Plné znění - 241/2006 Sb.

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

Xxxx Xxx/Xxxxx,

Xx apologise xxx xxxxxxxxx xxx with xxxxxxxx xxxxxxxxx in xxxx xxxxxxx xxxxxxxxx. Xxxxxxx, xxxxxxx xx xxxx xxxxxxxxxxxxx xx xxxxxxxx xxx xxx xxxxx xxxxxxxxxx of xxxx xxxxxxxxxxx xxx xxx provision xx xxxxxxxxx xxxxxxx pursuant xx Act xx. 209/1997. Thank you xxx your xxxxxxxxxxx; xx xx highly xxxxxxxxxxx.

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X. Please xxxxxxx xxxx xx xxx xxxxxxxx xxxx xx xxx applicant - x.x. xxx victim xx the xxxxxxxx xxx xxx xxx xxxxxxxx bodily xxxx, xx the xxxxxxxx xx x xxxxxx xxx has xxxx xx xxxxxxxxxxx of xxx xxxxxxxx xxx:

1. Xxxxxxx:

2. Xxxxx name:

3. Xxxx of xxxxx:

4. Xxxxxxxxx xxxxxxx:

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

6. Phone Number:

7. X-xxxx xxxxxxx:

8. Xxxxxxxxxxx:

XX. Xx the applicant xx represented xx xxxxxxx xxxxxx ("xxxxxxxxxxxxxx") xx xxx xxxxx xx statutory xxxxxxxxxxxxxx (xxx instance, a xxxxx child xxxxxxxxxxx xx xxx/xxx xxxxxx) xx xx xxx xxxxx xx x xxxxx xx xxxxxxxx, xxxxxx xxxx xx xxx data xx xxxx xxxxxxxxxxxxxx:

1. Surname:

2. Xxxxx xxxx:

3. Permanent xx xxxxxxxxxx xxxxxxx:

Xx xxx xxxxxxxxxxxxxx xx xxxxxx xxx xxxxxxxxxxx xx behalf of xxx xxxxxxxxx, xxxxxx xxxx submit x xxxxxxxx authorizing xxx/xxx xx xxxxxxxxx xxx xxxxxxxxx - a xxxx xx x xxxxx xx xxxxxxxx (xxx contractual xxxxxxxxxxxxxx) xx a xxxx xx xxx xxxxx xxxxxxxxxxx (xxx statutory xxxxxxxxxxxxxx) or xxx xxxxx xxxxxxxxxx xxxxxxxx.

XXX. Xx xxx xxxxxxxxx xx x xxxxxxxx xx x xxxxxx xxx xxx xxxx xx xxxxxxxxxxx xx xxx respective xxxxxxxx xxx, xxxxxx fill xx the xxxxxxxx xxxx xx the xxxxxxxx:

1. Surname:

2. Xxxxx xxxx:

3. Xxxx of xxxxx:

4. Date xx xxxxx:

5. Xxxx permanent xxxxxxx:

6. Xxxxxxxxxxx:

7. Xxxxxxxxxxxx xx xxx deceased xx xxx applicant (x.x. xxxxxx, xxxxxxxx, xx individual xxxxxx xx xxxxxx xxxxxxxxx)

Xx xxx xxxxxxxxx xx x xxxxxxxx xx x xxxxxx xxx xxxx in xxxxxxxxxxx xx xxx xxxxxxxx xxx, please xxxxxx x copy xx xxx xxxxx xxxxxxxxxxx xxx xxx xxxxxxxxx xxxxxxx xxxx xxx xxxxxxxx xxxxxxxxx xx xxx xx xxxxxxxxxx xx support xxx xxxxxxxx (in xxx xxxx of x xxxxxx-xxxxx xxxxxxxxxxxx, xxxx xxxxxxxxx xxxxxxx birth xxxxxxxxxxxx xx x xxxxx xxxxxxxx xx xxx xxxxxxxxxx xx xxxxxxx the dependent; xx the xxxx xx xxxxxxx xxxxxxx, xxxxxx attach x xxxxxxxx certificate).

Xxxxxx specify the xxxx xx xxxxx xxx crime was xxxxxxxxx xxx, if xxx victim xxxxxxx xxxxx xxx xxxxxxxxxxxx xx the xxxxx xx x later xxxx, xxxxxx xxxx xxxxxxx the date xxx xxx manner xx xxxxx xxx xxxxxx xxxxxxx of xxxx xxxxxxxxxxxx (x.x., xxx xxxx of xxx xxxxxxx xxxxxx).

XX. Xxxxxx specify xxx xxxxxxxx justice xxxxxxxxx (x.x. xxxxxx, public xxxxxxxxxx'x xxxxxx, court) xxxxx xxxx xxxxxxxx xxxxxxxxx xxxxxxxx xxxxxxxxxxx. Xxxxx xxx xxxxxxxxx xxxxxx xx the xxxx related xx xxx respective xxxxxxxxxxx.

Xx xxxxxxxxx, xxxxxx xxxxxx xxx xxxxxx xxxxxxxx xx the xxxxxxxxxxxxxx xxxxxxxx xxxxxxx xxxxxxxxx xxxxx could indicate xxx xxxxx xx xxx respective proceedings (x.x. xxxxxxxxxx xx xxx xxxxxxxxxxxxxxx of xxxxxxxx prosecution, copy xx xxx indictment, xxxxxxxxx - xxxxx xx xxxxxxxxx).

According xx xxx xxxxxxxxxx xx §8 xx Xxx xx. 209/1997, xxx xxxxxx xx xxxxxxxxx xxxxxxx may xx xxxxxxx xx xxxxxxxx depending xx xxxxxxx xxx victim xxx made use xx xxx xxxxx xxxxxxxx xx xxxxxxx x claim xxx xxxxxxxxxxxx xxxxxxx xxx xxxxxxxx xx any xxxxx person xxxxxxxxxxx xxx xxx xxxx xxxxxxxx. Do xxx xxxx in this xxxx if xxx xxxxxxxx xxx xxx xxxx xxxxxxxxxx.

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Xxxx in xxxx XxXx xx xxx applicant is x xxxxxxxx of xx individual who xxx xxxx in xxxxxxxxxxx xx the xxxxxxxxx crime.

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

2. Xxx you xxxx xx x common xxxxxxxxx with xxx xxxxxxxx xxxxxx prior xx xxx xxxxxxxxxx xx xxx crime?

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

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

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According xx xxx xxxxxxxxxx xx §2, xxxxxxx 2 xx Xxx xx. 209/1997, a xxxxxx xxx xx x xxxxxxxx xx x xxxxxx xxx xxxx xx xxxxxxxxxxx xx x xxxxxxxx xxx xx considered xx xx a xxxxxx xx he xx she xx x parent, spouse xx xxxxx xx xxx xxxxxxxx xxx xxxxx xxxx him xx xxx in xxx same xxxxxxxxx xx if the xxxxxx xxx x xxxxxxxxx xx xxx xxxxxxxx xx xxx xxxxxxxx xxx required xx xxxxxxx xxx xxxxxx.

Xx xxx applicant xx xxx xxxxxx xx a crime xxx xxx xxxxxxxx xxxxxx xxxx, xxxxxx xxxx xx xxxxx XX - XIV.

Xxxxxx xxxxxx x xxxxx-xxxxx xxxxxxxxxx xx xxxx and xxxxxxxxx xxxxxxxx xx Xxxxxx Xx. 440/2001 Xxxx. The xxxxxxxxxx xxxxxxxx should xx xxxxxxxx xxxx xxx xxxxxxxxx xxxxxxxxxxx xxx xxx xxxxxx'x xxxxxxxxx. Xxxx medical xxxxxx xxxx xxxxxxx a xxxxx-xxxxx xxxxxxxxxx xx xxx xxx xxxxxxxx xxx a point-based xxxxxxxxxx xx xxx xxxxxxxx xx xxx xxxxxx'x xxxxxx xxxxxxxx. Xxxxxx bear in xxxx xxxx xxxx xxx xxxxx-xxxxx xxxxxxxxxx xx xxx pam xxxxxxxx xx xxxxxxxx xxx xxx xxxxxxxx xx Xxx xx. 209/1997. Xxxxxxxxx xx xxx xxxxxxxxxx xx §6, xxxxxxx 2 xx Xxx xx. 209/1997, no xxxxxxxxx xxxxxxx will be xxxxxxxx unless xxx xxxxx assessment xx xxx xxxx suffered xx xx xxxxx 100 xxxxxx.

Xxx xxxxxx xxx xxxxxx xxxx xxx xxxxxxxxx xxxxxxx xx xxx xxxxxx of XXX 25,000 xx xx xxxxxx equal to xxx proved xxxxx xx xxxxxxx xxxxxxxxx xxx xxxx xxxxxx (§7, xxxxxxx 1, xxxxxx x xx Xxx No. 209/1997 Xxxx.). xx xxx xxxxxx xx xxxxx xxx a xxxx xxx payment, xxxxx xx no xxxx xx xxxx xx xxxxx XXX - XxX.

Xxxx xxxxxxxx xxx xxxxxxxx xxx xxxxxxxxxx, xxxxxxxx xxxxxxxxx, xxxxxxxxxxxxxx xxxxx, xxxxxx xx xxxxxxxxx to xxxx out xx xxx xxxx xx xxxx xxxxxxx treatment, xxxxxxxxx xxxxxxxxxxxxxx xxxxx xxx., xxxxxxxx xxxx xxxxx xxxx xxx xxxx xxxx xx xx insurance xxxxxxx. xx xxxx xxxxxxxx xxx xxx proved xx xxxxxxxxxxx xxxxxxxx, xxx Ministry xx Xxxxxxx xxx not xxxx xxxx xxxx xxxxxxxxxxxxx.

Xxxxxx xxxxxx xxx xxxxxxxxx xxxxxxxxxx xxxx xxxxx xx xxx xxxxxxxxxxx.

Xx the xxxxxxxxx xx xx xxxxxxxx, xxxxx documents xxxxx xxxxxxx x xxxxxxxxx xxxx his/her xxxxxxxx xxxxxxxxxx xxx xxxxxxx xxxxxx xxxxxxxxx xx §351 xx. xxx. xx Xxx xx. 262/2006, xxx Xxxxx Xxxxxx Code, xx xxxxxxx. xx xxx xxxxxxxxx xx xxxx-xxxxxxxx, xxxx xxxxxxxx xxxxx be a xxxx xx xxx/xxx xxxx xxxxxx tax xxxxxx. xx xxx xxxxxxxxx xx a xxxxxxx person xxx xx able xx xxxxx xxx/xxx impaired xxxxxx standing, please xxxxxx a document xxxxxxxxxx the amount xx xxx retirement xxxxxxx. lf for xxx xxxxxx the xxxxxxxxx'x xxxxxx xxxxxxxxx xxxxxx be xxxxxx, xx xxxxxxxxxxx xxxxx xx xxxxxxxxx may xx attached.

Xx xxxxxx xxxxxxxx xxx xxxx impaired as x xxxxxx of xxx criminal act xx xxxxx X xxx x xxxxxx. X have not xxx xxxx xxxxxxxxxxx xxx the xxxx 1 xxxx xxxxxxxx xx a xxxxxx xx the xxxxxxxx xxx.

X xxxxxx xxxxxx xxxx X xxxx xxx lodged xxx xxxxx xxx xxxxxxxxx xxxxxxx xx any xxxxxxx xxxxx for xxxxxxxxxxxx for the xxxx suffered xx x result xx xxx criminal xxx xx any xxxxxxx xxxxx xxxx xxx Xxxxx Xxxxxxxx.

X xxxxxxxxxxx xxxx xxxxxxxxx xx §12 of Act Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx support xxx xxx victims xx xxxxxxxx xxxx xxx xx xxxxxxxx xxxxxxx other xxxx, xx amended, X xx xxxxxxx xx xxxxxxxxx the Ministry xx Justice xxx xxxxxx xxxxxxxx as xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx, up xx xxx xxxxxx xx xxx xxxxxxxxx xxxxxxx, xxxxxx xxxx xxxxx xxxx the xxxx xx xxxxxxxxx xxx funding support. X xxxx acknowledge xxxx, xxxxx the xxxxx of xxx xxxx-xxxx period, I xxx xxxx an xxxxxxxxxxx xxxxxx the Xxxxxxxx xx Xxxxxxx xx waive the xxxxx'x claim for xxx xxxxxx of xxx xxxxxxxx support, xxxxxx xxxx a xxxxxx be well xxxxxxxx by xx xxxxxx xxxxxxxx, the xxxxx xxxxxx xx xxxx suffered xxx xxx amount xx xxxxxxxxxxxx xxxxxxxx.

X xxxx xxxxxxxxxxx xxxx xxxxxxxxxxx xxxxxx xxxxx xx xxxxxxxxxx information or xxxxxxxxxxx xxxxxxxxxxx for xxx xxxxxxxx xx xxxxxxxxxxxxx xxxxxxx benefits xxx xxxxxxxxx an xxxxxxx xxxxxxxx to §21, xxxxxxx 1, xxxxxx x) of Xxx xx. 200/1990 Xxxx., xx offences xx xxxxxxx.

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Xxxxxxxxx xx xxx xxxxxxxxx xx xxx/xxx representative

- Upon xxxxxxx xx xxx xxxxxxxxxxx for xxx xxxxxxxxx of xxxxxxxxx xxxxxxx pursuant to Xxx Xx. 209/1997, xxx Ministry xx Xxxxxxx xxxxx confirm xxxxxxx and assign xx x xxxxxx xxxxxx. Subsequently, xxx Xxxxxxxx xxxxx xxxxxxxx xx investigation xxxx xxx xxxxxx xx x similar xxxxxxxxx xx xxx xxx xxxxxxxx xxxxxxx xx xxx case. Xxxxxx xxxxx xxxxxx xxxx xxx xxxx of xxx xxxxxxx xx xxx application xxx xxxxxxxxxx xx xxx xxxxxxxxx documents, xxx Xxxxxxxx xxxxx xxxxxx xxxxxxx xxx xxxxxxx xx xxxxxx xxx xxxxxxxxx xx xxx xxxxxxx xxx such xxxxxxx has xxxx xxxxxxxx.

- Xxx xxxxxxxxx xxxxx xx considered x xxxxxx xx xxx Act Xx. 209/1997 Xxxx. xxxx xx xx/xxx xxx xxxxxxxx xxxxxx harm xx a xxxxxx xx the commitment xx x crime. X necessary xxx xxx the xxxx xxxxxxxxx xxx xxx xxxxxx'x xxxxxxx xx xxxxxxxx xxxxxxx xxxxx xx xxx amount xx the xxxxx-xxxxx xxxxxxxxxx xx xxx xxx suffercd (xxx xxx xxxxxxxxx xx xxxxxx position), xxxxx xxxx xx xx xxxxx 100 xxxxxx. Xxxxxxxxx xx x xxxxxx who xxx xxxx in consequence xx a crime xxxxx xx considered xx xx a xxxxxx xx xxx xxxxxxxx xx a xxxxxx, xxxxxx xx xxxxx xx xxx xxxxxxxx and xxx xxxxxxxx shared x xxxxxxxxx xxxx xxx xxxxxxxx xx xxx xxxx of xxx/xxx xxxxx or xx xxx deceased supported xx xxx xxxxxxxx xx xxxxxxx the xxxxxxxx.

- Act Xx. 209/1997 Coll. xx xxx xxxxxxxxx of xxxxxxxxx xxxxxxx to xxxxxxx of xxxxxxxx xxxx xxxxxxxxxx x xxxxxxxxxx xxxx of 1 xxxx from xxx date xx xxxxx xxx xxxxxx xxxxxxx of the xxxx caused xx xxx xxxxx. Xx xxxx xxxx xxxx xxx coincide xxxx xxx date xx xxx xxxxxxxxxx xx xxx crime, the xxxxxx xxxxx provide xxxxxxxx xx the xxxx on which xx/xxx learned of xxx consequences. Xxx Xxxxxxxx xx Xxxxxxx xxxxxx meet xx xxxxxxxxxxx xxx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx received anytime xxxxx the xxxxx xx xxx xxxxxxxxxxxxxx xxxxxx.

- Xxxxxxxxx xxxxxxx xx applied xxx xx x xxxxxx xxx has xxxxxxxx xxxxxx xxxx xx x result xx xxx xxxxxxxxxx xx x crime xxx xx xx the xxxx xx x xxxx xxx xxxxxxxxx xx XXX 25,000 xx xx xxxxxx xxxxx xx xxxx xxxxxx xx the xxxxx of xxxxxxx xxxxxxxxx xx xxxxxx xx xxx victim, xxxxxxx xx xxx xxxxxx previously xxxx xx the xxxxxx xx xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx. Xxx xxxxx xxxxxx xx xxxx xxxxxxx xxxx xxx xxxxxx XXX 150,000. Xx, xxxxx xxx xxxxxxxxx xx support, xxx xxxxxx xxxxxx xxxx xxx harm xxxxxxxx xxxxxxx the xxxxxx xxxxxxxx, the victim xxx xxxxxxx xxxxxxxxxx xxxxxxx up xx xxx amount of XXX 150,000 xx xx/xxx xxxxxxx xxx xx xxxxxx xxx xxxxxxxxxxxxxx xxxxxx xx xxxx (x.x., 1 xxxx xxxx the xxxx on xxxxx xxx xxxxxx xxxxxxx xx the xxxx xxxxxx by xxx xxxxx); in xxxx xxxx, xxx xxxxxxx xxxxxxx paid xxxx xx xxxxx xxxx xxxxxxx.

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

- Xxx Xx. 209/1997 Xxxx. xxxx xxx xxxxxxx xxx xxxxxxxxx of the xxxxxxxxx xxxxxxxxx xx xxxxxxxxx xx xxxxx xxxxxxxx xxxxxxx xx xxxxxxxxxx liability xxxxxxxxx. Xx xxxxxxx xxxxxxx xx xxxxxxx xxxxxxxxx, xxxxxxxxxxxx xxx insurance xxxxxxxx should xxxx xx xxxxxxxx xx xxx xxxxxxxx xxxxxxxxx xxxx xxxxxxxxx xxxxxxxxx. Xxxx xx isolated xxxxx, xx xxxx xx exceptional circumstances, xxx an xxxxxxxxxxx xxx xxx xxxxxxxxx xx financial xxxxxxx xx xxxxx with xxx Xxxxxxxx of Xxxxxxx.

- Xxxxxx xxxx xx xxxx xxxx xxx available documents xxx xxxxxxxxxxxxx required xxx xxx respective xxxxx must xx xxxxxxxx xx xxx xxxxxxxxxxx. Xx the xxxxxxxxx fails xx xx so, the Xxxxxxxx xx Xxxxxxx xxxxxx xxxxxxxx xxxxxxx xxx xxxxxxxxxxx. Should xxx applicant xxxx xx xxxxxxx xxx xxxx xxxxxxxxx xxx xxxxxxxxxxxxx even xxxxxx x supplementary xxxxxxxx, xxxx fact xxx xxxxxxx x xxxxxxxx xx xxxxxxxx xxx xxxxxxx xx per Xxx Xx. 209/1997 Xxxx. This xxxxx xxx, xxxxxxx, xxxxxxxxx xxx xxxxxx of xxxxxxx xxxxxxxxxxx.

- Please xxxx xx mind xxxx the applicant xxxxx be xxxxxxx xx xxxxxx xxx xxxxxxxxx xxxxxx received xx compensation xxx xxxx (from xxx xxxxxxxx, xxxxxxxx xxx.) xx xxx account xx xxx Xxxxxxxx xx Justice xx xx xxx amount xx xxx support xxxxxxxx. Xxxx xxxxxxxxxx xxxx xxx xxxxx xx xx/xxx xxx xxx xxxxxxxx xxx xxxxxxxxxxxx. If xx xxxxxxxxx xx xxx xxxxxx xx xx xxxxxxxxxxx, the Ministry xx Justice xxx xxxxx the state's xxxxx xx xxxxx xxx xxxxxx of xxx xxxxxxxxx xxxxxxx xxxxxxxx xxxxx xxx xxxxx of xxx xxxx-xxxx xxxx, provided xxxx x xxxxxx xx xxxxxxxxx by xxx xxxxxx'x social xxxxxxxx, xxx total xxxxxx xx the xxxx xxxxxxxx xxx xxx amount of xxxxxxxxxxxx xxxx xx xxx victim.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, xx x xxxxxxxx, x xxxxxx xx xxxxxxxxxx, sme xxxxxx Vás xxxxxxxxx xxxxxxxxxxxx xxxxxxxx. X xxxxxx xxxxxxxx posúdenia Xxxxx žiadosti x xxxxxxxxxxx xxxxxxxx xxxxxx xxxxxxx xxxxxxxx xxxxxxxx xxxľx xxxxxx č. 209/1997 Zb., xx xxxx xxxxxxxxx xxxxx xxxxxxxxx nevyhnutné. Xxxxxxxx Vám za xxxxxxxxxx, ktorú si xxxxx ceníme.

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I. Xxxxxx, xxxxxxx xxxxxxľxx xxxxxx xxxxx x xxxxxxxľxxx - obeti trestného xxxx, xxxxxx xxôxxxxxx xxxx xx xxxxxx, xxxxx xxxxx xxxxxxxxxx xx xxxxx, ktorá x dôsledku xxxxxxxxx xxxx xxxxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Xxxxxx trvalého xxxxxx:

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

6. Xxxxxxx:

7. X-Xxxx:

8. Xxxxxxxxxx:

XX. Xx xxxxxxxľx zastupuje xxx xxxxx (xxxxxxxx) na xxxxxxx xxxxxxxxx zastúpenia (xxxx. xxxxxxxx xxxxx xxxxxx rodičom) xxxxx xx základe xxxxxx x plnej xxxx, xxxxxxx údaje x xxxxxxxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxxxxxxxxxxx xxxxxx:

Xx xxxxxxx xx xxx xxxxx, xxxx xx xxxxxxx xxxxxxxxxx, xxxxx xxxxxxxxxx xxxxxxx. Xxxxx k xxxxxxxx priložte xxxxx xxxxx xxxx (xxx xxxxxxxx xxxxxxxxx) xxxxx xxxxx rodného listu (x xxxxxxx xxxxxxxxx xxxxxxxxxx) alebo inú xxxxxxx listinu.

III. Xx xxxxxxxľ xxxxx osoba xxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xxxxxxx, xxxxxx, xx xxxxx x xxxxxxx xxxxx:

1. Priezvisko:

2. Meno:

3. Xxxxx xxxxxxxxx:

4. Xxxxx xxxxxx:

5. Xxxxxxxx xxxxxxxx:

7. Xxxxxxxxxx:

8. V xxxx xxxxxx bola zomretá xxxxx x xôxxxxxx xxxxxxxxx xxxx x xxxxx xxxxxxxľx (xxxx, xxxxx, xxxxx žijúca x xxxxxxxxx xxxxxxxxxx):

Xx xx xxxxxxxľ osobou xxxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, x žiadosti xx xxxx priložiť xxxxx xxxxxxxx listu x xxxxxxx, xxxxx xxxxxxxxx xxxxxxxxxx, xx xxxxxx xxxxx vyživovala pozostalú xxxxx xxxxx xxxx xxxxxxxxx ju xxxxxxxxx (xx vzťahu xxxxx - xxxxx pôjde x xxxxx xxxx xxxxx rozhodnutie xxxx x xxxxxxxxxxx xxxxxxxxxx, xxx xxxxxxxx xxxxx xxxxxxxx bude sobášny xxxx x pod.)

IV. Xxxxxx, xx xxxxxxx xxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxxxxx pošty xxxxx xxxxxxxx xx xxxxxxx xxxx; x takom xxxxxxx láskavo oznámte xxxxx Vášho účtu.

V. Xxxxxx dátum, xxxx xx xxxx dozvedela x xxxxx xxôxxxxxxx xxxxxxxx xxxxx.

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

XX. Xxxxxxx xxxxx činný x xxxxxxxx xxxxxx (xxxxxxxxx xxxxx, štátne xxxxxxxxxxxxxx, xxx), xxxxx naposledy xxxxx xxxxxxx x xxxxxxxx čine. Xxxxxx xx xxxxxxx xxxxxx, xxx xxxxxx xxxxxxxx xxxxxxxxxxxx.

Xx máte x xxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxx xxxxxxx x xxxxxxxx xxxxxx, ktoré xxxx xxxxxxxxx x xxx, v xxxx xxxxxx sa vec xxxxxxxx (xxxx. xxxxxxxxx x xxxxxxxx trestného xxxxxxxx, opis xxxxxxxx, xxxxxxxx - i xxxxxxxxxxxxx), xxxxxxxx ho x žiadosti.

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

Xxxľx xxxxxxxxxxx §8 zákona x. 209/1997 (Zb)., xxxxxxxx xxxxx xx xôxx xxxxxx alebo xx xxxxxxxx x xxxxxxxxxxxxx xx xx, xx xxxx využila xxxxxx xxxxxxx xxxxxxxxxxx xx xxxxxxxxxx xxxxxx na xxxxxxx xxxxx xx xxxxxxxľx xxxxx inej xxxxx, ktorá zodpovedá xx xxxxx. Xxxxx xxx nevyplňujte, xx xxxxxxxľx xxxxxxxxx činu xxxxxxxxx.

Xxx VIII. Vyplňte, xx xxxxxxxľ je xxxxxxxxxx xx xxxxx, xxxxx x dôsledku xxxxxxxxx činu xxxxxxx.

XXXX. Xxxxxx, xx xxx xxxxxxx osobou, xxxxx xxľxx xxxxxxxxx uvedené x §2 xxxx. 2 xxxxxx x. 209/1997 Zb., prípadne xxľxx xxôx xxľxx xxxxx xxxxxxxxx, xx xx Vám xxxxx xxxxxxxxxxx xxxxx.

1. Boli xxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxx, xxxxx xxxxxxx v xôxxxxxx xxxxxxxxx činu?

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

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

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

Podľa xxxxxxxxxxx §2 odst. 2 zákona x. 209/1997 Xx. xx xx xxxx xxxxxxxx xxxxx xxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx činu xxxxxxx, ak xx xxxxxxx, xxxxxxxx alebo xxxxxxxx xxxxxxxxx x xxxxxxx v xxxx xxxx smrti x xxx žila x xxxxxxxxxx alebo xxxxx, xxxxxx xxxxxx xxxxxxxxxx xxxxx xxx xxxxxxx xxxxxxxxxx xxxxxx.

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Xxxx XX. xx XXX. Xxxxxxx, xx sa xxxxxxxľ xxxx xxxxxx trestného xxxx x bola xx xxôxxxxxx xxxx xx xxxxxx.

XX. Xxxxxx xxxxx, xxxx xx xxxxxxxx xxxxxxxx, respektíve xxxx xx xxxxxxxx xxxxxxxx xxxxxxxxxxx.

X. Xxxxxxx xxxxx bodového xxxxxxxxxxx xx xxxxxx činí:

K xxxxxxxx xx xxxx xxxxxxxx xxxxxx xxxxxxxxxxx xx xxxxxx podľa xxxxxxxx č. 440/2001 Zb., xxxxx xxxxxxxľ xxxxx od xxxxxx, xxxxx xx xxxxxxxxx. Tento xxxxxxxx xxxxxxx xxxx obsahovať xxxxxx hodnotenie vytrpenej xxxxxxx a bodové xxxxxxxxxx sťaženia spoločenského xxxxxxxxxx. Xxxxxxxxxxx, xx xxx xxxxx xxxxxx č. 209/1997 Zb. xx relevantné xxx xxxxxx xxxxxxxxxxx xxxxxxxxx bolesti. Xxxľx xxxxxxxxxxx §6 xxxx. 2 zákona č. 209/1997 Zb. xxxxxxx xxxxxxxxx' peňažnú xxxxx, xx bodové xxxxxxxxxxx xxxxxxxxx xxxxxxx xxxxxxxxxx xxxxxxxx 100 xxxxx.

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

Xxxľx xxxxxxxxxxx §7 odst. 1 xxxx. x) xxxxxx x. 209/1997 Zb. xx žiadosť obete xxxxx poskytnúť xxxxxxx xxxxx xx výške xxxxxxxxx sumy 25&xxxx;000.- Xx, xxxxx xx xxxxx xxxxxxxxxxxxxx xxxxxxxxxxx xxxxxxxx xx liečenie x ušlému zárobku. Xx xx rozhodnete xxxxxx x peňažnú xxxxx xx výške xxxxxxxxx xxxxxxx, nemusíte xx xxxxxxxxx xxxx XXX. - XXX. xxxxx dotazníka.

XII. Xxxxxxx xxxxxxx s liečením xxxxxx:

Xxx o náklady xx lieky, zdravotnícke xxxôxxx, xxxxxxx xx xxxxxxxxxxxxx, xxxxxxxxx xxxxxx xxxxx xx xxxxx x domácnosti xx xxxxxxxxxx, xxxxxxx xxxxxxx xx dopravu, x xxx. pod xxxxxxxxxx, xx tieto náklady xxxxxxxxx xxxxxxxxx. Tu xxxxxxx xxxxxxx sa xxxxx xxxxxxx, xxxx xx xx ministerstvo xxxxxxxxxxxxxx xxxxxx mócť xxxx zreteľ.

XIII. Popište xxxxxxxxx xxxxxx žiadateľa xxxx x po xxxxxx xxxx xx xxxxxx xxôxxxxxxx xxxxxxxx xxxxx.

X žiadosti xxxxxxxx xxxxxxx, xxxxx potvrdzujú xxxxxxx xxxxxxxxxxx.

X xxxxxxx, xx xxxxxxxľ xx x xxxxxxxxxxxxxx xxxxxx, xôxxx x xxxxxxxxxx xxxxxxxxxxxxľx o priemernom xxxxxxx podľa §351 x xxxx. zákona x. 262/2006 Xx., xxxxxxxx práce, x xxxxx xxxxxxxxxx xxxxxxxxx. Xx xx žiadateľ xxxxxx samostatne zárobkovo xxxxxx, takou listinou xxxx xxxxxxxxx xxxx xxxxxxxxxx xxxxxxxx xxxxxxxxx. Xx xxxxxxxľ xxxxxx xxxxxxxx xôxxxxxx, xxxxxxxx, xxxxx môže dokázať xxxxxxxx xxxxxxxx situáciu, xxxx potvrdenie o xxxxx starobného xôxxxxxx. X prípade, že x xxxxxxxx závažného xôxxxx xxxxxxx xxxxxxx xxxxxxxxx pomery xxxxxxxľx, x xxxxxxx xxxxxxx xx xxxxx nahradiť xxxxxxxxxx x nich xxxxxxx xxxxxxxxxx.

XXX. Xxxxxx xxxxx xxxxxxxxxxxx xxxxx (xxxxxxxxxxx xôxxxxxx) a xxxx, odkedy ich xxxxxxxľ xxxxxx, xx xxxxxxx xx vzniku xxxx xx zdraví, xxôxxxxxxx trestným činom.

K xxxxxxxx priložte xxxxxxxxxx xxxxxxxxxxxxľx xxxxx xxxxxxxxx x xxxxx nemocenských xxxxx. X prípade, xx v xôxxxxxx xxxxx xx xxxxxx xxôxxxxxxx trestným xxxxx Xxx xxxxxxxx xxxxxxxxx xôxxxxxx, uveďte x xxxxxxx xxxx xxxxx.

Xxxx xxxxxxxxx xxxxxx xx xxxx, xx xxxxxxxx činom, xxxxxxx xxx xxx(x) xxxxxx, xx xxxx sociálna xxxxxxxx xxxxxxxx. Xxxxx, xxxxx mi takto xxôxxxxx, xxxxxľ xxxxxx xxxxxxxx.

Xxxxxx xxxxxxxxxx, xx xxxxx xx xxxxxxx xxxxx či xxxxxxx xxxxx xx xxxxxxxxxxx xxxx spôsobenej xxxxxxxx xxxxx xxx xxxxxxxxxx(x) x xxxxxxx inom xxxxx xxx x Xxxxxx (Slovenskej) xxxxxxxxx.

Xxxxxx xx vedomie, že xx xxxľx ust. §12 xxxxxx č. 209/1997 Xx., o xxxxxxxxxx peňažnej pomoci xxxxxxx xxxxxxxx xxxxxxxx x x zmene x x doplnení xxxxxxxxxx xxxxxxx, x xxxxx xxxxxxxxxx xxxxxxxxx, xxxxxx xxxxxxxxx xx xxxxxxx xxxxx xxx xxx, keď xx xxxxxxxx xxxxx, xxxxxxx xx xxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx čiastky, xxxxx xxx xxxxxx(x) xxx xxxxxxx xxxxx, x xx xx do xxxxx xxxxxxxxxxx xxxxxx. Xxxxxxx x tým xxxxxx na xxxxxxx, xx xx uplynutí xxxxxxxxxx xäxxxxxxx xxxx xôxxx xxxxxxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx, xxx xx x xxxx xxxxx xxxxxx xxxxx na xxxxxxxx poskytnutej xxxxxx, xx xxxx sociálna xxxxxxxx bude xxxx xxxxxx odôvodňovať, celková xxxxx xxxxx, xxxxx xx spôsobili x xxxxx xxxxxxx, xxxxx xxx dostal(a).

Beriem xxxx xx vedomie, xx xxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxx xxxxxxxxx údaja xx jeho xxxxxxxxx xx účelom xxxxxxxx xxxxxxxxxxxx výhody, xx xôxxx dopustiť xxxxxxxxxx xxxľx §21 xxxx. 1 xxxx. c) xxxxxx č. 200/1990 Xx., x xxxxxxxxxxxx, x xxxxx neskorších xxxxxxxxx.

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xxxxxx žiadateľa alebo xxxxxxxx

- Xxxxxxxxxxxx xxxxxxxxxxxxxx Xxxxx xxxxxxxxx xx xxxxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx xxxľx xxxxxx č. 209/1997 Zb. xxxxxxx jej xxxxxx x udelí xxxxxxxx xxxxx. Xxxxx xxxx xxxxxxxxxx na polícii xx xx inom xxxxxxxx xxxxxx podľa xxxxxxxxxxx okolností xxxxxxx. Xx troch xxxxxxxx xx podaní xxxxxxxx x xxxxxxxxxx potrebných xxxxxxxx xxx pomoc xxxxxxxx xxxxx xxxxxxxľxxx xxxxxx xôxxxx, xxxxx xxxxx nemožno poskynúť.

- X xxxxxx xxxxxx č. 209/1997 Zb. bude xxxxxxxľ xxxxxxxxxx xx xxxx xxx v xxxxxxx, xx mu v xôxxxxxx trestného xxxx xxxx spôsobené poškodenie xxxxxxx. Xxxxxxxxxxx, xxx xxxx postačujúcou xxxxxxxxxx xx xxxxxxxxx xxxxxxxx xxxxxx takej xxxxx xx xxxxx xxxxxxxx xxxxxxxxxxx bolesti (nie xxxx xxxxxxxx spoločenského xxxxxxxxxx) xxxxxxxxxxxx aspoň 100 xxxxx. Xx xxxx sa xxxxxxxx xx xxxxx xxxxxxxxx xx obeti, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xx xxxx rodičom, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x zároveň x xxxx jeho xxxxx x xxx xxxx x xxxxxxxxxx, xxxxx xxxxx, ktorej zomretý xxxxxxxxxx xxxxx bol xxxxxxx poskytovať výživu.

- Xxxxx č. 209/1997 Zb. x xxxxxxxxxx xxxxxxxxx xxxxxx xxxxxxx xxxxxxxx činnosti xxxxxxxxx xxxxxxxxxxx (xxxxxxxx) xxxx 1 xxxx xxx xxx, xxx xx xxxx xxxxxxxxx x xxxxx spôsobenej xxxxxxxx xxxxx. Ak xxxxx xxxx už xxx xx xxx xxxxxxxxx trestného činu, xxxx dokazuje xxxxxxx, xxxx xx to xxxxx. Ministerstvo spravodlivosti xxxôxx vyhovieť xxxxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx, ktoré xx xxxxxxxx xx xxxxxxxx xxxxxxxxxx lehoty.

- Xxxxx xx xx žiadosť xxxxx, xxxxxx x xôxxxxxx trestného xxxx xxxxxxx xxxxx xx xxxxxx, xxxxxxxx x xxxxxxxxx xxxx 25 000.- Xx xxxxx vo xxxxx, xxxxx predstavuje xxxxxxxxxx xxxxxx xx xxxxxxx, xxxxxxxxxx xxxxxxx xxxxxxx x xxxxxxxx, xxxxxxx o xxxxx xxxxxxxx xxxxxxx, xxxxx xxxx x xxxxxx xxxxxxx xxxxx už xxxxxxx; pomoc xx xxxxxx xxxxx xxxxxx xxxxxxxxxx sumu 150 000.- Xx. Xx obeť - po xxx, xxx xxx xxxxxxxx xxxxx - xxxxxxxx, xx jej xxxxxxxxx xxxxx xx xxxxxx xxx xx, xxxxx xxxx xxxxxxxxx xx xxxxxxxxxxx pomoci, na xxx xxxxxxx x xxxxxx xxxxxxxxxx týmto xxxxxxx jej možno xxxxxxxxx xxxxx xxäx, x to xx xx xxxxxxxxxx xxxxx 150&xxxx;000.- Kč; xxxxxx xx xxxxxxxxxx xx xxxxxxx, xxxxx xx xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, xxxxx xx xxxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx (xx xxxx rodičom, xxxxxxxx xxxxx dieťaťom xxxxxxxxx x zároveň x čase jeho xxxxx x xxx xxxx x xxxxxxxxxx, xxxxx jej xxxxxxx xxxxxxxxxx, xx bol xxxxxxx xxxxxxxxxx xxxxxx), xx xxxxxxxx xxxxxxx xxxxx v xxxxxxxxx xxxx 150&xxxx;000.- Xx; xxxxx xx svojom xxxxx nesmie xxxxxxxxxx xxxx 450&xxxx;000.- Kč, x xx xx xxxxx obetí xxxx xxx tri xxxxx, xxxxxxxxxxx čiastka xx xxx xxxxxx obeti xxxxxxxxx xxxxx.

- Zákon č. 209/1997 Zb. xxxxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxxxxxxxxx vykonávateľa xxxxxxxxxx xxxxxxxx, xx xxxxx nadväzuje xxxxxxx xxxxxxx xxxxxxxxx xxxxxxxxxxxxx. Xxxxx xx xxxxxxxx x záležitostiach xxxxxxxxxx xxxôx xxxxxx xxxxxxx, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, x xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxx x xxxxxx xxxxxxxxxxx xxxxxxxxx x xxxxxxxxxxxxx xx xxxxxxxxx xxxxxxxxx xxxxxxxxx xx xxxxx xxxxxx xxxxxxxxxxxx xxxxxxxxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx.

- Xxxxxxxxxxx, xx xx xxxxxxxxxx xxxxxxxx xxxxxx dostupné doklady x potvrdenia, xx xxxxx xxxxxxxxxx xxx xxxxxxxxxxxx položkách. Ak xxx xxxxxxxľ xxxxxxx, xxxxxxxxxxxx spravodlivosti xxxôxx xxxxxxx xxxxxxx. Ak xxxxxx potvrdenia x xxxxxxx ani dodatočne xxxxxx, xxxx xxxxxxxxxx xôxx xxx dôvodom xxxxxxxxxxxxx xxxxxxxx pomoci xxxľx xxxxxx č. 209/1997 Zb. Xx xxxx nevylučuje xxxxxxx podať xxxx xxxxxxx.

- Xxxxxxxxxxxx, xx xx xxxx xxxxxxxľxxx xxxxxxxxxx xxxxxxx xxxxx, xxxxxxxľ je xx xxxxxxx xxxxx xxx xxx xxxxxxxxxxx pomoci xxxxxxx na xxxx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxx, xxxxx dostal xxx xxxxxxx xxxxx (od xxxxxxxľx, poisťovne a xxx.) xx do xxxxx xxxxxxxxxxx xxxxxx. Xxxx xxxxxxxxx nemá, xx mu škodu xxxxxxxxxx. Xx xxxxxxx xxxxxxxx xxxxx sa xxxxxxxxxxxx xxxxxxxxxxxxxx môže x xxxx štátu xx xxxxxxxx xxxxxxxxxx xäxxxxxxx xxxx xxxxx xxxxx na xxxxxxxx xxxxxxxxxxx peňažnej xxxxxx. Xx xxxxxx xxxxxx xxôxxxxxxx xxxxxxxx situácia xxxxx, xxxxxxx xxxxx xxxxx, xxxxx jej xxôxxxxxx, x xxxxx xxxxxxx, xxxxx obeť xxxxxxx.