Form Submission is restricted
Form is THANK YOU FOR YOUR COOPERATION!
QUESTIONNAIRE
1. Are you a victim or a witness of the crimes against humanity in the context of the military aggression of the Russian Federation against Ukraine and are you willing to answer this questionnaire?
Victim
Witness
Others
2. Were you a victim or a witness of one of the following situations:
Killing people
The damage of physical or mental integrity of people
Deportation or forcible transfer of population
Torture
Rape or sexual aggression
Illegal deprivation of freedom
Any acts causing great damages
Other situations?
3. Where did the offence take place? The name of the city / The region in Ukraine/ The village
4. When was the offence committed/ what is the period of time when the offence was committed?
5. Who are the authors of the offence?
The Russian militaries
Other people
I do not know
6. The evidence owned. If you own photos, video footage or other evidence, please do not destroy or delete them. Romanian authorities may ask for your permission in order to use this evidence.
Video
Photos
Documents
Others
7. Personal data
Surname (Last name) [Latin script (Latin letters)]:
*
First name [Latin script (Latin letters)]:
*
Gender:
*
Male
Female
Date of birth:
*
Nationality:
*
Mother tongue:
*
Ukrainian
Ukrainian
Russian
Other language
Date of entry into Romania:
Address in Romania:
0
/ 300
Telephone number:
*
E-mail address:
*
Facebook address:
These data are important in order to eventually contact you.
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