New Case Enquiry Form Thank you for approaching REDRESS in relation to this case. REDRESS is a small human rights organisation based in London and The Hague. Where we can, we seek to help torture survivors obtain justice and reparation. Our mission is: i) to deliver justice and reparation for survivors of torture, ii) to challenge impunity for perpetrators, and iii) to advocate for legal and policy reforms to combat torture.Given our size we only take on a few new cases every year. Whilst investigating your case, we will be polite and considerate, keep your information confidential, and not discriminate against anyone. If REDRESS is able to take on this case, we will put your interests first when representing you, treat all our clients fairly and, make every effort to provide relevant and realistic advice. To help us consider whether or not we can take on your case, please answer as many questions as possible in the form below. Please do not worry if you are unable to fill in some of the questions, complete as many as you can.Once the form has been submitted, we will review the information as soon as we can and then let you know whether or not we can take on your case. This process can take several weeks.YOUR CONTACT INFORMATIONTitle and name* Enter your titleMx.Mr.Mrs.MissMs.Dr.Prof.Rev. Title First Name Family Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home numberWork numberMobile numberFax numberEmail I am happy for REDRESS to contact me by:* Post Phone Email ADDITIONAL INFORMATIONDo you need an interpretation from English? Yes No Which language do you need an interpretation for?*What is your gender? Male Female Unspecified Date of birth DD slash MM slash YYYY Place of birthNationality at birthEthnicityNationality(ties)Please indicate your current location.Including address where available.Date of arrival in current location DD slash MM slash YYYY Please indicate your residential status. Citizen/ National Refugee (granted) Refugee (in progress) Asylum (granted) Asylum (in process) Other Please indicate your marital status and if you have children.STEPS ALREADY UNDERTAKEN (IF RELEVANT)Facts alleged: description of torture, when and where it occurred, by whom (names of authorities or individuals), and what happened. Brief details of any action already undertaken to seek justice, accountability and reparation in the State where the torture occurred.Brief details of any action(s) already undertaken to seek justice, accountability and reparation in your home State, if different from above.Brief details of any remedies, reparations, or awards already made, if applicable, in the State where the torture occurred.Brief details of any medical or psychological reports relating to torture obtained in/from the State where the torture occurred.Brief details of any other documentation of the torture available (photographs, witness statements or a list of people willing to provide statements; links to YouTube or other online videos; links to reports by NGOs or other bodies referring to the case).File Drop files here or Select files Max. file size: 50 MB. Use of the informationOur use of the information you provide is subject to your instructions, the Data Protection Act 1998 and our duty of confidentiality. If we need to speak with and provide information to third parties (such as experts or other professional advisers) we will always put in place a confidentiality agreement with these individuals. If however, you do not want your case to be disclosed to individuals outside the organisation, please tell us in advance.* I am happy for REDRESS to speak with and provide information to third parties. I prefer my information not to be disclosed to third parties.