Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Xxxxxxxxxx xx Applications xxx xxx Xxxxxxxxx xx Xxxxxxxxx Xxxxxxx xx Xxxxxxx xx Criminal Xxxx xxxxxxxx xx Xxx Xx. 209/1997 Xxxx., xx the xxxxxxxxx xx fulancial xxxxxxx xx xxx xxxxxxx xx criminal xxxx xxx on xxxxxxxx xxxxxxx xxxxx xxxx, as amended

Dear Xxx/Xxxxx,

Xx xxxxxxxxx xxx xxxxxxxxx xxx xxxx xxxxxxxx xxxxxxxxx xx xxxx xxxxxxx situation. Xxxxxxx, xxxxxxx in xxxx xxxxxxxxxxxxx xx xxxxxxxx for xxx xxxxx xxxxxxxxxx xx xxxx application xxx xxx xxxxxxxxx xx xxxxxxxxx support xxxxxxxx xx Xxx xx. 209/1997. Xxxxx xxx xxx xxxx cooperation; xx xx highly xxxxxxxxxxx.

_____________________________________________________________________________________________

X. Xxxxxx xxxxxxx xxxx xx xxx xxxxxxxx data of xxx xxxxxxxxx - x.x. xxx victim xx xxx criminal xxx xxx has xxxxxxxx xxxxxx xxxx, xx xxx xxxxxxxx xx a xxxxxx xxx xxx xxxx xx xxxxxxxxxxx xx xxx xxxxxxxx xxx:

1. Xxxxxxx:

2. Xxxxx name:

3. Xxxx xx xxxxx:

4. Xxxxxxxxx xxxxxxx:

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

6. Xxxxx Number:

7. X-xxxx xxxxxxx:

8. Xxxxxxxxxxx:

XX. Xx the xxxxxxxxx xx xxxxxxxxxxx xx xxxxxxx person ("representative") xx xxx xxxxx xx statutory representation (xxx instance, x xxxxx xxxxx xxxxxxxxxxx xx xxx/xxx parent) xx on xxx xxxxx xx x xxxxx xx xxxxxxxx, xxxxxx fill xx xxx data xx xxxx xxxxxxxxxxxxxx:

1. Xxxxxxx:

2. Xxxxx name:

3. Xxxxxxxxx xx registered xxxxxxx:

Xx xxx xxxxxxxxxxxxxx xx xxxxxx xxx application xx behalf xx xxx xxxxxxxxx, xxxxxx xxxx xxxxxx a xxxxxxxx xxxxxxxxxxx him/her xx represent xxx xxxxxxxxx - a xxxx xx a xxxxx xx xxxxxxxx (xxx contractual xxxxxxxxxxxxxx) xx a copy xx the xxxxx xxxxxxxxxxx (xxx xxxxxxxxx xxxxxxxxxxxxxx) or any xxxxx equivalent xxxxxxxx.

XXX. Xx xxx xxxxxxxxx xx x xxxxxxxx xx x person xxx xxx xxxx xx xxxxxxxxxxx of xxx respective xxxxxxxx xxx, please xxxx xx xxx xxxxxxxx xxxx of xxx xxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxx xx xxxxx:

4. Date xx xxxxx:

5. Xxxx xxxxxxxxx xxxxxxx:

6. Xxxxxxxxxxx:

7. Xxxxxxxxxxxx xx the deceased xx xxx applicant (x.x. father, xxxxxxxx, xx xxxxxxxxxx xxxxxx xx xxxxxx xxxxxxxxx)

Xx xxx xxxxxxxxx xx x xxxxxxxx xx x person xxx xxxx in xxxxxxxxxxx xx xxx criminal xxx, xxxxxx attach x xxxx of xxx death certificate xxx any xxxxxxxxx xxxxxxx xxxx xxx xxxxxxxx xxxxxxxxx xx xxx xx xxxxxxxxxx xx support xxx xxxxxxxx (in the xxxx of x xxxxxx-xxxxx xxxxxxxxxxxx, xxxx xxxxxxxxx include xxxxx xxxxxxxxxxxx or x xxxxx xxxxxxxx xx xxx xxxxxxxxxx to xxxxxxx xxx dependent; xx xxx xxxx xx married couples, xxxxxx attach a xxxxxxxx xxxxxxxxxxx).

Xxxxxx specify xxx xxxx xx which xxx crime was xxxxxxxxx and, xx xxx xxxxxx xxxxxxx xxxxx xxx consequences xx xxx xxxxx xx a later xxxx, xxxxxx xxxx xxxxxxx xxx date xxx xxx xxxxxx xx which xxx xxxxxx xxxxxxx of xxxx consequences (e.g., xxx xxxx of xxx xxxxxxx report).

VI. Xxxxxx xxxxxxx xxx xxxxxxxx xxxxxxx authority (x.x. police, xxxxxx xxxxxxxxxx'x office, xxxxx) xxxxx xxxx xxxxxxxx xxxxxxxxx criminal xxxxxxxxxxx. Xxxxx xxx reference xxxxxx of xxx xxxx xxxxxxx xx xxx respective xxxxxxxxxxx.

Xx xxxxxxxxx, please attach xxx xxxxxx xxxxxxxx xx xxx xxxxxxxxxxxxxx xxxxxxxx justice xxxxxxxxx xxxxx xxxxx xxxxxxxx xxx xxxxx xx xxx xxxxxxxxxx xxxxxxxxxxx (x.x. xxxxxxxxxx xx xxx xxxxxxxxxxxxxxx xx xxxxxxxx xxxxxxxxxxx, copy xx the indictment, xxxxxxxxx - final xx xxxxxxxxx).

Xxxxxxxxx xx the xxxxxxxxxx xx §8 of Xxx no. 209/1997, xxx xxxxxx xx xxxxxxxxx support may xx reduced xx xxxxxxxx xxxxxxxxx on xxxxxxx xxx xxxxxx xxx xxxx use xx xxx xxxxx xxxxxxxx to enforce x xxxxx xxx xxxxxxxxxxxx xxxxxxx the xxxxxxxx xx xxx xxxxx person xxxxxxxxxxx xxx xxx xxxx xxxxxxxx. Xx xxx xxxx in this xxxx if xxx xxxxxxxx has not xxxx xxxxxxxxxx.

______________________________________________________________________________________________

Xxxx in xxxx VlIl if xxx xxxxxxxxx xx x xxxxxxxx xx xx xxxxxxxxxx who xxx xxxx xx xxxxxxxxxxx of the xxxxxxxxx xxxxx.

1. Xxx you x xxxxx, spouse or xxxxx xx xxx xxxxxx who xxxx xx consequence xx xxx xxxxxxxx xxxxxxx?

2. Xxx you live xx x xxxxxx xxxxxxxxx xxxx xxx xxxxxxxx xxxxxx xxxxx xx the xxxxxxxxxx xx xxx xxxxx?

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

4. Xx xxx xxxxx xxxxxxx xxxx the xxxxxxxxxx xxxxxxxxx xx xxxxxxx 1 xx 3? Xxxxxx xxxx xxxxx number, if xxxxx to you.

______________________________________________________________________________________________

According xx xxx provisions xx §2, xxxxxxx 2 of Xxx xx. 209/1997, x xxxxxx who xx x survivor xx x victim who xxxx xx consequence xx a xxxxxxxx xxx xx xxxxxxxxxx xx xx x xxxxxx xx xx xx she xx x xxxxxx, xxxxxx xx child xx xxx xxxxxxxx and xxxxx with him xx xxx xx xxx xxxx household xx if xxx xxxxxx xxx x xxxxxxxxx xx the xxxxxxxx xx the xxxxxxxx xxx required xx support xxx xxxxxx.

Xx xxx applicant xx xxx xxxxxx xx x xxxxx xxx xxx xxxxxxxx xxxxxx harm, xxxxxx xxxx xx xxxxx XX - XIV.

Xxxxxx attach x xxxxx-xxxxx assessment xx pain and xxxxxxxxx xxxxxxxx xx Xxxxxx No. 440/2001 Xxxx. Xxx xxxxxxxxxx xxxxxxxx should xx xxxxxxxx from the xxxxxxxxx xxxxxxxxxxx xxx xxx victim's treatment. Xxxx xxxxxxx xxxxxx xxxx contain x xxxxx-xxxxx assessment xx xxx pam xxxxxxxx xxx x point-based xxxxxxxxxx xx xxx xxxxxxxx of xxx xxxxxx'x xxxxxx position. Xxxxxx xxxx xx xxxx that xxxx xxx point-based xxxxxxxxxx xx the xxx xxxxxxxx is xxxxxxxx xxx xxx xxxxxxxx xx Xxx xx. 209/1997. According xx xxx xxxxxxxxxx xx §6, section 2 xx Act xx. 209/1997, xx xxxxxxxxx xxxxxxx xxxx xx xxxxxxxx xxxxxx the xxxxx assessment of xxx xxxx xxxxxxxx xx xx xxxxx 100 xxxxxx.

Xxx xxxxxx xxx obtain xxxx xxx xxxxxxxxx xxxxxxx in xxx xxxxxx xx XXX 25,000 xx an xxxxxx xxxxx xx xxx proved costs xx xxxxxxx treatment xxx xxxx income (§7, section 1, xxxxxx x xx Xxx Xx. 209/1997 Xxxx.). xx you xxxxxx xx apply xxx x xxxx xxx xxxxxxx, there xx xx xxxx xx xxxx xx xxxxx XXX - XxX.

This xxxxxxxx xxx xxxxxxxx xxx xxxxxxxxxx, xxxxxxxx xxxxxxxxx, xxxxxxxxxxxxxx costs, hiring xx xxxxxxxxx xx xxxx xxx in xxx xxxx xx xxxx medical treatment, xxxxxxxxx xxxxxxxxxxxxxx xxxxx xxx., xxxxxxxx xxxx xxxxx xxxx xxx xxxx xxxx xx xx insurance xxxxxxx. xx such xxxxxxxx xxx not xxxxxx xx xxxxxxxxxxx xxxxxxxx, xxx Ministry of Xxxxxxx may not xxxx xxxx xxxx xxxxxxxxxxxxx.

Please xxxxxx xxx documents confirming xxxx facts to xxx xxxxxxxxxxx.

Xx xxx xxxxxxxxx is an xxxxxxxx, xxxxx xxxxxxxxx xxxxx xxxxxxx a xxxxxxxxx from his/her xxxxxxxx describing the xxxxxxx xxxxxx according xx §351 xx. xxx. of Xxx xx. 262/2006, xxx Xxxxx Xxxxxx Xxxx, xx xxxxxxx. xx xxx applicant xx xxxx-xxxxxxxx, xxxx document xxxxx be x xxxx xx xxx/xxx xxxx recent tax xxxxxx. lf the xxxxxxxxx xx a xxxxxxx xxxxxx xxx xx xxxx xx xxxxx his/her xxxxxxxx xxxxxx xxxxxxxx, please xxxxxx x xxxxxxxx xxxxxxxxxx the xxxxxx xx xxx xxxxxxxxxx xxxxxxx. xx for xxx xxxxxx xxx xxxxxxxxx'x xxxxxx situation xxxxxx xx xxxxxx, xx xxxxxxxxxxx xxxxx xx xxxxxxxxx xxx xx xxxxxxxx.

Xx xxxxxx xxxxxxxx has xxxx impaired xx x xxxxxx xx xxx xxxxxxxx xxx xx xxxxx X xxx a victim. X have not xxx been xxxxxxxxxxx xxx the harm 1 xxxx suffered xx x xxxxxx xx xxx criminal xxx.

X hereby xxxxxx xxxx X xxxx xxx xxxxxx xxx xxxxx for xxxxxxxxx xxxxxxx xx xxx xxxxxxx claim for xxxxxxxxxxxx for the xxxx suffered xx x result xx xxx xxxxxxxx xxx xx xxx country xxxxx xxxx xxx Xxxxx Republic.

I acknowledge xxxx according xx §12 xx Xxx Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxx xxx xxxxxxx xx xxxxxxxx acts xxx on xxxxxxxx xxxxxxx xxxxx xxxx, xx xxxxxxx, X xx xxxxxxx to xxxxxxxxx xxx Xxxxxxxx xx Xxxxxxx any xxxxxx received xx xxxxxxxxxxxx xxx the xxxx xxxxxxxx, xx xx xxx xxxxxx xx xxx financial xxxxxxx, within xxxx xxxxx xxxx xxx xxxx xx xxxxxxxxx xxx xxxxxxx xxxxxxx. X also acknowledge xxxx, xxxxx xxx xxxxx xx the xxxx-xxxx xxxxxx, I xxx xxxx xx xxxxxxxxxxx xxxxxx xxx Xxxxxxxx of Xxxxxxx xx xxxxx the xxxxx'x xxxxx for xxx xxxxxx of xxx xxxxxxxx support, xxxxxx such a xxxxxx be xxxx xxxxxxxx by xx xxxxxx standing, the xxxxx extent xx xxxx xxxxxxxx xxx xxx xxxxxx of xxxxxxxxxxxx xxxxxxxx.

X also xxxxxxxxxxx that xxxxxxxxxxx xxxxxx xxxxx or xxxxxxxxxx information xx xxxxxxxxxxx information xxx xxx xxxxxxxx xx xxxxxxxxxxxxx gaining benefits xxx xxxxxxxxx an xxxxxxx xxxxxxxx xx §21, section 1, xxxxxx x) xx Xxx xx. 200/1990 Xxxx., on offences xx amended.

-----------------------------------------------------------------

Signature of xxx applicant xx xxx/xxx xxxxxxxxxxxxxx

- Upon xxxxxxx xx the xxxxxxxxxxx xxx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xx Xxx No. 209/1997, xxx Xxxxxxxx xx Xxxxxxx shall xxxxxxx xxxxxxx xxx assign xx x serial xxxxxx. Xxxxxxxxxxxx, the Xxxxxxxx xxxxx xxxxxxxx xx investigation xxxx xxx xxxxxx xx x similar xxxxxxxxx xx xxx xxx xxxxxxxx details xx xxx xxxx. Within xxxxx xxxxxx xxxx xxx xxxx xx xxx xxxxxxx xx xxx application xxx xxxxxxxxxx xx xxx xxxxxxxxx xxxxxxxxx, xxx Xxxxxxxx xxxxx xxxxxx xxxxxxx xxx xxxxxxx xx xxxxxx xxx xxxxxxxxx xx the xxxxxxx xxx xxxx xxxxxxx xxx xxxx xxxxxxxx.

- The xxxxxxxxx xxxxx xx xxxxxxxxxx x victim xx xxx Xxx Xx. 209/1997 Coll. only xx xx/xxx xxx xxxxxxxx xxxxxx harm xx x xxxxxx xx the xxxxxxxxxx xx a xxxxx. X xxxxxxxxx xxx xxx xxx ohly xxxxxxxxx xxx xxx xxxxxx'x xxxxxxx of xxxxxxxx xxxxxxx xxxxx xx xxx xxxxxx xx the xxxxx-xxxxx xxxxxxxxxx xx xxx xxx xxxxxxxx (xxx xxx weakening xx xxxxxx position), xxxxx xxxx xx xx xxxxx 100 points. Xxxxxxxxx xx a xxxxxx who xxx xxxx xx consequence xx a crime xxxxx xx xxxxxxxxxx xx xx x xxxxxx xx xxx xxxxxxxx xx x xxxxxx, spouse xx xxxxx of xxx xxxxxxxx xxx the xxxxxxxx xxxxxx a xxxxxxxxx with xxx xxxxxxxx at the xxxx xx xxx/xxx xxxxx xx xx xxx xxxxxxxx supported xx xxx xxxxxxxx xx support xxx xxxxxxxx.

- Xxx No. 209/1997 Xxxx. on xxx provision of xxxxxxxxx xxxxxxx to xxxxxxx xx criminal xxxx xxxxxxxxxx x xxxxxxxxxx term xx 1 xxxx xxxx xxx date xx xxxxx xxx xxxxxx xxxxxxx xx xxx xxxx caused xx xxx xxxxx. If xxxx date xxxx xxx xxxxxxxx with xxx xxxx xx xxx xxxxxxxxxx xx xxx xxxxx, xxx xxxxxx xxxxx xxxxxxx xxxxxxxx xx the xxxx xx xxxxx xx/xxx xxxxxxx xx xxx xxxxxxxxxxxx. Xxx Xxxxxxxx xx Xxxxxxx xxxxxx xxxx xx xxxxxxxxxxx xxx the xxxxxxxxx xx xxxxxxxxx xxxxxxx received xxxxxxx xxxxx xxx lapse xx the xxxxxxxxxxxxxx xxxxxx.

- Xxxxxxxxx xxxxxxx xx xxxxxxx xxx xx x xxxxxx xxx has xxxxxxxx xxxxxx harm as x xxxxxx xx xxx commitment xx x xxxxx xxx xx in xxx xxxx xx x xxxx xxx amounting xx CZK 25,000 xx xx amount xxxxx xx lost xxxxxx or the xxxxx of xxxxxxx xxxxxxxxx xx xxxxxx xx xxx xxxxxx, xxxxxxx xx xxx xxxxxx previously xxxx xx xxx victim xx compensation xxx xxx harm incurred. Xxx total xxxxxx xx xxxx support xxxx xxx xxxxxx XXX 150,000. If, xxxxx the xxxxxxxxx xx xxxxxxx, the xxxxxx proves that xxx xxxx suffered xxxxxxx the xxxxxx xxxxxxxx, the xxxxxx xxx receive xxxxxxxxxx xxxxxxx up xx xxx xxxxxx xx XXX 150,000 xx xx/xxx xxxxxxx xxx xx xxxxxx xxx xxxxxxxxxxxxxx period of xxxx (x.x., 1 xxxx xxxx xxx xxxx xx xxxxx xxx victim learned xx the xxxx xxxxxx xx the xxxxx); in such xxxx, xxx xxxxxxx xxxxxxx xxxx will xx taken xxxx xxxxxxx.

- An xxxxxxxxxx xxx is x xxxxxxxx xx x xxxxxx xxx xxx xxxx xx a xxxxxx of xxx xxxxxxxxxx xx x xxxxx (a xxxxxx, xxxxxx or child xx xxx deceased xxxxxx xx a xxxxxx household xxxx xxx xxxxxxxx xx xxx time xx xxx/xxx xxxxx xx xxxxxxxxx by or xxxxxxxx xx xx xxxxxxxxx xx xxx xxxxxxxx) shall xx xxxxxxxx xxxx a xxxx xxx xxxxxxxxx xx XXX 150,000. Xxx xxxxx xxxxxx xxxxxxxx as xxxxxxxxx xxxxxxx xxxxx xxx xxxxxx CZK 450,000; xxxxxx the number xx xxxxxxx exceed xxxxx, the amount xxxxxxxx per victim xxxxx xx xxxxxxx xxxxxxxxxxx.

- Act Xx. 209/1997 Coll. does xxx xxxxxxx the xxxxxxxxx of xxx xxxxxxxxx liability xx xxxxxxxxx xx xxxxx xxxxxxxx related to xxxxxxxxxx liability xxxxxxxxx. Xx xxxxxxx xxxxxxx xx xxxxxxx xxxxxxxxx, xxxxxxxxxxxx xxx xxxxxxxxx xxxxxxxx should xxxx xx xxxxxxxx xx xxx insurers xxxxxxxxx xxxx xxxxxxxxx xxxxxxxxx. Xxxx xx isolated xxxxx, in view xx xxxxxxxxxxx circumstances, xxx xx application xxx xxx provision xx financial xxxxxxx xx xxxxx with xxx Ministry xx Xxxxxxx.

- Please bear xx xxxx xxxx xxx xxxxxxxxx documents xxx xxxxxxxxxxxxx required xxx xxx xxxxxxxxxx xxxxx xxxx xx xxxxxxxx xx xxx xxxxxxxxxxx. Xx the xxxxxxxxx xxxxx to xx so, xxx Xxxxxxxx of Xxxxxxx xxxxxx xxxxxxxx xxxxxxx xxx application. Xxxxxx xxx applicant fail xx xxxxxxx any xxxx documents and xxxxxxxxxxxxx xxxx xxxxxx x xxxxxxxxxxxxx xxxxxxxx, xxxx fact may xxxxxxx x xxxxxxxx xx xxxxxxxx xxx xxxxxxx xx xxx Xxx Xx. 209/1997 Xxxx. This xxxxx xxx, xxxxxxx, xxxxxxxxx xxx filing xx xxxxxxx application.

- Xxxxxx xxxx in xxxx xxxx the xxxxxxxxx xxxxx xx xxxxxxx xx return any xxxxxxxxx amount xxxxxxxx xx compensation xxx xxxx (xxxx the xxxxxxxx, xxxxxxxx xxx.) xx xxx xxxxxxx xx xxx Xxxxxxxx xx Xxxxxxx xx xx xxx amount xx the xxxxxxx xxxxxxxx. This xxxxxxxxxx xxxx not xxxxx xx he/she has xxx received xxx xxxxxxxxxxxx. Xx xx xxxxxxxxx by xxx xxxxxx xx xx xxxxxxxxxxx, xxx Ministry xx Xxxxxxx may xxxxx xxx xxxxx'x xxxxx xx xxxxx xxx return xx xxx xxxxxxxxx xxxxxxx xxxxxxxx xxxxx the xxxxx of the xxxx-xxxx xxxx, provided xxxx x xxxxxx xx justified by xxx victim's xxxxxx xxxxxxxx, xxx xxxxx xxxxxx xx xxx xxxx xxxxxxxx and xxx xxxxxx of xxxxxxxxxxxx xxxx xx xxx xxxxxx.

Vážený xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, že x xxxxxxxx, x xxxxxx xx xxxxxxxxxx, xxx xxxxxx Xxx obťažovať xxxxxxxxxxxx xxxxxxxx. V xxxxxx xxxxxxxx xxxxxxxxx Xxxxx xxxxxxxx x xxxxxxxxxxx peňažnej xxxxxx xxxxxxx xxxxxxxx xxxxxxxx xxxľx xxxxxx č. 209/1997 Zb., xx xxxx xxxxxxxxx xxxxx xxxxxxxxx xxxxxxxxxx. Xxxxxxxx Vám xx xxxxxxxxxx, xxxxx si xxxxx xxxxxx.

______________________________________________________________________________________________

X. Prosím, xxxxxxx čitateľne xxxxxx xxxxx o žiadateľovi - xxxxx trestného xxxx, xxxxxx xxôxxxxxx xxxx xx zdraví, xxxxx xxxxx xxxxxxxxxx xx xxxxx, ktorá x xôxxxxxx trestného xxxx zomrela:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx narodenia:

4. Xxxxxx xxxxxxxx pobytu:

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

6. Telefón:

7. X-Xxxx:

8. Xxxxxxxxxx:

XX. Xx xxxxxxxľx zastupuje xxx xxxxx (zástupca) xx xxxxxxx xxxxxxxxx xxxxxxxxxx (xxxx. xxxxxxxx xxxxx xxxxxx rodičom) xxxxx xx xxxxxxx xxxxxx x xxxxx moci, xxxxxxx xxxxx x xxxxxxxxxx:

1. Xxxxxxxxxx:

2. Meno:

3. Xxxxxxxxxxxxxx adresa:

Ak xxxxxxx xx inú xxxxx, xxxx sa xxxxxxx xxxxxxxxxx, ktorá xxxxxxxxxx xxxxxxx. Xxxxx x xxxxxxxx xxxxxxxx xxxxx xxxxx xxxx (pri xxxxxxxx xxxxxxxxx) alebo xxxxx rodného xxxxx (x xxxxxxx zákonného xxxxxxxxxx) xxxxx inú xxxxxxx xxxxxxx.

XXX. Ak xxxxxxxľ alebo osoba xxxxxxxxx xx xxxxx, xxxxx v dôsledku xxxxxxxxx xxxx xxxxxxx, xxxxxxx, prosím, xx xxxxx x xxxxxxx xxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Xxxxx xxxxxx:

5. Xxxxxxxx xxxxxxxx:

7. Xxxxxxxxxx:

8. X xxxx xxxxxx xxxx zomretá xxxxx v xôxxxxxx xxxxxxxxx xxxx x xxxxx xxxxxxxľx (otec, xxxxx, xxxxx xxxxxx x spoločnej domácnosti):

Ak xx xxxxxxxľ xxxxxx xxxxxxxxxx po osobe, xxxxx x dôsledku xxxxxxxxx xxxx xxxxxxx, x xxxxxxxx xx xxxx xxxxxxxx xxxxx xxxxxxxx xxxxx a xxxxxxx, xxxxx xxxxxxxxx xxxxxxxxxx, že xxxxxx xxxxx xxxxxxxxxx xxxxxxxxx xxxxx xxxxx xxxx xxxxxxxxx ju xxxxxxxxx (xx xxxxxx xxxxx - xxxxx pôjde x rodný xxxx xxxxx rozhodnutie xxxx x xxxxxxxxxxx xxxxxxxxxx, xxx manželov xxxxx xxxxxxxx xxxx xxxxxxx xxxx x pod.)

IV. Xxxxxx, xx xxxxxxx xxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxxxxx xxxxx xxxxx xxxxxxxx xx xxxxxxx xxxx; v takom xxxxxxx xxxxxxx oznámte xxxxx Xxxxx xxxx.

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

Xxxxxx dátum xxxxxxxxx xxxxxxxxx xxxx x ak xx xxxx x xxxxx xxx xxôxxxxxxx xxxxxxxxx xx xxxxôx, uveďte xxxx x xxx (xxxxxxxxx z xxxxxxxxx xxxxxx - dátum xxx xxxxxxxxxx).

XX. Xxxxxxx xxxxx činný v xxxxxxxx konaní (xxxxxxxxx xxxxx, štátne xxxxxxxxxxxxxx, xxx), xxxxx xxxxxxxxx xxxxx xxxxxxx x xxxxxxxx čine. Uveďte xx xxxxxxx značku, xxx xxxxxx prebieha xxxxxxxxxxxx.

Xx xxxx k xxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxx xxxxxxx x xxxxxxxx xxxxxx, xxxxx xxxx xxxxxxxxx o xxx, x xxxx xxxxxx xx xxx xxxxxxxx (xxxx. xxxxxxxxx x odložení trestného xxxxxxxx, xxxx xxxxxxxx, xxxxxxxx - i xxxxxxxxxxxxx), xxxxxxxx ho x xxxxxxxx.

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

Podľa ustanovenia §8 zákona x. 209/1997 (Xx)., xxxxxxxx xxxxx sa xôxx xxxxxx alebo sa xxxxxxxx x xxxxxxxxxxxxx xx to, či xxxx xxxxxxx xxxxxx xxxxxxx xxxxxxxxxxx na xxxxxxxxxx nároku xx xxxxxxx škody xx xxxxxxxľx alebo inej xxxxx, ktorá xxxxxxxxx xx škodu. Xxxxx xxx xxxxxxxxxxx, xx xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

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

XXXX. Xxxxxx, xx ste xxxxxxx xxxxxx, ktorá xxľxx xxxxxxxxx xxxxxxx x §2 odst. 2 zákona x. 209/1997 Xx., xxxxxxxx xxľxx xxôx spľňa xxxxx podmienky, xx xx Xxx xxxxx xxxxxxxxxxx xxxxx.

1. Boli xxx xxxxxxx, xxxxxxxx xxxxx dieťaťom osoby, xxxxx zomrela x xôxxxxxx trestného činu?

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

3. Poskytovala Xxx xxxx trestného činu xxxxxx, xx xxxx x xxxx povinná?

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

Podľa xxxxxxxxxxx §2 odst. 2 zákona č. 209/1997 Xx. xx xx xxxx xxxxxxxx xxxxx pozostalá po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xx je xxxxxxx, xxxxxxxx alebo xxxxxxxx xxxxxxxxx x xxxxxxx x čase xxxx xxxxx x xxx xxxx v xxxxxxxxxx xxxxx xxxxx, xxxxxx nebohý poskytoval xxxxx bol povinný xxxxxxxxxx xxxxxx.

______________________________________________________________________________________________

Xxxx XX. xx XXX. Vyplňte, xx xx xxxxxxxľ xxxx xxxxxx xxxxxxxxx xxxx a bola xx xxôxxxxxx ujma xx zdraví.

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

X. Xxxxxxx xxxxx xxxxxxxx ohodnotenia xx xxxxxx xxxx:

X xxxxxxxx xx xxxx xxxxxxxx xxxxxx ohodnotenie xx xxxxxx xxxľx xxxxxxxx č. 440/2001 Zb., ktoré xxxxxxxľ xxxxx xx xxxxxx, xxxxx xx xxxxxxxxx. Xxxxx lekársky xxxxxxx bude xxxxxxxxx xxxxxx hodnotenie xxxxxxxxx xxxxxxx a xxxxxx xxxxxxxxxx xxxxxxxx spoločenského xxxxxxxxxx. Pripomíname, xx xxx xxxxx xxxxxx č. 209/1997 Zb. xx relevantné xxx xxxxxx xxxxxxxxxxx xxxxxxxxx bolesti. Xxxľx xxxxxxxxxxx §6 odst. 2 xxxxxx x. 209/1997 Zb. xxxxxxx xxxxxxxxx' peňažnú pomoc, xx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx xxxxxxxxxx xxxxxxxx 100 xxxxx.

XX. Xxxxxx, xx žiadate x xxxxxxxxxxx peňažnej xxxxxx xx xxxxx xxxxxxxxx čiastky 25&xxxx;000.- Xx alebo či xxxxxxxx xxxxx xxxxxx xxxxxxx x xxxxxxxx xx xxxxxxxx.

Xxxľx ustanovenia §7 xxxx. 1 xxxx. x) zákona x. 209/1997 Xx. xx žiadosť obete xxxxx xxxxxxxxx xxxxxxx xxxxx vo xxxxx xxxxxxxxx xxxx 25&xxxx;000.- Xx, xxxxx xx xxxxx zodpovedajúcej xxxxxxxxxxx xxxxxxxx xx xxxxxxxx x xxxxxx zárobku. Xx xx xxxxxxxxxx xxxxxx x xxxxxxx xxxxx xx xxxxx xxxxxxxxx xxxxxxx, xxxxxxxx xx vyplňovať xxxx XXX. - XIV. xxxxx dotazníka.

XII. Xxxxxxx xxxxxxx s xxxxxxxx xxxxxx:

Xxx x xxxxxxx xx lieky, xxxxxxxxxxxx xxxôxxx, xxxxxxx na xxxxxxxxxxxxx, pribranie xxxxxx xxxxx xx xxxxx x xxxxxxxxxx či xxxxxxxxxx, xxxxxxx náklady xx dopravu, x xxx. pod xxxxxxxxxx, xx xxxxx xxxxxxx xxxxxxxxx pojsťovňa. Xx xxxxxxx náklady xx xxxxx xxxxxxx, inak xx xx xxxxxxxxxxxx xxxxxxxxxxxxxx nebude mócť xxxx xxxxxľ.

XXXX. Xxxxxxx xxxxxxxxx xxxxxx xxxxxxxľx xxxx x xx xxxxxx xxxx xx xxxxxx spôsobenej xxxxxxxx xxxxx.

X žiadosti xxxxxxxx xxxxxxx, xxxxx xxxxxxxxxx xxxxxxx skutočnosti.

V prípade, xx xxxxxxxľ xx x xxxxxxxxxxxxxx pomere, 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 xxxxxxxx xxxx xxxxxxxxx opis xxxxxxxxxx xxxxxxxx priznania. Xx žiadateľ poberá xxxxxxxx xôxxxxxx, xxxxxxxx, xxxxx xôxx xxxxxxx xxxxxxxx sociálnu situáciu, xxxx xxxxxxxxxx x xxxxx xxxxxxxxxx dôchodku. X prípade, xx x xxxxxxxx závažného xôxxxx nemožno xxxxxxx xxxxxxxxx xxxxxx xxxxxxxľx, x xxxxxxx xxxxxxx xx možné nahradiť xxxxxxxxxx o xxxx xxxxxxx xxxxxxxxxx.

XXX. Xxxxxx xxxxx nemocenských xxxxx (xxxxxxxxxxx dôchodku) a xxxx, xxxxxx xxx xxxxxxxľ xxxxxx, či xxxxxxx xx xxxxxx xxxx na xxxxxx, xxôxxxxxxx xxxxxxxx xxxxx.

X xxxxxxxx xxxxxxxx potvrdenie xxxxxxxxxxxxľx alebo poisťovne x xxxxx xxxxxxxxxxxx xxxxx. X xxxxxxx, xx v dôsledku xxxxx xx xxxxxx xxôxxxxxxx xxxxxxxx činom Xxx priznali xxxxxxxxx xôxxxxxx, xxxxxx a xxxxxxx xxxx výšku.

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

Xxxxxx xxxxxxxxxx, xx xxxxx xx xxxxxxx xxxxx xx xxxxxxx xxxxx xx odškodnenie xxxx xxôxxxxxxx xxxxxxxx xxxxx som neuplatnil(a) x xxxxxxx xxxx xxxxx ako v Xxxxxx (Slovenskej) xxxxxxxxx.

Xxxxxx xx vedomie, že xx podľa xxx. §12 xxxxxx x. 209/1997 Xx., x xxxxxxxxxx peňažnej xxxxxx xxxxxxx trestnej xxxxxxxx x x zmene x x xxxxxxxx xxxxxxxxxx xxxxxxx, x xxxxx neskorších predpisov, xxxxxx xxxxxxxxx do xxxxxxx rokov xxx xxx, keď xx xxxxxxxx pomoc, xxxxxxx xx účet Ministerstva xxxxxxxxxxxxxx čiastky, ktoré xxx dostal(a) xxx xxxxxxx škody, x xx xx xx xxxxx poskytnutej xxxxxx. Xxxxxxx x xxx xxxxxx xx xxxxxxx, xx po uplynutí xxxxxxxxxx päťročnej doby xôxxx požiadať Xxxxxxxxxxxx xxxxxxxxxxxxxx, xxx xx x xxxx xxxxx xxxxxx práva xx xxxxxxxx xxxxxxxxxxx xxxxxx, xx xxxx xxxxxxxx xxxxxxxx xxxx taký xxxxxx xxôxxxxxxxx, celková xxxxx xxxxx, xxxxx xx spôsobili x xxxxx xxxxxxx, ktorú xxx dostal(a).

Beriem xxxx xx vedomie, xx xxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxx xxxxxxxxx údaja xx xxxx xxxxxxxxx xx účelom xxxxxxxx xxxxxxxxxxxx xxxxxx, xx xôxxx dopustiť priestupku xxxľx §21 odst. 1 xxxx. x) xxxxxx č. 200/1990 Xx., o xxxxxxxxxxxx, x znení xxxxxxxxxx xxxxxxxxx.

------------------------------------------

xxxxxx xxxxxxxľx alebo xxxxxxxx

- Xxxxxxxxxxxx xxxxxxxxxxxxxx Xxxxx republiky xx xxxxxxx žiadosti x xxxxxxxxxxx xxxxxxxx pomoci xxxľx zákona č. 209/1997 Zb. xxxxxxx xxx xxxxxx x xxxxx poradové xxxxx. Xxxxx xxxx xxxxxxxxxx xx xxxxxxx xx na xxxx xxxxxxxx xxxxxx xxxľx xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xx xxxxx mesiacov xx xxxxxx xxxxxxxx x xxxxxxxxxx xxxxxxxxxx xxxxxxxx xxx xxxxx xxxxxxxx xxxxx xxxxxxxľxxx xxxxxx dôvody, xxxxx xxxxx xxxxxxx poskynúť.

- X zmysle zákona č. 209/1997 Zb. xxxx žiadateľ xxxxxxxxxx xx obeť xxx x xxxxxxx, xx xx x xôxxxxxx xxxxxxxxx činu xxxx xxôxxxxxx poškodenie xxxxxxx. Nevyhnutnou, xxx xxxx postačujúcou podmienkou xx priznanie xxxxxxxx xxxxxx xxxxx obeti xx xxxxx xxxxxxxx xxxxxxxxxxx xxxxxxx (nie xxxx xxxxxxxx spoločenského xxxxxxxxxx) dosahujúceho xxxxx 100 xxxxx. Za xxxx sa xxxxxxxx xx xxxxx xxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xx xxxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx zomretého x zároveň v xxxx xxxx smrti x xxx xxxx x xxxxxxxxxx, xxxxx xxxxx, ktorej xxxxxxx xxxxxxxxxx alebo bol xxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx č. 209/1997 Zb. x xxxxxxxxxx xxxxxxxxx xxxxxx xxxxxxx trestnej xxxxxxxx xxxxxxxxx xxxxxxxxxxx (prepadnú) xxxx 1 xxxx xxx xxx, keď xx obeť dozvedela x škode xxôxxxxxxx xxxxxxxx xxxxx. Xx xxxxx xxxx už xxx xx xxx xxxxxxxxx trestného xxxx, xxxx xxxxxxxx xxxxxxx, xxxx sa xx xxxxx. Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx xxxxxxxx žiadostiam x xxxxxxxxxxx peňažnej xxxxxx, xxxxx xx xxxxxxxx xx xxxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx xx xx xxxxxxx xxxxx, xxxxxx v xôxxxxxx trestného xxxx xxxxxxx xxxxx xx xxxxxx, poskytne x xxxxxxxxx xxxx 25&xxxx;000.- Xx xxxxx xx xxxxx, ktorá xxxxxxxxxxx xxxxxxxxxx xxxxxx na xxxxxxx, preukázané xxxxxxx xxxxxxx x xxxxxxxx, xxxxxxx x xxxxx xxxxxxxx čiastok, xxxxx xxxx z xxxxxx xxxxxxx xxxxx xx xxxxxxx; xxxxx xx xxxxxx súčte xxxxxx xxxxxxxxxx xxxx 150&xxxx;000.- Xx. Xx obeť - po xxx, xxx xxx poskytli xxxxx - xxxxxxxx, xx jej xxxxxxxxx xxxxx xx vyššia xxx xx, ktorá xxxx xxxxxxxxx xx xxxxxxxxxxx xxxxxx, xx xxx žiadosť v xxxxxx stanovenej xxxxx xxxxxxx jej možno xxxxxxxxx pomoc xxäx, x xx až xx xxxxxxxxxx xxxxx 150&xxxx;000.- Xx; xxxxxx xx xxxxxxxxxx xx xxxxxxx, ktoré xx xxxx vyplatené.

- Fyzickej xxxxx, xxxxx je xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx (xx xxxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx s xxx xxxx v domácnosti, xxxxx xxx xxxxxxx xxxxxxxxxx, xx xxx xxxxxxx xxxxxxxxxx xxxxxx), xx xxxxxxxx xxxxxxx xxxxx v paušálnej xxxx 150 000.- Kč; xxxxx vo xxxxxx xxxxx nesmie presiahnuť xxxx 450&xxxx;000.- Xx, x xx xx xxxxx xxxxx xxxx xxx xxx osoby, xxxxxxxxxxx xxxxxxx xx xxx xxxxxx xxxxx xxxxxxxxx xxxxx.

- Zákon č. 209/1997 Zb. nenahradzuje xxxxxxxx xxxxxxxxxxx zodpovednosti xxxxxxxxxxľx xxxxxxxxxx vozidiel, xx xxxxx xxxxäxxxx povinné xxxxxxx xxxxxxxxx zodpovednosti. Xxxxx je xxxxxxxx x xxxxxxxxxxxxxx dopravných xxxôx žiadať subjekt, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, x xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxx x celkom xxxxxxxxxxx xxxxxxxxx s xxxxxxxxxxxxx xx xxxxxxxxx xxxxxxxxx xxxxxxxxx xx xxxxx xxxxxx xxxxxxxxxxxx xxxxxxxxxxxxxx x xxxxxxxxxxx peňažnej xxxxxx.

- Xxxxxxxxxxx, že xx xxxxxxxxxx xxxxxxxx xxxxxx xxxxxxxx doklady x xxxxxxxxxx, xx xxxxx odkazujeme xxx xxxxxxxxxxxx xxxxxxxxx. Ak xxx žiadateľ xxxxxxx, xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx xxxxxxx xxxxxxx. Xx xxxxxx xxxxxxxxxx x xxxxxxx xxx xxxxxxxxx xxxxxx, xxxx xxxxxxxxxx xôxx xxx dôvodom xxxxxxxxxxxxx xxxxxxxx pomoci xxxľx xxxxxx č. 209/1997 Zb. Xx však xxxxxxxxxx xxxxxxx xxxxx novú xxxxxxx.

- Upozorňujeme, xx xx xxxx žiadateľovi xxxxxxxxxx peňažná pomoc, xxxxxxxľ xx xx xxxxxxx xxxxx xxx xxx xxxxxxxxxxx xxxxxx xxxxxxx na xxxx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxx, xxxxx xxxxxx xxx xxxxxxx xxxxx (xx xxxxxxxľx, xxxxxxxxx x xxx.) xx xx xxxxx xxxxxxxxxxx xxxxxx. Xxxx povinnosť xxxx, xx mu škodu xxxxxxxxxx. Xx xxxxxxx xxxxxxxx xxxxx sa xxxxxxxxxxxx xxxxxxxxxxxxxx môže x mene xxxxx xx xxxxxxxx stanovenej xäxxxxxxx xxxx vzdať xxxxx na xxxxxxxx xxxxxxxxxxx peňažnej pomoci. Xx xxxxxx xxxxxx xxôxxxxxxx xxxxxxxx xxxxxxxx xxxxx, xxxxxxx výška xxxxx, xxxxx jej xxôxxxxxx, x xxxxx xxxxxxx, xxxxx obeť xxxxxxx.