Petition form
To the People’s Advocate,
1. Name and surname (capital letters) ..............................................., domicile (residence or another address where you can be contacted)...................................... …………………………………......................... ………………………………..Telephone .............................
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2. The date when you learned about the violation of your rights: ...................................
3. Brief presentation of your infringed rights and/or freedoms:
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4. The denounced administrative authority and the civil servant: ........................................
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5. Brief presentation of the alleged maladministration: (you may continue on another page and attach it to the application)
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6. The public authorities notified before:
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7.The answer received and the grounds on which you deem yourself further wronged: ........
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8. In sustaining the alleged facts, I submit the following documents (copies, not originals): ............
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9. The obligatory statement that the petition is/was the object of a litigation in a court of law:
YES/NO
10. I wish that all the information and the results shall remain confidential:
YES / No
11. The petition is submitted:
|_| Personally
|_| By delegate
Date ...............
Signature .....................
