Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Assessment xx Xxxxxxxxxxxx xxx xxx Xxxxxxxxx xx Xxxxxxxxx Xxxxxxx to Xxxxxxx xx Xxxxxxxx Xxxx xxxxxxxx xx Xxx No. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xx the xxxxxxx of xxxxxxxx xxxx and xx xxxxxxxx certain xxxxx xxxx, as xxxxxxx

Xxxx Xxx/Xxxxx,

Xx xxxxxxxxx for xxxxxxxxx you xxxx xxxxxxxx xxxxxxxxx xx xxxx xxxxxxx situation. Xxxxxxx, xxxxxxx xx xxxx xxxxxxxxxxxxx xx xxxxxxxx for xxx xxxxx xxxxxxxxxx xx xxxx xxxxxxxxxxx for xxx xxxxxxxxx of xxxxxxxxx support pursuant xx Act no. 209/1997. Thank xxx xxx xxxx cooperation; xx is xxxxxx xxxxxxxxxxx.

_____________________________________________________________________________________________

X. Xxxxxx xxxxxxx xxxx xx xxx xxxxxxxx xxxx of xxx xxxxxxxxx - x.x. xxx xxxxxx xx the criminal xxx who has xxxxxxxx xxxxxx xxxx, xx the survivor xx x xxxxxx xxx xxx xxxx xx xxxxxxxxxxx xx xxx xxxxxxxx xxx:

1. Xxxxxxx:

2. Xxxxx name:

3. Xxxx xx xxxxx:

4. Xxxxxxxxx xxxxxxx:

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

6. Xxxxx Xxxxxx:

7. X-xxxx xxxxxxx:

8. Xxxxxxxxxxx:

XX. Xx xxx xxxxxxxxx xx xxxxxxxxxxx xx xxxxxxx xxxxxx ("representative") xx xxx xxxxx xx xxxxxxxxx xxxxxxxxxxxxxx (xxx xxxxxxxx, x xxxxx child xxxxxxxxxxx xx xxx/xxx xxxxxx) xx xx the xxxxx of a xxxxx xx xxxxxxxx, xxxxxx xxxx xx xxx xxxx xx xxxx representative:

1. Xxxxxxx:

2. Xxxxx name:

3. Xxxxxxxxx xx registered address:

If xxx xxxxxxxxxxxxxx is xxxxxx xxx application xx behalf xx xxx xxxxxxxxx, please xxxx xxxxxx x xxxxxxxx authorizing xxx/xxx xx represent xxx xxxxxxxxx - x xxxx of x xxxxx of xxxxxxxx (xxx xxxxxxxxxxx representation) xx a xxxx xx xxx xxxxx xxxxxxxxxxx (xxx statutory xxxxxxxxxxxxxx) or xxx xxxxx xxxxxxxxxx xxxxxxxx.

XXX. Xx xxx xxxxxxxxx xx a survivor xx a xxxxxx xxx xxx xxxx xx xxxxxxxxxxx of xxx xxxxxxxxxx xxxxxxxx xxx, please xxxx xx the xxxxxxxx xxxx xx xxx xxxxxxxx:

1. Xxxxxxx:

2. Given xxxx:

3. Date xx xxxxx:

4. Xxxx xx xxxxx:

5. Xxxx xxxxxxxxx xxxxxxx:

6. Xxxxxxxxxxx:

7. Xxxxxxxxxxxx xx xxx xxxxxxxx xx xxx applicant (x.x. xxxxxx, daughter, xx individual xxxxxx xx xxxxxx household)

If xxx xxxxxxxxx is x xxxxxxxx of x xxxxxx xxx xxxx xx xxxxxxxxxxx xx xxx xxxxxxxx xxx, xxxxxx attach x xxxx xx xxx xxxxx certificate xxx xxx xxxxxxxxx xxxxxxx xxxx the xxxxxxxx xxxxxxxxx or xxx xx obligation xx support the xxxxxxxx (xx the xxxx of x xxxxxx-xxxxx xxxxxxxxxxxx, such xxxxxxxxx xxxxxxx birth xxxxxxxxxxxx xx x xxxxx xxxxxxxx xx xxx xxxxxxxxxx xx xxxxxxx the xxxxxxxxx; xx xxx xxxx xx married xxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxxx).

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

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

Xx xxxxxxxxx, xxxxxx xxxxxx xxx xxxxxx decision xx the xxxxxxxxxxxxxx xxxxxxxx xxxxxxx xxxxxxxxx xxxxx xxxxx xxxxxxxx xxx stage xx xxx xxxxxxxxxx xxxxxxxxxxx (x.x. xxxxxxxxxx on xxx xxxxxxxxxxxxxxx xx xxxxxxxx xxxxxxxxxxx, copy xx the xxxxxxxxxx, xxxxxxxxx - final xx otherwise).

According xx the provisions xx §8 xx Xxx no. 209/1997, xxx xxxxxx xx xxxxxxxxx xxxxxxx xxx xx xxxxxxx xx xxxxxxxx depending xx xxxxxxx the xxxxxx xxx xxxx use xx all xxxxx xxxxxxxx to xxxxxxx x xxxxx xxx xxxxxxxxxxxx xxxxxxx xxx xxxxxxxx or any xxxxx xxxxxx xxxxxxxxxxx xxx xxx harm xxxxxxxx. Do xxx xxxx in xxxx xxxx xx the xxxxxxxx xxx not xxxx identified.

______________________________________________________________________________________________

Fill xx xxxx XxXx if xxx applicant xx x survivor xx xx individual xxx xxx xxxx in xxxxxxxxxxx of the xxxxxxxxx xxxxx.

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

2. Xxx xxx xxxx xx a xxxxxx xxxxxxxxx with the xxxxxxxx xxxxxx xxxxx xx xxx xxxxxxxxxx xx the xxxxx?

3. Xxxx xxx x xxxxxxxxx xx xxx xxxxxx xx xxx xxx deceased xxxxxxx xx xxxxxxx xxx?

4. Xx xxx xxxxx xxxxxxx meet xxx xxxxxxxxxx xxxxxxxxx in xxxxxxx 1 to 3? Xxxxxx give xxxxx number, xx xxxxx xx you.

______________________________________________________________________________________________

According xx the xxxxxxxxxx xx §2, xxxxxxx 2 xx Xxx xx. 209/1997, x xxxxxx xxx xx x xxxxxxxx of x xxxxxx xxx xxxx in xxxxxxxxxxx xx a criminal xxx xx xxxxxxxxxx xx be a xxxxxx if he xx she is x xxxxxx, spouse xx child xx xxx xxxxxxxx and xxxxx xxxx xxx xx xxx in xxx same xxxxxxxxx xx xx the xxxxxx was x xxxxxxxxx xx xxx xxxxxxxx xx xxx xxxxxxxx was xxxxxxxx xx xxxxxxx xxx xxxxxx.

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

Please xxxxxx x xxxxx-xxxxx xxxxxxxxxx xx xxxx xxx xxxxxxxxx xxxxxxxx to Xxxxxx No. 440/2001 Xxxx. Xxx xxxxxxxxxx xxxxxxxx should xx xxxxxxxx from xxx xxxxxxxxx responsible xxx xxx xxxxxx'x xxxxxxxxx. Xxxx xxxxxxx xxxxxx xxxx contain x xxxxx-xxxxx xxxxxxxxxx of xxx pam xxxxxxxx xxx x xxxxx-xxxxx xxxxxxxxxx xx xxx xxxxxxxx xx xxx xxxxxx'x social xxxxxxxx. Xxxxxx bear xx xxxx xxxx xxxx xxx xxxxx-xxxxx xxxxxxxxxx xx the pam xxxxxxxx is relevant xxx xxx purposes xx Act xx. 209/1997. Xxxxxxxxx to xxx provisions of §6, xxxxxxx 2 xx Xxx xx. 209/1997, xx financial xxxxxxx xxxx be xxxxxxxx xxxxxx the xxxxx assessment of xxx xxxx xxxxxxxx xx xx xxxxx 100 xxxxxx.

The xxxxxx xxx xxxxxx xxxx xxx financial xxxxxxx in the xxxxxx of CZK 25,000 xx an xxxxxx equal xx xxx proved costs xx medical xxxxxxxxx xxx lost xxxxxx (§7, section 1, xxxxxx a xx Xxx No. 209/1997 Xxxx.). xx xxx xxxxxx xx xxxxx xxx x lump xxx xxxxxxx, xxxxx xx no xxxx xx xxxx xx xxxxx XXX - XxX.

Xxxx includes xxx xxxxxxxx xxx xxxxxxxxxx, xxxxxxxx xxxxxxxxx, xxxxxxxxxxxxxx xxxxx, hiring xx xxxxxxxxx xx xxxx xxx xx xxx home xx xxxx medical xxxxxxxxx, xxxxxxxxx transportation xxxxx xxx., xxxxxxxx such xxxxx xxxx xxx xxxx xxxx xx xx xxxxxxxxx company. xx xxxx xxxxxxxx xxx not xxxxxx xx documentary xxxxxxxx, xxx Ministry xx Xxxxxxx xxx xxx xxxx xxxx xxxx xxxxxxxxxxxxx.

Xxxxxx xxxxxx xxx documents xxxxxxxxxx xxxx facts to xxx xxxxxxxxxxx.

Xx the xxxxxxxxx xx xx xxxxxxxx, xxxxx xxxxxxxxx xxxxx include x xxxxxxxxx xxxx xxx/xxx xxxxxxxx describing xxx xxxxxxx xxxxxx xxxxxxxxx xx §351 xx. xxx. xx Xxx xx. 262/2006, the Xxxxx Xxxxxx Xxxx, xx xxxxxxx. lf xxx xxxxxxxxx xx xxxx-xxxxxxxx, such xxxxxxxx xxxxx xx a xxxx xx xxx/xxx xxxx xxxxxx tax xxxxxx. lf xxx xxxxxxxxx xx a xxxxxxx xxxxxx who xx xxxx xx xxxxx his/her xxxxxxxx xxxxxx xxxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxx xxx xxxxxx xx the retirement xxxxxxx. xx xxx xxx xxxxxx the xxxxxxxxx'x income xxxxxxxxx xxxxxx be xxxxxx, xx xxxxxxxxxxx xxxxx xx xxxxxxxxx may xx attached.

Xx xxxxxx xxxxxxxx xxx xxxx xxxxxxxx xx x result of xxx xxxxxxxx xxx xx which I xxx x xxxxxx. X have xxx xxx xxxx xxxxxxxxxxx xxx the xxxx 1 xxxx xxxxxxxx xx x xxxxxx xx the criminal xxx.

X xxxxxx affirm xxxx X xxxx xxx xxxxxx xxx xxxxx xxx xxxxxxxxx xxxxxxx or xxx xxxxxxx claim xxx xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx as x result of xxx criminal xxx xx xxx country xxxxx xxxx xxx Xxxxx Republic.

I xxxxxxxxxxx xxxx xxxxxxxxx xx §12 of Xxx Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx support xxx the xxxxxxx xx xxxxxxxx xxxx xxx xx amending xxxxxxx xxxxx xxxx, xx amended, X xx xxxxxxx xx xxxxxxxxx xxx Xxxxxxxx xx Xxxxxxx xxx xxxxxx xxxxxxxx xx xxxxxxxxxxxx for the xxxx xxxxxxxx, up xx xxx xxxxxx xx xxx financial xxxxxxx, xxxxxx five xxxxx from the xxxx xx receiving xxx xxxxxxx xxxxxxx. X xxxx acknowledge xxxx, after xxx xxxxx xx xxx xxxx-xxxx xxxxxx, X xxx xxxx xx xxxxxxxxxxx xxxxxx xxx Xxxxxxxx xx Justice xx waive xxx xxxxx'x xxxxx xxx xxx xxxxxx xx xxx xxxxxxxx support, xxxxxx xxxx x xxxxxx be well xxxxxxxx by xx xxxxxx standing, the xxxxx extent xx xxxx suffered and xxx xxxxxx of xxxxxxxxxxxx received.

I xxxx xxxxxxxxxxx xxxx xxxxxxxxxxx xxxxxx false xx xxxxxxxxxx xxxxxxxxxxx or xxxxxxxxxxx xxxxxxxxxxx for xxx xxxxxxxx xx xxxxxxxxxxxxx xxxxxxx xxxxxxxx xxx represent xx xxxxxxx xxxxxxxx xx §21, xxxxxxx 1, xxxxxx x) xx Xxx xx. 200/1990 Xxxx., xx xxxxxxxx xx xxxxxxx.

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

Xxxxxxxxx of xxx xxxxxxxxx xx xxx/xxx xxxxxxxxxxxxxx

- Xxxx xxxxxxx xx xxx xxxxxxxxxxx xxx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx pursuant to Xxx No. 209/1997, xxx Xxxxxxxx xx Xxxxxxx xxxxx xxxxxxx xxxxxxx xxx assign xx x xxxxxx xxxxxx. Subsequently, xxx Xxxxxxxx xxxxx xxxxxxxx xx xxxxxxxxxxxxx xxxx xxx xxxxxx xx x similar xxxxxxxxx xx xxx the xxxxxxxx details xx xxx xxxx. Xxxxxx xxxxx months from xxx xxxx xx xxx xxxxxxx of xxx application xxx xxxxxxxxxx of xxx xxxxxxxxx documents, the Xxxxxxxx xxxxx either xxxxxxx xxx support xx inform the xxxxxxxxx of the xxxxxxx xxx xxxx xxxxxxx has xxxx xxxxxxxx.

- Xxx xxxxxxxxx xxxxx xx xxxxxxxxxx x victim as xxx Xxx No. 209/1997 Xxxx. xxxx xx he/she xxx xxxxxxxx bodily xxxx xx x xxxxxx xx xxx xxxxxxxxxx xx x xxxxx. X necessary xxx xxx the xxxx xxxxxxxxx xxx xxx xxxxxx'x receipt xx xxxxxxxx xxxxxxx xxxxx xx xxx xxxxxx xx xxx xxxxx-xxxxx xxxxxxxxxx xx xxx xxx xxxxxxxx (xxx xxx xxxxxxxxx of xxxxxx position), xxxxx xxxx xx xx xxxxx 100 xxxxxx. Xxxxxxxxx xx x xxxxxx xxx xxx xxxx xx consequence xx x xxxxx xxxxx xx xxxxxxxxxx xx xx x xxxxxx if xxx xxxxxxxx xx a xxxxxx, spouse or xxxxx xx xxx xxxxxxxx xxx xxx xxxxxxxx xxxxxx a xxxxxxxxx xxxx the xxxxxxxx xx xxx xxxx xx his/her xxxxx xx xx xxx xxxxxxxx supported xx was xxxxxxxx xx xxxxxxx the xxxxxxxx.

- Act No. 209/1997 Xxxx. xx xxx provision xx xxxxxxxxx support to xxxxxxx of xxxxxxxx xxxx stipulates a xxxxxxxxxx term xx 1 year xxxx xxx xxxx xx xxxxx xxx xxxxxx xxxxxxx of xxx xxxx xxxxxx xx xxx crime. Xx xxxx xxxx xxxx xxx xxxxxxxx xxxx xxx xxxx of xxx xxxxxxxxxx of xxx crime, xxx xxxxxx xxxxx provide xxxxxxxx xx xxx xxxx xx xxxxx xx/xxx learned xx xxx xxxxxxxxxxxx. Xxx Xxxxxxxx of Justice xxxxxx xxxx xx xxxxxxxxxxx xxx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xxxxxxx xxxxx xxx lapse xx xxx abovementioned xxxxxx.

- Financial xxxxxxx xx applied for xx x xxxxxx xxx has xxxxxxxx xxxxxx xxxx xx x xxxxxx of xxx commitment xx x crime xxx xx xx xxx xxxx of x xxxx xxx xxxxxxxxx xx XXX 25,000 xx an xxxxxx xxxxx xx xxxx xxxxxx or the xxxxx xx xxxxxxx xxxxxxxxx xx proved xx xxx victim, xxxxxxx xx xxx xxxxxx xxxxxxxxxx xxxx xx the victim xx xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx. Xxx xxxxx xxxxxx xx such xxxxxxx xxxx xxx xxxxxx XXX 150,000. If, xxxxx xxx provision xx support, the xxxxxx xxxxxx xxxx xxx xxxx xxxxxxxx xxxxxxx the amount xxxxxxxx, the xxxxxx xxx receive additional xxxxxxx up to xxx amount xx XXX 150,000 xx xx/xxx xxxxxxx for xx within xxx xxxxxxxxxxxxxx period xx xxxx (i.e., 1 xxxx from xxx xxxx xx xxxxx xxx xxxxxx xxxxxxx xx xxx harm xxxxxx xx the xxxxx); xx such xxxx, any amounts xxxxxxx xxxx will xx xxxxx xxxx xxxxxxx.

- Xx xxxxxxxxxx xxx xx x xxxxxxxx xx x xxxxxx who xxx xxxx as x xxxxxx of xxx xxxxxxxxxx xx a xxxxx (a xxxxxx, xxxxxx xx xxxxx xx xxx xxxxxxxx xxxxxx in x xxxxxx household with xxx xxxxxxxx xx xxx xxxx xx xxx/xxx xxxxx xx xxxxxxxxx xx or xxxxxxxx to xx xxxxxxxxx xx the xxxxxxxx) xxxxx xx xxxxxxxx xxxx a xxxx sum amounting xx XXX 150,000. Xxx total xxxxxx xxxxxxxx xx xxxxxxxxx xxxxxxx xxxxx xxx xxxxxx CZK 450,000; xxxxxx xxx xxxxxx xx xxxxxxx xxxxxx xxxxx, the amount xxxxxxxx per xxxxxx xxxxx xx xxxxxxx xxxxxxxxxxx.

- Xxx Xx. 209/1997 Coll. xxxx xxx xxxxxxx the xxxxxxxxx xx the xxxxxxxxx xxxxxxxxx of xxxxxxxxx xx xxxxx xxxxxxxx xxxxxxx xx xxxxxxxxxx xxxxxxxxx xxxxxxxxx. Xx matters xxxxxxx xx traffic xxxxxxxxx, xxxxxxxxxxxx for xxxxxxxxx xxxxxxxx xxxxxx thus xx xxxxxxxx xx xxx xxxxxxxx xxxxxxxxx xxxx liability xxxxxxxxx. Xxxx xx xxxxxxxx xxxxx, xx view xx exceptional xxxxxxxxxxxxx, xxx an application xxx xxx provision xx xxxxxxxxx xxxxxxx xx xxxxx xxxx xxx Xxxxxxxx xx Xxxxxxx.

- Xxxxxx bear xx mind xxxx xxx xxxxxxxxx xxxxxxxxx xxx confirmations xxxxxxxx xxx the respective xxxxx xxxx be xxxxxxxx to xxx xxxxxxxxxxx. If the xxxxxxxxx xxxxx xx xx xx, the Xxxxxxxx of Xxxxxxx xxxxxx xxxxxxxx xxxxxxx xxx application. Should xxx xxxxxxxxx xxxx xx xxxxxxx xxx xxxx xxxxxxxxx and xxxxxxxxxxxxx even within x xxxxxxxxxxxxx deadline, xxxx xxxx may xxxxxxx x decision xx withhold any xxxxxxx xx xxx Xxx Xx. 209/1997 Xxxx. This xxxxx xxx, xxxxxxx, prejudice xxx filing xx xxxxxxx xxxxxxxxxxx.

- Please xxxx xx xxxx xxxx xxx xxxxxxxxx xxxxx xx xxxxxxx xx xxxxxx xxx xxxxxxxxx xxxxxx xxxxxxxx xx xxxxxxxxxxxx for xxxx (xxxx xxx xxxxxxxx, xxxxxxxx etc.) xx xxx xxxxxxx xx the Xxxxxxxx xx Justice xx xx the amount xx xxx xxxxxxx xxxxxxxx. Xxxx obligation xxxx xxx apply xx xx/xxx has xxx received xxx xxxxxxxxxxxx. Xx so xxxxxxxxx xx xxx xxxxxx xx an xxxxxxxxxxx, xxx Ministry xx Xxxxxxx xxx xxxxx xxx state's xxxxx xx claim xxx xxxxxx xx xxx financial support xxxxxxxx xxxxx the xxxxx of the xxxx-xxxx term, provided xxxx x xxxxxx xx xxxxxxxxx xx xxx victim's xxxxxx xxxxxxxx, xxx xxxxx xxxxxx xx xxx xxxx xxxxxxxx xxx xxx xxxxxx xx xxxxxxxxxxxx xxxx xx xxx victim.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, xx x xxxxxxxx, v xxxxxx xx xxxxxxxxxx, xxx xxxxxx Vás xxxxxxxxx xxxxxxxxxxxx xxxxxxxx. X xxxxxx xxxxxxxx xxxxxxxxx Xxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx pomoci xxxxxxx trestnej činnosti xxxľx zákona č. 209/1997 Zb., xx však xxxxxxxxx xxxxx dotazníku xxxxxxxxxx. Xxxxxxxx Xxx xx xxxxxxxxxx, xxxxx xx xxxxx xxxxxx.

______________________________________________________________________________________________

X. Prosím, xxxxxxx xxxxxxľxx xxxxxx xxxxx x xxxxxxxľxxx - xxxxx trestného xxxx, ktorej xxôxxxxxx xxxx na xxxxxx, xxxxx xxxxx xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx trestného xxxx xxxxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Xxxxxx xxxxxxxx xxxxxx:

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

6. Xxxxxxx:

7. X-Xxxx:

8. Občianstvo:

II. Ak xxxxxxxľx zastupuje xxx xxxxx (zástupca) xx xxxxxxx xxxxxxxxx xxxxxxxxxx (xxxx. xxxxxxxx dieťa xxxxxx xxxxxxx) xxxxx xx xxxxxxx xxxxxx x xxxxx xxxx, xxxxxxx xxxxx x xxxxxxxxxx:

1. Priezvisko:

2. Xxxx:

3. Xxxxxxxxxxxxxx xxxxxx:

Xx xxxxxxx xx xxx osobu, xxxx xx xxxxxxx xxxxxxxxxx, xxxxx zastúpenie xxxxxxx. Xxxxx x xxxxxxxx priložte xxxxx xxxxx xxxx (pri xxxxxxxx xxxxxxxxx) alebo xxxxx xxxxxxx xxxxx (x xxxxxxx xxxxxxxxx xxxxxxxxxx) alebo xxx xxxxxxx xxxxxxx.

XXX. Ak xxxxxxxľ alebo xxxxx xxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xxxxxxx, prosím, xx xxxxx o umretej xxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Xxxxx xxxxxx:

5. Xxxxxxxx xxxxxxxx:

7. Xxxxxxxxxx:

8. V xxxx xxxxxx bola xxxxxxx xxxxx x dôsledku xxxxxxxxx činu x xxxxx xxxxxxxľx (xxxx, xxxxx, osoba xxxxxx x spoločnej domácnosti):

Ak xx xxxxxxxľ xxxxxx xxxxxxxxxx po osobe, xxxxx v xôxxxxxx xxxxxxxxx xxxx xxxxxxx, x žiadosti sa xxxx xxxxxxxx kópia xxxxxxxx listu a xxxxxxx, xxxxx xxxxxxxxx xxxxxxxxxx, že umretá xxxxx xxxxxxxxxx pozostalú xxxxx xxxxx mala xxxxxxxxx xx xxxxxxxxx (xx vzťahu xxxxx - dieťa pôjde x rodný xxxx xxxxx rozhodnutie súdu x vyživovacej xxxxxxxxxx, xxx xxxxxxxx xxxxx xxxxxxxx xxxx xxxxxxx xxxx x pod.)

IV. Xxxxxx, xx xxxxxxx xxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxxxxx xxxxx xxxxx xxxxxxxx xx xxxxxxx xxxx; x xxxxx xxxxxxx xxxxxxx xxxxxxx xxxxx Xxxxx účtu.

V. Xxxxxx xxxxx, xxxx xx xxxx xxxxxxxxx x xxxxx xxôxxxxxxx xxxxxxxx xxxxx.

Xxxxxx xxxxx xxxxxxxxx xxxxxxxxx xxxx x xx xx xxxx x xxxxx xxx spôsobenej dozvedela xx neskôr, uveďte xxxx a xxx (xxxxxxxxx x xxxxxxxxx xxxxxx - xxxxx xxx xxxxxxxxxx).

XX. Označte xxxxx činný x xxxxxxxx xxxxxx (xxxxxxxxx xxxxx, xxxxxx xxxxxxxxxxxxxx, xxx), xxxxx naposledy xxxxx konanie o xxxxxxxx xxxx. Uveďte xx xxxxxxx značku, xxx xxxxxx prebieha xxxxxxxxxxxx.

Xx xxxx x xxxxxxxxxx posledné rozhodnutie xxxxxx činného x xxxxxxxx konaní, ktoré xxxx xxxxxxxxx o xxx, x xxxx xxxxxx xx xxx xxxxxxxx (xxxx. uznesenie x odložení xxxxxxxxx xxxxxxxx, opis xxxxxxxx, xxxxxxxx - x xxxxxxxxxxxxx), pripojte ho x žiadosti.

VII. Uveďte, xxxx xxôxxxxx ste xxxxxxxxx xxxxx na xxxxxxx xxxxx xx xxxxxxxľx xxxxx xxxx xxxxx, xxxxx zodpovedá xx škodu.

Podľa ustanovenia §8 xxxxxx x. 209/1997 (Zb)., peňažitá xxxxx xx xôxx xxxxxx xxxxx xx xxxxxxxx x prihliadnutím xx xx, či xxxx využila všetky xxxxxxx xxxxxxxxxxx na xxxxxxxxxx xxxxxx na xxxxxxx škody od xxxxxxxľx alebo xxxx xxxxx, xxxxx xxxxxxxxx xx xxxxx. Xxxxx xxx xxxxxxxxxxx, xx xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

Xxx XXXX. Vyplňte, xx žiadateľ je xxxxxxxxxx po xxxxx, xxxxx v dôsledku xxxxxxxxx xxxx xxxxxxx.

XXXX. Xxxxxx, xx xxx xxxxxxx xxxxxx, ktorá xxľxx xxxxxxxxx xxxxxxx x §2 odst. 2 zákona x. 209/1997 Zb., xxxxxxxx xxľxx osôb spľňa xxxxx xxxxxxxxx, ak xx Xxx xxxxx xxxxxxxxxxx xxxxx.

1. Boli xxx rodičom, xxxxxxxx xxxxx dieťaťom xxxxx, xxxxx xxxxxxx x xôxxxxxx xxxxxxxxx xxxx?

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

3. Xxxxxxxxxxx Xxx xxxx trestného xxxx xxxxxx, xx xxxx x tomu xxxxxxx?

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

Xxxľx xxxxxxxxxxx §2 xxxx. 2 xxxxxx č. 209/1997 Zb. sa xx xxxx xxxxxxxx xxxxx pozostalá xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx činu xxxxxxx, ak xx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx x xxx žila v xxxxxxxxxx alebo xxxxx, xxxxxx xxxxxx xxxxxxxxxx xxxxx xxx xxxxxxx xxxxxxxxxx xxxxxx.

______________________________________________________________________________________________

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

XX. Xxxxxx xxxxx, xxxx sa xxxxxxxx xxxxxxxx, xxxxxxxxxx xxxx sa xxxxxxxx xxxxxxxx xxxxxxxxxxx.

X. Xxxxxxx xxxxx xxxxxxxx xxxxxxxxxxx xx bolesť činí:

K xxxxxxxx xx musí xxxxxxxx bodové xxxxxxxxxxx xx xxxxxx podľa xxxxxxxx č. 440/2001 Zb., ktoré xxxxxxxľ xxxxx xx xxxxxx, ktorý xx xxxxxxxxx. Tento xxxxxxxx xxxxxxx xxxx obsahovať xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxxx x bodové xxxxxxxxxx xxxxxxxx spoločenského xxxxxxxxxx. Pripomíname, že xxx xxxxx xxxxxx č. 209/1997 Zb. je relevantné xxx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xxxľx xxxxxxxxxxx §6 odst. 2 xxxxxx x. 209/1997 Xx. nemožno xxxxxxxxx' xxxxxxx xxxxx, xx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx xxxxxxxxxx xxxxxxxx 100 xxxxx.

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

Xxxľx ustanovenia §7 xxxx. 1 xxxx. a) zákona x. 209/1997 Xx. xx xxxxxxx obete xxxxx xxxxxxxxx xxxxxxx xxxxx vo výške xxxxxxxxx sumy 25&xxxx;000.- Xx, xxxxx xx xxxxx xxxxxxxxxxxxxx preukázaným xxxxxxxx na xxxxxxxx x xxxxxx xxxxxxx. Xx xx xxxxxxxxxx xxxxxx x peňažnú xxxxx xx xxxxx xxxxxxxxx xxxxxxx, xxxxxxxx xx xxxxxxxxx xxxx XXX. - XXX. xxxxx dotazníka.

XII. Xxxxxxx xxxxxxx x xxxxxxxx xxxxxx:

Xxx o náklady xx xxxxx, xxxxxxxxxxxx xxxôxxx, náklady xx xxxxxxxxxxxxx, xxxxxxxxx xxxxxx xxxxx xx pomoc x xxxxxxxxxx xx xxxxxxxxxx, xxxxxxx xxxxxxx xx xxxxxxx, x xxx. pod xxxxxxxxxx, xx xxxxx xxxxxxx xxxxxxxxx xxxxxxxxx. Xx xxxxxxx xxxxxxx xx xxxxx doložiť, xxxx xx xx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxx xxxx xxxx xxxxxľ.

XXXX. Xxxxxxx xxxxxxxxx pomery xxxxxxxľx xxxx x xx xxxxxx xxxx xx xxxxxx xxôxxxxxxx trestným xxxxx.

X xxxxxxxx pripojte xxxxxxx, xxxxx xxxxxxxxxx xxxxxxx xxxxxxxxxxx.

X prípade, xx xxxxxxxľ xx x xxxxxxxxxxxxxx pomere, xôxxx x potvrdenie xxxxxxxxxxxxľx o priemernom xxxxxxx xxxľx §351 x xxxx. xxxxxx x. 262/2006 Xx., xxxxxxxx xxxxx, v xxxxx xxxxxxxxxx xxxxxxxxx. Xx je xxxxxxxľ xxxxxx samostatne xxxxxxxxx xxxxxx, xxxxx xxxxxxxx xxxx xxxxxxxxx xxxx xxxxxxxxxx daňového xxxxxxxxx. Xx xxxxxxxľ poberá xxxxxxxx xôxxxxxx, dokladom, xxxxx môže xxxxxxx xxxxxxxx xxxxxxxx xxxxxxxx, xxxx xxxxxxxxxx x xxxxx xxxxxxxxxx xôxxxxxx. X xxxxxxx, že x xxxxxxxx xxxxxxxxx xôxxxx xxxxxxx xxxxxxx xxxxxxxxx xxxxxx žiadateľa, x xxxxxxx xxxxxxx xx možné xxxxxxxx xxxxxxxxxx o xxxx xxxxxxx xxxxxxxxxx.

XXX. Xxxxxx xxxxx xxxxxxxxxxxx xxxxx (xxxxxxxxxxx xôxxxxxx) x xxxx, xxxxxx xxx xxxxxxxľ xxxxxx, xx xxxxxxx xx xxxxxx xxxx na xxxxxx, xxôxxxxxxx trestným xxxxx.

X xxxxxxxx priložte xxxxxxxxxx xxxxxxxxxxxxľx alebo xxxxxxxxx x výške xxxxxxxxxxxx xxxxx. X xxxxxxx, xx v xôxxxxxx xxxxx na xxxxxx xxôxxxxxxx trestným xxxxx Xxx priznali invalidný xôxxxxxx, uveďte x xxxxxxx jeho xxxxx.

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

Xxxxxx xxxxxxxxxx, xx xxxxx na xxxxxxx xxxxx či obdobný xxxxx xx odškodnenie xxxx xxôxxxxxxx trestným xxxxx xxx xxxxxxxxxx(x) x žiadnom inom xxxxx ako x Xxxxxx (Xxxxxxxxxx) xxxxxxxxx.

Xxxxxx xx vedomie, xx xx xxxľx ust. §12 xxxxxx x. 209/1997 Xx., x xxxxxxxxxx xxxxxxxx pomoci xxxxxxx xxxxxxxx xxxxxxxx x x xxxxx x o xxxxxxxx xxxxxxxxxx zákonov, v xxxxx neskorších xxxxxxxxx, xxxxxx xxxxxxxxx xx xxxxxxx rokov odo xxx, keď mi xxxxxxxx xxxxx, xxxxxxx xx xxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxx, xxxxx xxx dostal(a) ako xxxxxxx škody, a xx xx xx xxxxx xxxxxxxxxxx xxxxxx. Xxxxxxx x xxx xxxxxx na xxxxxxx, xx po xxxxxxxx xxxxxxxxxx päťročnej doby xôxxx xxxxxxxx Ministerstvo xxxxxxxxxxxxxx, xxx xx x xxxx xxxxx xxxxxx práva xx xxxxxxxx xxxxxxxxxxx pomoci, xx xxxx sociálna xxxxxxxx xxxx xxxx xxxxxx odôvodňovať, celková xxxxx xxxxx, ktorú xx xxôxxxxxx a xxxxx xxxxxxx, ktorú xxx xxxxxx(x).

Xxxxxx tiež xx xxxxxxx, xx xxxxxxxxx xxxxxxxx nesprávneho xxxxx neúplného xxxxx xx xxxx xxxxxxxxx xx xxxxxx získania xxxxxxxxxxxx výhody, xx xôxxx xxxxxxxx priestupku xxxľx §21 odst. 1 xxxx. x) xxxxxx x. 200/1990 Xx., o xxxxxxxxxxxx, x znení neskorších xxxxxxxxx.

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

xxxxxx xxxxxxxľx xxxxx xxxxxxxx

- Xxxxxxxxxxxx xxxxxxxxxxxxxx Xxxxx xxxxxxxxx xx xxxxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx xxxľx zákona č. 209/1997 Zb. xxxxxxx xxx xxxxxx x xxxxx xxxxxxxx xxxxx. Potom xxxx xxxxxxxxxx xx xxxxxxx xx na xxxx xxxxxxxx xxxxxx podľa xxxxxxxxxxx xxxxxxxxx xxxxxxx. Xx troch xxxxxxxx xx podaní xxxxxxxx x predložení potrebných xxxxxxxx buď xxxxx xxxxxxxx xxxxx xxxxxxxľxxx xxxxxx xôxxxx, xxxxx xxxxx xxxxxxx poskynúť.

- X zmysle zákona č. 209/1997 Zb. bude xxxxxxxľ xxxxxxxxxx za xxxx xxx x prípade, xx xx v xôxxxxxx xxxxxxxxx činu xxxx xxôxxxxxx poškodenie xxxxxxx. Xxxxxxxxxxx, xxx xxxx xxxxxxxxxxxx podmienkou xx xxxxxxxxx xxxxxxxx xxxxxx xxxxx xxxxx xx xxxxx xxxxxxxx xxxxxxxxxxx xxxxxxx (nie xxxx xxxxxxxx spoločenského xxxxxxxxxx) xxxxxxxxxxxx aspoň 100 xxxxx. Xx xxxx xx považuje xx osoba pozostalá xx obeti, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, ak xxxx xxxxxxx, manželom xxxxx xxxxxxxx xxxxxxxxx x zároveň x xxxx xxxx smrti x xxx xxxx x xxxxxxxxxx, xxxxx xxxxx, xxxxxx xxxxxxx xxxxxxxxxx alebo xxx xxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx č. 209/1997 Zb. x xxxxxxxxxx peňažitej xxxxxx xxxxxxx xxxxxxxx xxxxxxxx xxxxxxxxx prekluzívnu (xxxxxxxx) xxxx 1 xxxx xxx xxx, xxx xx xxxx dozvedela x škode xxôxxxxxxx xxxxxxxx xxxxx. Ak xxxxx xxxx xx xxx xx deň xxxxxxxxx trestného činu, xxxx xxxxxxxx okamžik, xxxx xx to xxxxx. Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx xxxxxxxx žiadostiam x xxxxxxxxxxx peňažnej xxxxxx, xxxxx mu xxxxxxxx xx uplynutí xxxxxxxxxx lehoty.

- Xxxxx xx xx xxxxxxx xxxxx, ktorej v xôxxxxxx xxxxxxxxx xxxx xxxxxxx xxxxx xx xxxxxx, xxxxxxxx x xxxxxxxxx xxxx 25 000.- Xx xxxxx xx xxxxx, xxxxx xxxxxxxxxxx xxxxxxxxxx xxxxxx xx xxxxxxx, xxxxxxxxxx xxxxxxx xxxxxxx x liečením, xxxxxxx x súčet xxxxxxxx čiastok, ktoré xxxx z xxxxxx xxxxxxx xxxxx xx xxxxxxx; xxxxx xx xxxxxx xxxxx nesmie xxxxxxxxxx xxxx 150 000.- Xx. Xx obeť - po tom, xxx xxx xxxxxxxx xxxxx - xxxxxxxx, xx xxx xxxxxxxxx xxxxx xx vyššia xxx tá, xxxxx xxxx podkladom na xxxxxxxxxxx xxxxxx, xx xxx xxxxxxx v xxxxxx xxxxxxxxxx xxxxx xxxxxxx jej xxxxx xxxxxxxxx pomoc xxäx, x xx xx xx maximálnej xxxxx 150&xxxx;000.- Xx; pričom xx xxxxxxxxxx xx xxxxxxx, xxxxx xx xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, xxxxx xx xxxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx (xx xxxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x zároveň x xxxx xxxx xxxxx x ním xxxx x xxxxxxxxxx, xxxxx xxx xxxxxxx xxxxxxxxxx, či bol xxxxxxx xxxxxxxxxx výživu), xx poskytne xxxxxxx xxxxx v xxxxxxxxx xxxx 150&xxxx;000.- Xx; xxxxx xx xxxxxx xxxxx xxxxxx xxxxxxxxxx xxxx 450 000.- Kč, x xx xx xxxxx xxxxx viac xxx tri osoby, xxxxxxxxxxx xxxxxxx xx xxx xxxxxx obeti xxxxxxxxx xxxxx.

- Zákon č. 209/1997 Zb. xxxxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxxxxxxxxx xxxxxxxxxxľx xxxxxxxxxx xxxxxxxx, na xxxxx xxxxäxxxx xxxxxxx xxxxxxx xxxxxxxxx zodpovednosti. Xxxxx xx xxxxxxxx x xxxxxxxxxxxxxx xxxxxxxxxx xxxôx xxxxxx subjekt, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, x xxxxxxxxxxx xxxxxxxxx plnenia. Xxx x celkom ojedinelých xxxxxxxxx s xxxxxxxxxxxxx xx xxxxxxxxx xxxxxxxxx xxxxxxxxx je xxxxx xxxxxx xxxxxxxxxxxx spravodlivosti x xxxxxxxxxxx peňažnej xxxxxx.

- Xxxxxxxxxxx, že xx xxxxxxxxxx priložiť xxxxxx dostupné xxxxxxx x xxxxxxxxxx, na xxxxx xxxxxxxxxx pri xxxxxxxxxxxx xxxxxxxxx. Xx xxx xxxxxxxľ xxxxxxx, xxxxxxxxxxxx spravodlivosti nemôže xxxxxxx xxxxxxx. Xx xxxxxx xxxxxxxxxx a xxxxxxx xxx xxxxxxxxx xxxxxx, táto skutočnosť xôxx xxx xôxxxxx xxxxxxxxxxxxx xxxxxxxx xxxxxx xxxľx zákona č. 209/1997 Zb. Xx xxxx xxxxxxxxxx xxxxxxx xxxxx xxxx xxxxxxx.

- Xxxxxxxxxxxx, xx xx xxxx xxxxxxxľxxx xxxxxxxxxx xxxxxxx xxxxx, xxxxxxxľ xx do xxxxxxx rokov xxx xxx xxxxxxxxxxx xxxxxx xxxxxxx xx xxxx xxxxxxxxxxxx spravodlivosti xxxx, xxxxx dostal xxx xxxxxxx xxxxx (od xxxxxxxľx, xxxxxxxxx x xxx.) až do xxxxx poskytnutej pomoci. Xxxx povinnosť xxxx, xx xx xxxxx xxxxxxxxxx. Xx xxxxxxx xxxxxxxx xxxxx sa xxxxxxxxxxxx xxxxxxxxxxxxxx môže x mene xxxxx xx xxxxxxxx xxxxxxxxxx xäxxxxxxx xxxx xxxxx xxxxx na vrátenie xxxxxxxxxxx peňažnej pomoci. Xx xxxxxx postup xxôxxxxxxx xxxxxxxx situácia xxxxx, xxxxxxx výška xxxxx, xxxxx xxx xxôxxxxxx, x výška xxxxxxx, xxxxx xxxx xxxxxxx.