxxxxxxx xx xxxxxxx, xxx xxxxxx xxxxxx that xxx xxxx xxxxxxxx xxxxxxx the amount xxxxxxxx, the xxxxxx xxx receive xxxxxxxxxx xxxxxxx up xx xxx xxxxxx xx XXX 150,000 xx xx/xxx xxxxxxx xxx xx xxxxxx xxx xxxxxxxxxxxxxx xxxxxx xx xxxx (i.e., 1 xxxx from xxx xxxx xx xxxxx xxx victim learned xx xxx harm xxxxxx xx xxx xxxxx); xx xxxx xxxx, xxx amounts xxxxxxx xxxx xxxx xx taken xxxx xxxxxxx.

- An xxxxxxxxxx xxx is a xxxxxxxx xx x xxxxxx xxx xxx xxxx xx a xxxxxx xx xxx xxxxxxxxxx xx x xxxxx (a parent, xxxxxx or xxxxx xx xxx deceased xxxxxx xx a xxxxxx xxxxxxxxx with xxx xxxxxxxx at xxx time xx xxx/xxx xxxxx xx xxxxxxxxx xx xx xxxxxxxx to xx xxxxxxxxx xx xxx xxxxxxxx) xxxxx xx xxxxxxxx with x xxxx xxx xxxxxxxxx xx XXX 150,000. Xxx total xxxxxx xxxxxxxx xx xxxxxxxxx xxxxxxx shall not xxxxxx XXX 450,000; xxxxxx xxx xxxxxx xx victims xxxxxx xxxxx, xxx amount xxxxxxxx per xxxxxx xxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxx Xx. 209/1997 Xxxx. xxxx xxx xxxxxxx the xxxxxxxxx of xxx xxxxxxxxx liability of xxxxxxxxx of xxxxx xxxxxxxx xxxxxxx xx xxxxxxxxxx liability xxxxxxxxx. Xx xxxxxxx xxxxxxx xx xxxxxxx accidents, xxxxxxxxxxxx xxx xxxxxxxxx xxxxxxxx should xxxx xx directed xx xxx xxxxxxxx xxxxxxxxx xxxx liability insurance. Xxxx in xxxxxxxx xxxxx, in view xx xxxxxxxxxxx xxxxxxxxxxxxx, xxx an xxxxxxxxxxx xxx xxx provision xx xxxxxxxxx support xx filed with xxx Ministry of Xxxxxxx.

- Xxxxxx xxxx xx mind xxxx xxx available documents xxx xxxxxxxxxxxxx required xxx xxx xxxxxxxxxx xxxxx must xx xxxxxxxx xx xxx xxxxxxxxxxx. Xx the xxxxxxxxx fails to xx xx, xxx Xxxxxxxx xx Xxxxxxx xxxxxx xxxxxxxx process xxx xxxxxxxxxxx. Should xxx xxxxxxxxx xxxx xx xxxxxxx any xxxx xxxxxxxxx and xxxxxxxxxxxxx xxxx within x xxxxxxxxxxxxx deadline, xxxx xxxx xxx xxxxxxx x xxxxxxxx xx xxxxxxxx xxx xxxxxxx xx xxx Xxx Xx. 209/1997 Xxxx. This shall xxx, xxxxxxx, xxxxxxxxx xxx xxxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxxxxx xxxx in xxxx xxxx xxx xxxxxxxxx xxxxx xx xxxxxxx xx return xxx xxxxxxxxx xxxxxx xxxxxxxx xx xxxxxxxxxxxx xxx xxxx (from the xxxxxxxx, xxxxxxxx xxx.) xx xxx xxxxxxx xx the Xxxxxxxx xx Xxxxxxx xx xx the xxxxxx xx the support xxxxxxxx. This obligation xxxx xxx xxxxx xx he/she has xxx received xxx xxxxxxxxxxxx. Xx xx xxxxxxxxx by xxx xxxxxx xx xx xxxxxxxxxxx, the Ministry xx Xxxxxxx xxx xxxxx xxx xxxxx'x xxxxx xx xxxxx xxx xxxxxx xx xxx xxxxxxxxx xxxxxxx xxxxxxxx xxxxx the xxxxx of xxx xxxx-xxxx xxxx, provided xxxx x xxxxxx xx xxxxxxxxx xx xxx xxxxxx'x social xxxxxxxx, xxx xxxxx xxxxxx xx the xxxx suffered and xxx amount xx xxxxxxxxxxxx paid xx xxx xxxxxx.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, xx x xxxxxxxx, x xxxxxx xx xxxxxxxxxx, sme xxxxxx Vás xxxxxxxxx xxxxxxxxxxxx xxxxxxxx. V xxxxxx rýchleho posúdenia Xxxxx žiadosti x xxxxxxxxxxx peňažnej pomoci xxxxxxx xxxxxxxx xxxxxxxx xxxľx xxxxxx č. 209/1997 Zb., xx však xxxxxxxxx xxxxx xxxxxxxxx nevyhnutné. Xxxxxxxx Xxx za xxxxxxxxxx, xxxxx si xxxxx xxxxxx.

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X. Prosím, xxxxxxx xxxxxxľxx osobné xxxxx x žiadateľovi - obeti xxxxxxxxx xxxx, xxxxxx xxôxxxxxx xxxx na xxxxxx, xxxxx osobe xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx trestného xxxx zomrela:

1. Priezvisko:

2. Xxxx:

3. Xxxxx narodenia:

4. Xxxxxx xxxxxxxx xxxxxx:

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

6. Xxxxxxx:

7. X-Xxxx:

8. Občianstvo:

II. Xx xxxxxxxľx xxxxxxxxx xxx xxxxx (xxxxxxxx) xx xxxxxxx zákonného xxxxxxxxxx (xxxx. maloleté xxxxx xxxxxx rodičom) xxxxx xx základe xxxxxx x xxxxx xxxx, xxxxxxx údaje x xxxxxxxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxxxxxxxxxxx adresa:

Ak žiadate xx xxx xxxxx, xxxx sa xxxxxxx xxxxxxxxxx, xxxxx xxxxxxxxxx xxxxxxx. Xxxxx k xxxxxxxx xxxxxxxx kópiu xxxxx xxxx (xxx xxxxxxxx zastúpení) alebo xxxxx xxxxxxx listu (x prípade xxxxxxxxx xxxxxxxxxx) alebo xxx xxxxxxx listinu.

III. Xx xxxxxxxľ xxxxx osoba xxxxxxxxx xx xxxxx, xxxxx v xôxxxxxx xxxxxxxxx činu xxxxxxx, xxxxxxx, prosím, aj xxxxx o xxxxxxx xxxxx:

1. Priezvisko:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Dátum xxxxxx:

5. Xxxxxxxx xxxxxxxx:

7. Xxxxxxxxxx:

8. X xxxx xxxxxx xxxx xxxxxxx xxxxx x xôxxxxxx xxxxxxxxx činu x xxxxx xxxxxxxľx (xxxx, xxxxx, osoba žijúca x xxxxxxxxx xxxxxxxxxx):

Xx xx xxxxxxxľ xxxxxx xxxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx zomrela, x xxxxxxxx sa xxxx xxxxxxxx xxxxx xxxxxxxx xxxxx x xxxxxxx, ktoré xxxxxxxxx xxxxxxxxxx, že xxxxxx xxxxx xxxxxxxxxx pozostalú xxxxx xxxxx xxxx xxxxxxxxx xx vyživovať (xx xxxxxx xxxxx - xxxxx pôjde x xxxxx xxxx xxxxx xxxxxxxxxxx súdu x xxxxxxxxxxx xxxxxxxxxx, xxx xxxxxxxx xxxxx xxxxxxxx xxxx sobášny xxxx x xxx.)

XX. Xxxxxx, či xxxxxxx xxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxxxxx xxxxx alebo xxxxxxxx xx peňažný xxxx; x xxxxx xxxxxxx xxxxxxx oznámte xxxxx Vášho xxxx.

X. Xxxxxx xxxxx, xxxx xx xxxx dozvedela x škode xxôxxxxxxx xxxxxxxx činom.

Uveďte xxxxx xxxxxxxxx trestného xxxx x ak xx xxxx x xxxxx xxx xxôxxxxxxx dozvedela xx neskôr, xxxxxx xxxx x xxx (xxxxxxxxx z lekárskej xxxxxx - xxxxx xxx xxxxxxxxxx).

XX. Xxxxxxx xxxxx xxxxx v xxxxxxxx xxxxxx (policajný xxxxx, štátne xxxxxxxxxxxxxx, xxx), xxxxx naposledy xxxxx xxxxxxx o xxxxxxxx xxxx. Uveďte xx xxxxxxx značku, xxx xxxxxx prebieha xxxxxxxxxxxx.

Xx máte x xxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxx xxxxxxx v xxxxxxxx konaní, xxxxx xxxx xxxxxxxxx x xxx, v akom xxxxxx xx xxx xxxxxxxx (xxxx. uznesenie x odložení xxxxxxxxx xxxxxxxx, opis xxxxxxxx, xxxxxxxx - x xxxxxxxxxxxxx), pripojte ho x xxxxxxxx.

XXX. Xxxxxx, xxxx xxôxxxxx ste xxxxxxxxx xxxxx xx xxxxxxx xxxxx xx xxxxxxxľx xxxxx xxxx xxxxx, ktorá xxxxxxxxx xx škodu.

Podľa xxxxxxxxxxx §8 xxxxxx x. 209/1997 (Xx)., peňažitá xxxxx xx môže xxxxxx xxxxx sa xxxxxxxx s xxxxxxxxxxxxx xx xx, či xxxx využila xxxxxx xxxxxxx xxxxxxxxxxx xx xxxxxxxxxx xxxxxx xx xxxxxxx škody xx xxxxxxxľx xxxxx inej xxxxx, xxxxx xxxxxxxxx xx xxxxx. Xxxxx xxx nevyplňujte, xx xxxxxxxľx xxxxxxxxx činu xxxxxxxxx.

Xxx XXXX. Xxxxxxx, xx xxxxxxxľ xx xxxxxxxxxx xx xxxxx, xxxxx v xôxxxxxx xxxxxxxxx činu xxxxxxx.

XXXX. Xxxxxx, xx ste xxxxxxx osobou, xxxxx xxľxx xxxxxxxxx uvedené x §2 xxxx. 2 zákona č. 209/1997 Xx., xxxxxxxx xxľxx xxôx xxľxx xxxxx xxxxxxxxx, xx xx Xxx xxxxx xxxxxxxxxxx xxxxx.

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

2. Xxxx ste x xxxxxx xxxxxxxxx xxxx xxxx xxxxxxxxx xxxxxxxxx xxxx v xxxxxxxxx xxxxxxxxxx?

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

4. Xxľxxxx xxxxx osoby xxxxxxxxxxx xxxxxxxxx 1 xx 3? Xxxxxx xxx počet, xx Xxx xx známy.

Podľa xxxxxxxxxxx §2 odst. 2 xxxxxx x. 209/1997 Xx. xx xx xxxx xxxxxxxx xxxxx xxxxxxxxx xx xxxxx, xxxxx v xôxxxxxx trestného činu xxxxxxx, xx xx xxxxxxx, manželom xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx x čase xxxx smrti x xxx xxxx x xxxxxxxxxx alebo xxxxx, xxxxxx xxxxxx poskytoval xxxxx bol xxxxxxx xxxxxxxxxx výživu.

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Body XX. xx XXX. Xxxxxxx, xx xx xxxxxxxľ xxxx xxxxxx xxxxxxxxx xxxx x xxxx xx spôsobená xxxx xx xxxxxx.

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

X. Celková xxxxx xxxxxxxx xxxxxxxxxxx xx bolesť xxxx:

X xxxxxxxx sa xxxx xxxxxxxx xxxxxx ohodnotenie xx xxxxxx podľa xxxxxxxx č. 440/2001 Zb., xxxxx xxxxxxxľ xxxxx xx xxxxxx, xxxxx xx xxxxxxxxx. Tento xxxxxxxx xxxxxxx xxxx obsahovať xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxxx x xxxxxx xxxxxxxxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx. Xxxxxxxxxxx, xx xxx účely zákona č. 209/1997 Zb. xx xxxxxxxxxx xxx bodové xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxxľx xxxxxxxxxxx §6 xxxx. 2 zákona č. 209/1997 Zb. nemožno xxxxxxxxx' xxxxxxx xxxxx, xx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx xxxxxxxxxx xxxxxxxx 100 xxxxx.

XX. Xxxxxx, či xxxxxxx x poskytnutie xxxxxxxx xxxxxx xx xxxxx xxxxxxxxx čiastky 25&xxxx;000.- Xx xxxxx či xxxxxxxx výšku ušlého xxxxxxx x xxxxxxxx xx liečenie.

Podľa xxxxxxxxxxx §7 xxxx. 1 xxxx. a) zákona x. 209/1997 Xx. xx žiadosť xxxxx xxxxx xxxxxxxxx xxxxxxx xxxxx xx xxxxx xxxxxxxxx xxxx 25 000.- Xx, xxxxx vo xxxxx xxxxxxxxxxxxxx preukázaným xxxxxxxx xx liečenie x xxxxxx xxxxxxx. Xx xx xxxxxxxxxx xxxxxx x xxxxxxx xxxxx vo xxxxx xxxxxxxxx xxxxxxx, nemusíte xx xxxxxxxxx xxxx XXX. - XXX. xxxxx dotazníka.

XII. Náklady xxxxxxx x xxxxxxxx xxxxxx:

Xxx o xxxxxxx xx xxxxx, xxxxxxxxxxxx xxxôxxx, xxxxxxx na xxxxxxxxxxxxx, pribranie cudzej xxxxx na pomoc x xxxxxxxxxx xx xxxxxxxxxx, xxxxxxx xxxxxxx xx xxxxxxx, x xxx. pod xxxxxxxxxx, xx xxxxx xxxxxxx xxxxxxxxx pojsťovňa. Xx xxxxxxx náklady sa xxxxx doložiť, xxxx xx ne xxxxxxxxxxxx xxxxxxxxxxxxxx nebude xxxx xxxx xxxxxľ.

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

X žiadosti xxxxxxxx xxxxxxx, ktoré xxxxxxxxxx xxxxxxx xxxxxxxxxxx.

X xxxxxxx, xx žiadateľ je x xxxxxxxxxxxxxx pomere, xôxxx x potvrdenie xxxxxxxxxxxxľx x xxxxxxxxxx xxxxxxx xxxľx §351 x xxxx. xxxxxx x. 262/2006 Xx., xxxxxxxx xxxxx, x xxxxx xxxxxxxxxx xxxxxxxxx. Xx xx žiadateľ xxxxxx xxxxxxxxxx zárobkovo xxxxxx, xxxxx listinou xxxx xxxxxxxxx xxxx xxxxxxxxxx daňového xxxxxxxxx. Xx xxxxxxxľ xxxxxx xxxxxxxx xôxxxxxx, xxxxxxxx, xxxxx xôxx dokázať xxxxxxxx xxxxxxxx xxxxxxxx, xxxx xxxxxxxxxx x xxxxx starobného xôxxxxxx. X xxxxxxx, že x xxxxxxxx závažného xôxxxx xxxxxxx xxxxxxx xxxxxxxxx pomery žiadateľa, x xxxxxxx xxxxxxx xx xxxxx xxxxxxxx xxxxxxxxxx x nich xxxxxxx xxxxxxxxxx.

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

X xxxxxxxx xxxxxxxx xxxxxxxxxx xxxxxxxxxxxxľx xxxxx poisťovne x xxxxx nemocenských xxxxx. X xxxxxxx, xx x xôxxxxxx xxxxx na xxxxxx xxôxxxxxxx xxxxxxxx xxxxx Xxx xxxxxxxx xxxxxxxxx xôxxxxxx, uveďte x xxxxxxx jeho xxxxx.

Xxxx majetkové xxxxxx xx xxxx, xx xxxxxxxx xxxxx, ktorého xxx bol(a) xxxxxx, xx xxxx sociálna xxxxxxxx xxxxxxxx. Xxxxx, xxxxx mi xxxxx xxôxxxxx, xxxxxľ nebola xxxxxxxx.

Xxxxxx xxxxxxxxxx, xx xxxxx xx xxxxxxx xxxxx či xxxxxxx xxxxx xx xxxxxxxxxxx xxxx xxôxxxxxxx trestným xxxxx xxx xxxxxxxxxx(x) x xxxxxxx xxxx xxxxx xxx v Xxxxxx (Xxxxxxxxxx) xxxxxxxxx.

Xxxxxx xx xxxxxxx, xx xx xxxľx xxx. §12 xxxxxx x. 209/1997 Xx., x xxxxxxxxxx peňažnej pomoci xxxxxxx xxxxxxxx činnosti x x zmene x o xxxxxxxx xxxxxxxxxx xxxxxxx, x xxxxx xxxxxxxxxx predpisov, xxxxxx povinnosť xx xxxxxxx rokov odo xxx, xxx mi xxxxxxxx xxxxx, xxxxxxx xx xxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxx, xxxxx xxx xxxxxx(x) xxx xxxxxxx xxxxx, x xx xx xx xxxxx poskytnutej pomoci. Xxxxxxx x xxx xxxxxx na xxxxxxx, xx po xxxxxxxx xxxxxxxxxx xäxxxxxxx xxxx xôxxx požiadať Xxxxxxxxxxxx xxxxxxxxxxxxxx, xxx sa x xxxx štátu xxxxxx xxxxx xx xxxxxxxx poskytnutej pomoci, xx xxxx xxxxxxxx xxxxxxxx xxxx xxxx xxxxxx xxôxxxxxxxx, xxxxxxx xxxxx xxxxx, xxxxx xx xxôxxxxxx x xxxxx náhrady, xxxxx xxx dostal(a).

Beriem xxxx xx xxxxxxx, xx xxxxxxxxx xxxxxxxx nesprávneho xxxxx xxxxxxxxx údaja xx xxxx xxxxxxxxx xx xxxxxx xxxxxxxx xxxxxxxxxxxx xxxxxx, xx xôxxx xxxxxxxx xxxxxxxxxx xxxľx §21 xxxx. 1 xxxx. x) xxxxxx x. 200/1990 Xx., x xxxxxxxxxxxx, x xxxxx xxxxxxxxxx xxxxxxxxx.

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xxxxxx xxxxxxxľx xxxxx xxxxxxxx

- Xxxxxxxxxxxx xxxxxxxxxxxxxx Xxxxx xxxxxxxxx po xxxxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx xxxľx zákona č. 209/1997 Zb. xxxxxxx xxx príjem x udelí poradové xxxxx. Potom bude xxxxxxxxxx na xxxxxxx xx xx xxxx xxxxxxxx xxxxxx xxxľx xxxxxxxxxxx xxxxxxxxx prípadu. Xx xxxxx mesiacov xx xxxxxx žiadosti x predložení potrebných 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 xx x xôxxxxxx trestného xxxx xxxx xxôxxxxxx poškodenie xxxxxxx. Nevyhnutnou, xxx xxxx postačujúcou xxxxxxxxxx xx priznanie xxxxxxxx xxxxxx takej xxxxx xx xxxxx xxxxxxxx xxxxxxxxxxx xxxxxxx (xxx xxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx) dosahujúceho xxxxx 100 xxxxx. Xx xxxx xx xxxxxxxx xx xxxxx xxxxxxxxx xx xxxxx, xxxxx x dôsledku trestného xxxx zomrela, ak xxxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx v xxxx xxxx xxxxx x xxx xxxx x xxxxxxxxxx, xxxxx xxxxx, ktorej zomretý xxxxxxxxxx xxxxx bol xxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx č. 209/1997 Zb. x xxxxxxxxxx peňažitej xxxxxx xxxxxxx xxxxxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxx (xxxxxxxx) xxxx 1 xxxx xxx xxx, keď xx xxxx dozvedela x xxxxx spôsobenej xxxxxxxx xxxxx. Ak xxxxx xxxx xx xxx xx xxx xxxxxxxxx trestného xxxx, xxxx xxxxxxxx xxxxxxx, xxxx xx xx xxxxx. Xxxxxxxxxxxx spravodlivosti xxxôxx xxxxxxxx žiadostiam x poskytnutie peňažnej xxxxxx, ktoré xx xxxxxxxx po uplynutí xxxxxxxxxx xxxxxx.

- Xxxxx xx xx xxxxxxx xxxxx, xxxxxx x xôxxxxxx trestného xxxx xxxxxxx xxxxx na xxxxxx, poskytne x xxxxxxxxx xxxx 25 000.- Xx xxxxx xx xxxxx, xxxxx xxxxxxxxxxx xxxxxxxxxx xxxxxx xx xxxxxxx, xxxxxxxxxx xxxxxxx xxxxxxx x xxxxxxxx, xxxxxxx x xxxxx xxxxxxxx xxxxxxx, xxxxx xxxx z xxxxxx xxxxxxx xxxxx xx xxxxxxx; xxxxx xx xxxxxx xxxxx xxxxxx xxxxxxxxxx xxxx 150 000.- Xx. Xx xxxx - po xxx, xxx xxx poskytli xxxxx - xxxxxxxx, xx xxx xxxxxxxxx xxxxx je xxxxxx xxx xx, ktorá xxxx xxxxxxxxx na xxxxxxxxxxx pomoci, xx xxx žiadosť x xxxxxx xxxxxxxxxx týmto xxxxxxx jej xxxxx xxxxxxxxx pomoc opäť, x to až xx xxxxxxxxxx výšky 150&xxxx;000.- Kč; xxxxxx xx xxxxxxxxxx xx xxxxxxx, ktoré xx xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, ktorá xx xxxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx zomrela (xx xxxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x zároveň x xxxx xxxx xxxxx s ním xxxx x xxxxxxxxxx, xxxxx jej zomretý xxxxxxxxxx, či bol xxxxxxx xxxxxxxxxx xxxxxx), xx poskytne peňažná xxxxx x xxxxxxxxx xxxx 150&xxxx;000.- Xx; xxxxx vo xxxxxx xxxxx xxxxxx xxxxxxxxxx xxxx 450&xxxx;000.- Xx, x ak xx xxxxx obetí xxxx xxx xxx xxxxx, xxxxxxxxxxx čiastka sa xxx xxxxxx obeti xxxxxxxxx xxxxx.

- Zákon č. 209/1997 Zb. nenahradzuje inštitút xxxxxxxxxxx zodpovednosti vykonávateľa xxxxxxxxxx vozidiel, xx xxxxx xxxxäxxxx xxxxxxx xxxxxxx poistenie xxxxxxxxxxxxx. Xxxxx xx xxxxxxxx x záležitostiach xxxxxxxxxx xxxôx xxxxxx subjekt, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, x xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxx x xxxxxx xxxxxxxxxxx xxxxxxxxx s xxxxxxxxxxxxx xx xxxxxxxxx xxxxxxxxx xxxxxxxxx xx xxxxx xxxxxx xxxxxxxxxxxx xxxxxxxxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx.

- Pripomíname, že xx nevyhnutné priložiť xxxxxx dostupné xxxxxxx x xxxxxxxxxx, xx xxxxx xxxxxxxxxx xxx xxxxxxxxxxxx xxxxxxxxx. Xx xxx žiadateľ xxxxxxx, xxxxxxxxxxxx spravodlivosti xxxôxx xxxxxxx xxxxxxx. Xx xxxxxx xxxxxxxxxx x xxxxxxx xxx dodatočne xxxxxx, xxxx skutočnosť xôxx xxx xôxxxxx xxxxxxxxxxxxx xxxxxxxx xxxxxx xxxľx xxxxxx č. 209/1997 Zb. Xx však xxxxxxxxxx xxxxxxx podať xxxx xxxxxxx.

- Xxxxxxxxxxxx, xx xx xxxx žiadateľovi xxxxxxxxxx peňažná xxxxx, xxxxxxxľ xx do xxxxxxx xxxxx xxx xxx poskytnutia pomoci xxxxxxx na xxxx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxx, xxxxx xxxxxx xxx xxxxxxx škody (xx xxxxxxxľx, xxxxxxxxx x xxx.) xx do xxxxx poskytnutej pomoci. Xxxx povinnosť xxxx, xx mu xxxxx xxxxxxxxxx. Xx xxxxxxx xxxxxxxx xxxxx xx xxxxxxxxxxxx spravodlivosti xôxx x xxxx xxxxx xx uplynutí xxxxxxxxxx xäxxxxxxx xxxx xxxxx xxxxx xx vrátenie xxxxxxxxxxx xxxxxxxx pomoci. Xx xxxxxx xxxxxx xxôxxxxxxx sociálna xxxxxxxx xxxxx, xxxxxxx výška xxxxx, xxxxx xxx xxôxxxxxx, x xxxxx xxxxxxx, xxxxx xxxx xxxxxxx.