ANNEXES ANNEXE III: Model format for communications/complaints (Source: Human Rights Fact Sheet No. 7: Communications Procedures, UN, Geneva.) Several bodies dealing with communications have developed a model format to facilitate their examination of reported violations of human rights and these have been made available to those wishing to report cases of alleged violations. It should, however, be noted that communications are considered even when they are not submitted in the form of the format. Whatever the reporting format, the precise address of the body to which a reported case(s) is (are) sent for examination should appear at the very beginning of the communication so as to ensure its easy and immediate channeling to the addressee. Model communication Date ........................ III. State concerned/Articles violated/domestic remedies Communication to: Name of the state party (country) to the International Convention on the Elimination of All Forms of Racial Discrimination against which the communication is directed .......................................................................................................... Secretariat Committee on the Elimination of Racial Discrimination c/o Office of the High Commissioner of Human Rights Palais des Nations, 1211 Geneva 10, Switzerland Articles of the International Convention on the Elimination of All Forms of Racial Discrimination allegedly violated .......................................................................................................... I. Information concerning the author of the communication Name ....................................... First name(s) ................................ Nationality................................ Profession ................................... Date and place of birth ................................................................... Present address ................................................................................ .......................................................................................................... .......................................................................................................... Address for exchange of confidential correspondence (if other than present address) .......................................................................................................... .......................................................................................................... Submitting the communication as: (a) Victim of the violation or violations set forth below (b) Appointed representative/legal counsel of the alleged victim(s) (c) Other If box (c) is marked, the author should explain: (i) In what capacity he/she is acting on behalf of the victim(s) (e.g. family relationship or other personal links with the alleged victim[s]) .......................................................................................................... (ii) Why the victim(s) is (are) unable to submit the communication himself/herself (themselves) .......................................................................................................... An unrelated third party having no link to the victim(s) cannot submit a communication on his/her (their) behalf. II. Information concerning the alleged victim(s) (if other than the author) Name ....................................... First name(s) ................................ Nationality................................ Profession ................................... Date and place of birth ................................................................... Present address or whereabouts ..................................................... .......................................................................................................... .......................................................................................................... Steps taken by or on behalf of the alleged victim(s) to exhaust domestic remedies — recourse to the courts or other public authorities, when and with what results (if possible, enclose copies of all relevant judicial or administrative decisions) .......................................................................................................... If domestic remedies have not been exhausted, explain why .......................................................................................................... IV. Other international procedures Has the same matter been submitted for examination under another procedure of international investigation or settlement (e.g. the Inter-American Commission on Human Rights, the European Commission on Human Rights)? If so, when and with what results? .......................................................................................................... V. Facts of the claim Detailed description of the facts of the alleged violation or violations (including relevant dates)* ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... ........................................................................................................... Author s signature ............................................................................. * Add as many pages as needed for this description. ICERD: A GUIDE FOR NON-GOVERNMENTAL ORGANIZATIONS 25