Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Assessment xx Applications for xxx Xxxxxxxxx of Xxxxxxxxx Support to Xxxxxxx of Xxxxxxxx Xxxx pursuant xx Xxx Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx of xxxxxxxxx xxxxxxx to xxx xxxxxxx xx xxxxxxxx xxxx and on xxxxxxxx xxxxxxx other xxxx, as amended

Dear Xxx/Xxxxx,

Xx xxxxxxxxx xxx xxxxxxxxx xxx xxxx xxxxxxxx questions in xxxx current xxxxxxxxx. Xxxxxxx, xxxxxxx xx xxxx questionnaire xx xxxxxxxx for the xxxxx xxxxxxxxxx of xxxx application for xxx xxxxxxxxx of xxxxxxxxx xxxxxxx pursuant xx Act xx. 209/1997. Xxxxx xxx xxx xxxx cooperation; xx xx highly xxxxxxxxxxx.

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X. Xxxxxx legibly xxxx xx xxx xxxxxxxx xxxx xx xxx xxxxxxxxx - x.x. the xxxxxx xx xxx criminal xxx xxx xxx xxxxxxxx xxxxxx xxxx, xx xxx survivor xx x xxxxxx xxx xxx died xx consequence xx xxx xxxxxxxx xxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxx xx xxxxx:

4. Xxxxxxxxx xxxxxxx:

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

6. Xxxxx Xxxxxx:

7. X-xxxx address:

8. Xxxxxxxxxxx:

XX. Xx xxx xxxxxxxxx xx represented xx xxxxxxx xxxxxx ("xxxxxxxxxxxxxx") xx xxx xxxxx xx statutory representation (xxx xxxxxxxx, x xxxxx xxxxx xxxxxxxxxxx xx xxx/xxx xxxxxx) xx xx xxx xxxxx xx x xxxxx xx xxxxxxxx, xxxxxx fill xx xxx xxxx xx xxxx xxxxxxxxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxxxxxxx xx xxxxxxxxxx address:

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

III. Xx xxx applicant xx a xxxxxxxx xx x xxxxxx xxx xxx xxxx xx consequenee xx xxx xxxxxxxxxx criminal xxx, xxxxxx xxxx xx the xxxxxxxx xxxx xx the xxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxx xx xxxxx:

4. Date xx xxxxx:

5. Last xxxxxxxxx xxxxxxx:

6. Xxxxxxxxxxx:

7. Relationship xx xxx deceased xx xxx xxxxxxxxx (x.x. xxxxxx, xxxxxxxx, xx xxxxxxxxxx xxxxxx xx xxxxxx xxxxxxxxx)

Xx xxx applicant xx x xxxxxxxx of x xxxxxx who xxxx in xxxxxxxxxxx xx xxx criminal xxx, please attach x copy xx xxx death xxxxxxxxxxx xxx xxx documents xxxxxxx xxxx xxx xxxxxxxx xxxxxxxxx or xxx xx obligation xx xxxxxxx xxx xxxxxxxx (in the xxxx xx x xxxxxx-xxxxx xxxxxxxxxxxx, xxxx xxxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxx xx x xxxxx xxxxxxxx xx xxx xxxxxxxxxx to xxxxxxx xxx dependent; xx xxx case xx xxxxxxx xxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxxx).

Xxxxxx xxxxxxx xxx xxxx xx xxxxx xxx xxxxx xxx xxxxxxxxx and, xx xxx xxxxxx xxxxxxx xxxxx xxx xxxxxxxxxxxx xx xxx xxxxx xx x later xxxx, xxxxxx xxxx xxxxxxx xxx xxxx xxx xxx manner xx xxxxx xxx xxxxxx learned xx xxxx xxxxxxxxxxxx (x.x., xxx xxxx of xxx xxxxxxx xxxxxx).

XX. Xxxxxx xxxxxxx xxx xxxxxxxx justice xxxxxxxxx (x.x. xxxxxx, xxxxxx xxxxxxxxxx'x office, xxxxx) xxxxx xxxx recently xxxxxxxxx xxxxxxxx xxxxxxxxxxx. Xxxxx xxx xxxxxxxxx xxxxxx xx xxx xxxx xxxxxxx xx xxx respective xxxxxxxxxxx.

Xx xxxxxxxxx, xxxxxx attach xxx xxxxxx xxxxxxxx xx xxx abovementioned xxxxxxxx xxxxxxx xxxxxxxxx xxxxx xxxxx indicate xxx stage xx xxx respective proceedings (x.x. xxxxxxxxxx xx xxx discontinuation xx xxxxxxxx xxxxxxxxxxx, xxxx xx the xxxxxxxxxx, xxxxxxxxx - xxxxx xx xxxxxxxxx).

According xx xxx provisions xx §8 xx Xxx no. 209/1997, xxx xxxxxx of xxxxxxxxx xxxxxxx xxx xx xxxxxxx xx xxxxxxxx xxxxxxxxx on xxxxxxx xxx xxxxxx xxx made use xx xxx xxxxx xxxxxxxx to enforce x claim xxx xxxxxxxxxxxx xxxxxxx xxx xxxxxxxx xx xxx xxxxx person responsible xxx the xxxx xxxxxxxx. Xx xxx xxxx in this xxxx xx xxx xxxxxxxx xxx xxx xxxx identified.

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Fill in xxxx XxXx xx xxx applicant is x xxxxxxxx xx xx individual who xxx died xx xxxxxxxxxxx xx xxx xxxxxxxxx xxxxx.

1. Xxx xxx x xxxxx, spouse xx xxxxx of xxx xxxxxx who xxxx xx xxxxxxxxxxx xx xxx xxxxxxxx xxxxxxx?

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

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

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

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Xxxxxxxxx xx xxx xxxxxxxxxx xx §2, section 2 xx Xxx xx. 209/1997, a xxxxxx xxx xx x xxxxxxxx xx x xxxxxx who xxxx in consequence xx x xxxxxxxx xxx xx xxxxxxxxxx xx be a xxxxxx if xx xx xxx is x xxxxxx, xxxxxx xx child of xxx deceased xxx xxxxx with him xx xxx xx xxx same xxxxxxxxx xx xx xxx xxxxxx xxx x xxxxxxxxx xx xxx xxxxxxxx or xxx xxxxxxxx xxx required xx xxxxxxx the xxxxxx.

Xx xxx xxxxxxxxx xx the xxxxxx xx x crime xxx xxx xxxxxxxx xxxxxx xxxx, please xxxx in xxxxx XX - XIV.

Xxxxxx xxxxxx x point-based xxxxxxxxxx xx xxxx xxx xxxxxxxxx pursuant xx Xxxxxx Xx. 440/2001 Xxxx. Xxx xxxxxxxxxx xxxxxxxx xxxxxx xx xxxxxxxx xxxx the xxxxxxxxx xxxxxxxxxxx for xxx xxxxxx'x xxxxxxxxx. Xxxx xxxxxxx xxxxxx xxxx xxxxxxx x xxxxx-xxxxx xxxxxxxxxx xx xxx xxx xxxxxxxx xxx x point-based xxxxxxxxxx xx the xxxxxxxx of xxx xxxxxx'x xxxxxx position. Xxxxxx xxxx xx xxxx xxxx xxxx xxx xxxxx-xxxxx assessment xx xxx xxx xxxxxxxx xx xxxxxxxx xxx xxx purposes xx Xxx xx. 209/1997. According to xxx xxxxxxxxxx of §6, xxxxxxx 2 xx Xxx xx. 209/1997, xx xxxxxxxxx xxxxxxx will xx xxxxxxxx unless xxx xxxxx xxxxxxxxxx xx xxx xxxx xxxxxxxx xx at xxxxx 100 points.

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

This includes xxx expenses xxx xxxxxxxxxx, sanitary equipment, xxxxxxxxxxxxxx xxxxx, xxxxxx xx assistant xx xxxx xxx xx xxx home xx xxxx xxxxxxx treatment, xxxxxxxxx xxxxxxxxxxxxxx costs xxx., xxxxxxxx xxxx xxxxx have xxx xxxx xxxx xx xx insurance xxxxxxx. xx xxxx xxxxxxxx xxx not xxxxxx xx xxxxxxxxxxx xxxxxxxx, xxx Xxxxxxxx of Xxxxxxx may not xxxx them into xxxxxxxxxxxxx.

Xxxxxx attach xxx documents confirming xxxx facts to xxx xxxxxxxxxxx.

Xx xxx xxxxxxxxx xx xx xxxxxxxx, these xxxxxxxxx xxxxx include x xxxxxxxxx xxxx xxx/xxx xxxxxxxx xxxxxxxxxx xxx xxxxxxx xxxxxx xxxxxxxxx xx §351 xx. xxx. xx Act xx. 262/2006, the Xxxxx Xxxxxx Code, xx xxxxxxx. lf xxx applicant xx xxxx-xxxxxxxx, xxxx xxxxxxxx xxxxx xx a xxxx xx xxx/xxx xxxx xxxxxx xxx xxxxxx. xx the xxxxxxxxx is x xxxxxxx xxxxxx who xx xxxx to xxxxx xxx/xxx xxxxxxxx xxxxxx xxxxxxxx, xxxxxx xxxxxx x document xxxxxxxxxx xxx xxxxxx xx xxx xxxxxxxxxx xxxxxxx. xx xxx xxx xxxxxx xxx xxxxxxxxx'x income situation xxxxxx xx xxxxxx, xx xxxxxxxxxxx xxxxx xx xxxxxxxxx xxx xx xxxxxxxx.

My xxxxxx xxxxxxxx has xxxx impaired xx x result of xxx xxxxxxxx act xx which I xxx x victim. X have xxx xxx been xxxxxxxxxxx xxx the harm 1 have suffered xx x result xx xxx xxxxxxxx xxx.

X xxxxxx xxxxxx xxxx X have xxx xxxxxx xxx xxxxx for xxxxxxxxx xxxxxxx xx xxx xxxxxxx xxxxx xxx xxxxxxxxxxxx xxx the xxxx xxxxxxxx as x result xx xxx criminal xxx xx xxx country xxxxx xxxx the Xxxxx Republic.

I xxxxxxxxxxx xxxx xxxxxxxxx to §12 xx Xxx Xx. 209/1997 Coll., xx xxx provision xx xxxxxxxxx xxxxxxx xxx xxx xxxxxxx xx xxxxxxxx xxxx xxx on xxxxxxxx xxxxxxx xxxxx xxxx, xx xxxxxxx, X xx xxxxxxx to xxxxxxxxx xxx Xxxxxxxx xx Xxxxxxx xxx xxxxxx received as xxxxxxxxxxxx for xxx xxxx xxxxxxxx, xx xx xxx amount xx xxx xxxxxxxxx xxxxxxx, within xxxx xxxxx xxxx xxx xxxx xx xxxxxxxxx xxx funding xxxxxxx. X xxxx xxxxxxxxxxx xxxx, after the xxxxx xx the xxxx-xxxx xxxxxx, X xxx xxxx xx xxxxxxxxxxx asking the Xxxxxxxx xx Xxxxxxx xx waive xxx xxxxx'x xxxxx xxx xxx xxxxxx xx xxx xxxxxxxx xxxxxxx, xxxxxx xxxx x xxxxxx xx well xxxxxxxx xx xx xxxxxx xxxxxxxx, the xxxxx xxxxxx xx xxxx suffered xxx xxx xxxxxx xx xxxxxxxxxxxx xxxxxxxx.

X also xxxxxxxxxxx xxxx xxxxxxxxxxx xxxxxx xxxxx or xxxxxxxxxx xxxxxxxxxxx or xxxxxxxxxxx information xxx xxx xxxxxxxx xx xxxxxxxxxxxxx gaining xxxxxxxx xxx represent an xxxxxxx pursuant xx §21, xxxxxxx 1, xxxxxx c) xx Xxx no. 200/1990 Xxxx., xx offences xx xxxxxxx.

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Xxxxxxxxx xx xxx xxxxxxxxx xx xxx/xxx xxxxxxxxxxxxxx

- Xxxx xxxxxxx xx xxx xxxxxxxxxxx xxx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xx Xxx Xx. 209/1997, xxx Xxxxxxxx of Xxxxxxx xxxxx xxxxxxx xxxxxxx xxx xxxxxx xx a serial xxxxxx. Subsequently, xxx Xxxxxxxx xxxxx xxxxxxxx xx xxxxxxxxxxxxx with xxx police xx x similar authority xx xxx xxx xxxxxxxx xxxxxxx xx xxx case. Within xxxxx xxxxxx xxxx xxx xxxx of xxx xxxxxxx of xxx application and xxxxxxxxxx xx the xxxxxxxxx xxxxxxxxx, xxx Xxxxxxxx shall xxxxxx xxxxxxx xxx xxxxxxx xx inform the xxxxxxxxx xx xxx xxxxxxx why xxxx xxxxxxx xxx been xxxxxxxx.

- Xxx applicant xxxxx be considered x victim as xxx Xxx Xx. 209/1997 Xxxx. xxxx xx xx/xxx xxx xxxxxxxx bodily xxxx xx a xxxxxx xx xxx xxxxxxxxxx xx x crime. X xxxxxxxxx but xxx xxx xxxx xxxxxxxxx xxx xxx xxxxxx'x xxxxxxx xx xxxxxxxx xxxxxxx shall xx xxx xxxxxx xx xxx xxxxx-xxxxx xxxxxxxxxx xx xxx xxx xxxxxxxx (xxx xxx weakening of xxxxxx position), which xxxx xx xx xxxxx 100 xxxxxx. Xxxxxxxxx xx a xxxxxx xxx xxx xxxx in consequence xx a crime xxxxx xx xxxxxxxxxx xx be a xxxxxx xx the xxxxxxxx is x xxxxxx, spouse or xxxxx xx the xxxxxxxx xxx xxx xxxxxxxx xxxxxx x xxxxxxxxx xxxx xxx xxxxxxxx xx xxx xxxx of xxx/xxx xxxxx xx xx xxx deceased xxxxxxxxx xx xxx xxxxxxxx xx xxxxxxx xxx xxxxxxxx.

- Act Xx. 209/1997 Coll. xx xxx provision xx xxxxxxxxx xxxxxxx xx xxxxxxx of xxxxxxxx xxxx xxxxxxxxxx x xxxxxxxxxx term xx 1 xxxx xxxx xxx xxxx xx xxxxx the victim xxxxxxx xx xxx xxxx xxxxxx xx xxx xxxxx. Xx xxxx xxxx xxxx xxx xxxxxxxx xxxx xxx xxxx of xxx xxxxxxxxxx of xxx xxxxx, xxx xxxxxx shall xxxxxxx xxxxxxxx of xxx xxxx on xxxxx xx/xxx xxxxxxx xx xxx xxxxxxxxxxxx. The Xxxxxxxx xx Xxxxxxx xxxxxx xxxx an xxxxxxxxxxx for xxx xxxxxxxxx of financial xxxxxxx xxxxxxxx anytime xxxxx xxx xxxxx xx the xxxxxxxxxxxxxx xxxxxx.

- Financial xxxxxxx xx applied for xx a xxxxxx xxx xxx suffered xxxxxx xxxx as x xxxxxx xx xxx xxxxxxxxxx xx x xxxxx may xx xx the xxxx xx x xxxx sum xxxxxxxxx xx CZK 25,000 xx xx xxxxxx xxxxx to lost xxxxxx xx xxx xxxxx xx medical xxxxxxxxx xx xxxxxx xx xxx xxxxxx, xxxxxxx xx xxx xxxxxx xxxxxxxxxx xxxx xx xxx victim xx compensation for xxx xxxx xxxxxxxx. Xxx xxxxx amount xx xxxx xxxxxxx xxxx xxx exceed XXX 150,000. If, xxxxx the xxxxxxxxx xx xxxxxxx, xxx xxxxxx xxxxxx xxxx xxx xxxx suffered xxxxxxx xxx amount xxxxxxxx, xxx victim xxx xxxxxxx xxxxxxxxxx xxxxxxx xx to xxx amount xx XXX 150,000 xx xx/xxx xxxxxxx xxx xx xxxxxx the xxxxxxxxxxxxxx xxxxxx xx xxxx (x.x., 1 xxxx xxxx xxx xxxx xx which xxx xxxxxx xxxxxxx xx the xxxx xxxxxx by the xxxxx); in xxxx xxxx, xxx amounts xxxxxxx xxxx xxxx xx taken xxxx xxxxxxx.

- An xxxxxxxxxx xxx is a xxxxxxxx xx x xxxxxx who xxx xxxx xx x xxxxxx of xxx xxxxxxxxxx xx a xxxxx (x xxxxxx, xxxxxx xx xxxxx xx the xxxxxxxx xxxxxx xx x xxxxxx xxxxxxxxx with xxx xxxxxxxx xx xxx xxxx of xxx/xxx xxxxx xx xxxxxxxxx xx xx xxxxxxxx xx xx xxxxxxxxx xx the xxxxxxxx) shall be xxxxxxxx with a xxxx xxx xxxxxxxxx xx XXX 150,000. Xxx xxxxx xxxxxx xxxxxxxx as xxxxxxxxx xxxxxxx shall not xxxxxx CZK 450,000; xxxxxx the xxxxxx xx victims xxxxxx xxxxx, the amount xxxxxxxx per victim xxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxx Xx. 209/1997 Coll. xxxx xxx xxxxxxx xxx xxxxxxxxx xx the xxxxxxxxx xxxxxxxxx of xxxxxxxxx of xxxxx xxxxxxxx related xx xxxxxxxxxx xxxxxxxxx xxxxxxxxx. Xx xxxxxxx xxxxxxx xx xxxxxxx xxxxxxxxx, xxxxxxxxxxxx xxx insurance xxxxxxxx xxxxxx thus xx xxxxxxxx to xxx xxxxxxxx xxxxxxxxx xxxx liability xxxxxxxxx. Xxxx xx xxxxxxxx xxxxx, xx view xx xxxxxxxxxxx xxxxxxxxxxxxx, xxx an xxxxxxxxxxx xxx xxx provision xx xxxxxxxxx support xx xxxxx xxxx xxx Xxxxxxxx xx Xxxxxxx.

- Xxxxxx xxxx xx xxxx that xxx available xxxxxxxxx xxx xxxxxxxxxxxxx xxxxxxxx xxx xxx respective xxxxx xxxx be xxxxxxxx to xxx xxxxxxxxxxx. Xx xxx xxxxxxxxx fails to xx so, xxx Xxxxxxxx of Xxxxxxx xxxxxx xxxxxxxx process xxx xxxxxxxxxxx. Xxxxxx xxx applicant fail xx deliver xxx xxxx xxxxxxxxx and xxxxxxxxxxxxx xxxx xxxxxx x xxxxxxxxxxxxx deadline, xxxx fact xxx xxxxxxx x xxxxxxxx xx xxxxxxxx xxx xxxxxxx as xxx Xxx Xx. 209/1997 Xxxx. Xxxx xxxxx xxx, xxxxxxx, xxxxxxxxx xxx filing of xxxxxxx application.

- Xxxxxx xxxx in xxxx xxxx the xxxxxxxxx xxxxx xx obliged xx xxxxxx any xxxxxxxxx xxxxxx received xx xxxxxxxxxxxx xxx xxxx (xxxx xxx xxxxxxxx, xxxxxxxx xxx.) xx the account xx the Ministry xx Xxxxxxx xx xx the xxxxxx xx the support xxxxxxxx. Xxxx xxxxxxxxxx xxxx xxx xxxxx xx xx/xxx has xxx received xxx xxxxxxxxxxxx. If xx xxxxxxxxx xx the xxxxxx xx an xxxxxxxxxxx, the Xxxxxxxx xx Justice xxx xxxxx xxx xxxxx'x xxxxx xx xxxxx xxx return xx xxx xxxxxxxxx xxxxxxx xxxxxxxx xxxxx xxx xxxxx xx xxx xxxx-xxxx xxxx, xxxxxxxx xxxx x xxxxxx xx justified xx xxx xxxxxx'x xxxxxx xxxxxxxx, the xxxxx xxxxxx xx the xxxx suffered xxx xxx xxxxxx xx xxxxxxxxxxxx xxxx xx xxx xxxxxx.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, xx x xxxxxxxx, v ktorej xx nachádzate, xxx xxxxxx Xxx xxxxxxxxx xxxxxxxxxxxx otázkami. X xxxxxx rýchleho xxxxxxxxx Xxxxx xxxxxxxx o xxxxxxxxxxx peňažnej xxxxxx xxxxxxx xxxxxxxx xxxxxxxx xxxľx zákona č. 209/1997 Zb., xx xxxx vyplnenie xxxxx dotazníku xxxxxxxxxx. Xxxxxxxx Vám xx xxxxxxxxxx, xxxxx si xxxxx xxxxxx.

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X. Xxxxxx, xxxxxxx xxxxxxľxx xxxxxx xxxxx x xxxxxxxľxxx - xxxxx xxxxxxxxx xxxx, xxxxxx xxôxxxxxx xxxx na xxxxxx, xxxxx xxxxx pozostalej xx osobe, 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 bydliska):

6. Xxxxxxx:

7. X-Xxxx:

8. Občianstvo:

II. Xx xxxxxxxľx zastupuje xxx xxxxx (xxxxxxxx) na xxxxxxx zákonného zastúpenia (xxxx. xxxxxxxx xxxxx xxxxxx xxxxxxx) xxxxx xx základe dohody x xxxxx xxxx, xxxxxxx údaje x xxxxxxxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxxxxxxxxxxx xxxxxx:

Xx xxxxxxx xx inú osobu, xxxx sa doložiť xxxxxxxxxx, xxxxx zastúpenie xxxxxxx. Xxxxx x xxxxxxxx xxxxxxxx xxxxx xxxxx moci (xxx xxxxxxxx zastúpení) alebo xxxxx xxxxxxx xxxxx (x prípade xxxxxxxxx xxxxxxxxxx) alebo xxx xxxxxxx xxxxxxx.

XXX. Xx xxxxxxxľ xxxxx xxxxx xxxxxxxxx xx xxxxx, xxxxx x dôsledku xxxxxxxxx xxxx xxxxxxx, xxxxxxx, xxxxxx, xx xxxxx x xxxxxxx xxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx narodenia:

4. Xxxxx xxxxxx:

5. Xxxxxxxx xxxxxxxx:

7. Xxxxxxxxxx:

8. X xxxx xxxxxx bola zomretá xxxxx x dôsledku xxxxxxxxx činu x xxxxx xxxxxxxľx (xxxx, xxxxx, xxxxx žijúca x spoločnej xxxxxxxxxx):

Xx xx xxxxxxxľ xxxxxx xxxxxxxxxx xx xxxxx, xxxxx x dôsledku xxxxxxxxx xxxx xxxxxxx, x žiadosti xx xxxx xxxxxxxx kópia xxxxxxxx listu x xxxxxxx, ktoré dokladajú xxxxxxxxxx, xx xxxxxx xxxxx xxxxxxxxxx pozostalú xxxxx xxxxx xxxx xxxxxxxxx ju vyživovať (xx xxxxxx xxxxx - xxxxx xôxxx x xxxxx xxxx xxxxx xxxxxxxxxxx súdu x vyživovacej xxxxxxxxxx, xxx manželov xxxxx xxxxxxxx xxxx xxxxxxx xxxx a xxx.)

XX. Xxxxxx, či žiadate xxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxxxxx pošty xxxxx xxxxxxxx xx xxxxxxx xxxx; x takom xxxxxxx xxxxxxx xxxxxxx xxxxx Xxxxx účtu.

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

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

XX. Xxxxxxx xxxxx činný v xxxxxxxx xxxxxx (xxxxxxxxx xxxxx, štátne xxxxxxxxxxxxxx, xxx), xxxxx xxxxxxxxx xxxxx xxxxxxx x xxxxxxxx xxxx. Xxxxxx xx xxxxxxx xxxxxx, xxx xxxxxx prebieha xxxxxxxxxxxx.

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

XXX. Xxxxxx, xxxx xxôxxxxx xxx xxxxxxxxx nárok na xxxxxxx škody od xxxxxxxľx xxxxx inej xxxxx, xxxxx zodpovedá xx škodu.

Podľa ustanovenia §8 zákona x. 209/1997 (Xx)., peňažitá xxxxx xx môže xxxxxx xxxxx xx xxxxxxxx x xxxxxxxxxxxxx xx to, xx xxxx xxxxxxx xxxxxx xxxxxxx prostriedky xx xxxxxxxxxx nároku na xxxxxxx xxxxx xx xxxxxxxľx xxxxx xxxx xxxxx, xxxxx zodpovedá xx xxxxx. Xxxxx xxx xxxxxxxxxxx, xx xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

Xxx XXXX. Vyplňte, xx žiadateľ xx xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx.

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

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

2. Xxxx xxx s xxxxxx trestného xxxx xxxx xxxxxxxxx xxxxxxxxx xxxx x spoločnej xxxxxxxxxx?

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

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

Podľa xxxxxxxxxxx §2 xxxx. 2 zákona x. 209/1997 Xx. xx xx obeť xxxxxxxx xxxxx xxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xx je xxxxxxx, manželom xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx x xxx žila x xxxxxxxxxx xxxxx xxxxx, xxxxxx nebohý poskytoval xxxxx xxx xxxxxxx xxxxxxxxxx xxxxxx.

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Xxxx XX. xx XXX. Vyplňte, xx sa žiadateľ xxxx obeťou xxxxxxxxx xxxx a xxxx xx xxôxxxxxx xxxx xx zdraví.

IX. Xxxxxx xxxxx, kedy xx xxxxxxxx liečenie, respektíve xxxx xx xxxxxxxx xxxxxxxx xxxxxxxxxxx.

X. Xxxxxxx xxxxx xxxxxxxx xxxxxxxxxxx xx xxxxxx činí:

K xxxxxxxx sa musí xxxxxxxx xxxxxx xxxxxxxxxxx xx bolesť xxxľx xxxxxxxx č. 440/2001 Zb., xxxxx xxxxxxxľ získa xx xxxxxx, xxxxx xx xxxxxxxxx. Xxxxx lekársky xxxxxxx xxxx xxxxxxxxx xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxxx x bodové xxxxxxxxxx sťaženia xxxxxxxxxxxxx xxxxxxxxxx. Xxxxxxxxxxx, že xxx xxxxx zákona č. 209/1997 Zb. xx xxxxxxxxxx xxx xxxxxx xxxxxxxxxxx xxxxxxxxx bolesti. Xxxľx xxxxxxxxxxx §6 xxxx. 2 xxxxxx x. 209/1997 Zb. xxxxxxx xxxxxxxxx' xxxxxxx xxxxx, xx bodové xxxxxxxxxxx xxxxxxxxx bolesti nedosiahne xxxxxxxx 100 xxxxx.

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

Xxxľx xxxxxxxxxxx §7 xxxx. 1 xxxx. x) zákona x. 209/1997 Xx. xx xxxxxxx xxxxx xxxxx xxxxxxxxx xxxxxxx xxxxx vo xxxxx xxxxxxxxx sumy 25 000.- Xx, xxxxx vo xxxxx xxxxxxxxxxxxxx xxxxxxxxxxx xxxxxxxx na liečenie x xxxxxx xxxxxxx. Xx sa xxxxxxxxxx xxxxxx x xxxxxxx xxxxx vo xxxxx xxxxxxxxx čiastky, xxxxxxxx xx vyplňovať body XXX. - XIV. xxxxx xxxxxxxxx.

XXX. Xxxxxxx xxxxxxx x xxxxxxxx xxxxxx:

Xxx o xxxxxxx xx xxxxx, zdravotnícke xxxôxxx, xxxxxxx na xxxxxxxxxxxxx, xxxxxxxxx cudzej xxxxx na xxxxx x domácnosti xx xxxxxxxxxx, zvýšené xxxxxxx xx xxxxxxx, x xxx. xxx xxxxxxxxxx, xx xxxxx náklady xxxxxxxxx xxxxxxxxx. Tu xxxxxxx xxxxxxx xx xxxxx xxxxxxx, inak xx xx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxx xxxx xxxx xxxxxľ.

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

X xxxxxxxx xxxxxxxx xxxxxxx, xxxxx xxxxxxxxxx xxxxxxx skutočnosti.

V prípade, xx xxxxxxxľ xx x xxxxxxxxxxxxxx xxxxxx, xôxxx x xxxxxxxxxx xxxxxxxxxxxxľx x xxxxxxxxxx xxxxxxx xxxľx §351 x xxxx. zákona x. 262/2006 Xx., xxxxxxxx práce, x xxxxx xxxxxxxxxx xxxxxxxxx. Xx xx žiadateľ xxxxxx samostatne xxxxxxxxx xxxxxx, takou xxxxxxxx xxxx xxxxxxxxx xxxx xxxxxxxxxx xxxxxxxx xxxxxxxxx. Xx xxxxxxxľ xxxxxx xxxxxxxx xôxxxxxx, xxxxxxxx, xxxxx xôxx dokázať xxxxxxxx sociálnu situáciu, xxxx potvrdenie x xxxxx xxxxxxxxxx xôxxxxxx. X xxxxxxx, xx x nejakého závažného xôxxxx xxxxxxx doložiť xxxxxxxxx xxxxxx xxxxxxxľx, x xxxxxxx prípade xx možné xxxxxxxx xxxxxxxxxx x xxxx xxxxxxx xxxxxxxxxx.

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

X xxxxxxxx xxxxxxxx xxxxxxxxxx xxxxxxxxxxxxľx xxxxx xxxxxxxxx x xxxxx xxxxxxxxxxxx xxxxx. X prípade, xx x xôxxxxxx xxxxx xx xxxxxx xxôxxxxxxx xxxxxxxx xxxxx Xxx xxxxxxxx xxxxxxxxx xôxxxxxx, xxxxxx x xxxxxxx xxxx xxxxx.

Xxxx xxxxxxxxx xxxxxx xx xxxx, xx xxxxxxxx xxxxx, ktorého xxx xxx(x) xxxxxx, xx xxxx sociálna xxxxxxxx xxxxxxxx. Xxxxx, xxxxx xx xxxxx xxôxxxxx, xxxxxľ nebola xxxxxxxx.

Xxxxxx xxxxxxxxxx, že xxxxx xx xxxxxxx xxxxx xx xxxxxxx xxxxx xx odškodnenie xxxx spôsobenej trestným xxxxx som neuplatnil(a) x žiadnom xxxx xxxxx xxx x Xxxxxx (Xxxxxxxxxx) republike.

Beriem xx vedomie, že xx xxxľx xxx. §12 zákona č. 209/1997 Zb., x xxxxxxxxxx xxxxxxxx xxxxxx xxxxxxx trestnej xxxxxxxx x x xxxxx x o xxxxxxxx xxxxxxxxxx xxxxxxx, x xxxxx xxxxxxxxxx predpisov, xxxxxx povinnosť xx xxxxxxx rokov odo xxx, keď xx xxxxxxxx xxxxx, xxxxxxx xx xxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxx, ktoré xxx xxxxxx(x) xxx xxxxxxx xxxxx, x xx xx xx xxxxx poskytnutej xxxxxx. Xxxxxxx x tým xxxxxx xx xxxxxxx, xx po xxxxxxxx xxxxxxxxxx xäxxxxxxx xxxx xôxxx xxxxxxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx, xxx xx x xxxx štátu xxxxxx xxxxx xx xxxxxxxx poskytnutej xxxxxx, xx xxxx xxxxxxxx xxxxxxxx xxxx taký xxxxxx odôvodňovať, xxxxxxx xxxxx xxxxx, ktorú xx spôsobili x xxxxx xxxxxxx, xxxxx xxx xxxxxx(x).

Xxxxxx xxxx xx vedomie, xx xxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxx neúplného xxxxx xx jeho xxxxxxxxx xx účelom získania xxxxxxxxxxxx výhody, xx xôxxx xxxxxxxx xxxxxxxxxx xxxľx §21 xxxx. 1 písm. x) xxxxxx č. 200/1990 Xx., x xxxxxxxxxxxx, x znení xxxxxxxxxx xxxxxxxxx.

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xxxxxx xxxxxxxľx alebo xxxxxxxx

- Ministerstvo xxxxxxxxxxxxxx Xxxxx republiky xx xxxxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx xxxľx xxxxxx č. 209/1997 Zb. xxxxxxx xxx xxxxxx x udelí xxxxxxxx xxxxx. Xxxxx xxxx xxxxxxxxxx xx polícii xx na inom xxxxxxxx xxxxxx podľa xxxxxxxxxxx xxxxxxxxx prípadu. Xx xxxxx xxxxxxxx xx xxxxxx žiadosti x xxxxxxxxxx xxxxxxxxxx xxxxxxxx buď xxxxx xxxxxxxx xxxxx xxxxxxxľxxx xxxxxx xôxxxx, prečo xxxxx xxxxxxx xxxxxxxx.

- X xxxxxx zákona č. 209/1997 Zb. xxxx xxxxxxxľ xxxxxxxxxx xx xxxx xxx x prípade, xx mu v xôxxxxxx xxxxxxxxx xxxx xxxx xxôxxxxxx poškodenie xxxxxxx. Xxxxxxxxxxx, xxx xxxx postačujúcou xxxxxxxxxx xx priznanie xxxxxxxx xxxxxx xxxxx obeti xx výška xxxxxxxx xxxxxxxxxxx xxxxxxx (xxx xxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx) dosahujúceho xxxxx 100 bodov. Xx xxxx xx považuje xx xxxxx pozostalá xx xxxxx, ktorá x xôxxxxxx xxxxxxxxx xxxx zomrela, xx xxxx xxxxxxx, manželom xxxxx dieťaťom xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx x ním xxxx x domácnosti, xxxxx xxxxx, xxxxxx zomretý xxxxxxxxxx xxxxx xxx xxxxxxx poskytovať xxxxxx.

- Xxxxx č. 209/1997 Zb. x xxxxxxxxxx peňažitej pomoci xxxxxxx xxxxxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxx (prepadnú) xxxx 1 roka xxx xxx, keď xx xxxx xxxxxxxxx x xxxxx spôsobenej xxxxxxxx xxxxx. Xx xxxxx dňom xx xxx xx deň xxxxxxxxx trestného xxxx, xxxx xxxxxxxx xxxxxxx, xxxx xx xx xxxxx. Xxxxxxxxxxxx spravodlivosti xxxôxx vyhovieť xxxxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx, xxxxx xx xxxxxxxx xx xxxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx xx na žiadosť xxxxx, xxxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx xxxxx xx xxxxxx, xxxxxxxx v xxxxxxxxx xxxx 25&xxxx;000.- Xx alebo vo xxxxx, ktorá xxxxxxxxxxx xxxxxxxxxx stratu xx xxxxxxx, preukázané náklady xxxxxxx x xxxxxxxx, xxxxxxx x súčet xxxxxxxx xxxxxxx, xxxxx xxxx x titulu xxxxxxx xxxxx už xxxxxxx; pomoc xx xxxxxx xxxxx xxxxxx xxxxxxxxxx xxxx 150&xxxx;000.- Xx. Xx xxxx - xx xxx, xxx xxx xxxxxxxx xxxxx - xxxxxxxx, xx jej xxxxxxxxx xxxxx je vyššia xxx tá, xxxxx xxxx xxxxxxxxx xx xxxxxxxxxxx pomoci, xx xxx žiadosť v xxxxxx stanovenej xxxxx xxxxxxx xxx xxxxx xxxxxxxxx pomoc opäť, x to xx xx xxxxxxxxxx xxxxx 150&xxxx;000.- Kč; xxxxxx xx xxxxxxxxxx xx xxxxxxx, xxxxx už xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, xxxxx xx xxxxxxxxxx xx xxxxx, xxxxx v xôxxxxxx xxxxxxxxx činu xxxxxxx (xx bola rodičom, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx a xxxxxxx x čase xxxx xxxxx s xxx xxxx x xxxxxxxxxx, xxxxx jej xxxxxxx xxxxxxxxxx, xx xxx xxxxxxx poskytovať xxxxxx), xx poskytne peňažná xxxxx v paušálnej xxxx 150&xxxx;000.- Xx; xxxxx xx xxxxxx xxxxx xxxxxx xxxxxxxxxx xxxx 450&xxxx;000.- Kč, x xx je xxxxx obetí viac xxx tri xxxxx, xxxxxxxxxxx čiastka xx xxx xxxxxx xxxxx xxxxxxxxx kráti.

- Xxxxx č. 209/1997 Zb. xxxxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxxxxxxxxx vykonávateľa xxxxxxxxxx xxxxxxxx, xx xxxxx xxxxäxxxx xxxxxxx xxxxxxx xxxxxxxxx zodpovednosti. Xxxxx je xxxxxxxx x záležitostiach xxxxxxxxxx xxxôx žiadať subjekt, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, x poskytnutie xxxxxxxxx xxxxxxx. Xxx x xxxxxx xxxxxxxxxxx xxxxxxxxx s prihliadnutím xx konkrétne xxxxxxxxx xxxxxxxxx xx možné xxxxxx xxxxxxxxxxxx xxxxxxxxxxxxxx x poskytnutie xxxxxxxx xxxxxx.

- Pripomíname, xx xx nevyhnutné xxxxxxxx xxxxxx xxxxxxxx doklady x xxxxxxxxxx, xx xxxxx xxxxxxxxxx xxx xxxxxxxxxxxx xxxxxxxxx. Xx xxx xxxxxxxľ neučiní, xxxxxxxxxxxx spravodlivosti xxxôxx xxxxxxx xxxxxxx. Ak xxxxxx xxxxxxxxxx a xxxxxxx xxx dodatočne xxxxxx, xxxx skutočnosť xôxx xxx dôvodom xxxxxxxxxxxxx xxxxxxxx xxxxxx xxxľx zákona č. 209/1997 Zb. Xx xxxx xxxxxxxxxx xxxxxxx xxxxx xxxx xxxxxxx.

- Upozorňujeme, xx xx bude xxxxxxxľxxx xxxxxxxxxx xxxxxxx pomoc, xxxxxxxľ xx do xxxxxxx xxxxx xxx xxx xxxxxxxxxxx pomoci xxxxxxx xx xxxx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxx, xxxxx dostal xxx xxxxxxx škody (od xxxxxxxľx, xxxxxxxxx x xxx.) xx xx xxxxx xxxxxxxxxxx xxxxxx. Xxxx xxxxxxxxx nemá, xx xx xxxxx xxxxxxxxxx. Xx xxxxxxx xxxxxxxx xxxxx xx xxxxxxxxxxxx spravodlivosti xôxx x xxxx xxxxx xx xxxxxxxx xxxxxxxxxx xäxxxxxxx xxxx xxxxx xxxxx na vrátenie xxxxxxxxxxx peňažnej xxxxxx. Xx xxxxxx xxxxxx xxôxxxxxxx xxxxxxxx situácia xxxxx, xxxxxxx výška xxxxx, ktorú xxx xxôxxxxxx, x xxxxx xxxxxxx, xxxxx xxxx xxxxxxx.