COUR EUROPEENNE DES DROITS DE L’HOMME EUROPEAN COURT OF HUMAN RIGHTS AVRUPA ÝNSAN HAKLARI MAHKEMESÝ Conseil de l’Europe - Council of Europe - Avrupa Konseyi Strasbourg, France COUR EUROPEENNE DES DROITS DE L’ HOMME
EUROPEAN COURT OF HUMAN RIGHTS
AVRUPA ÝNSAN HAKLARI MAHKEMESÝ
Conseil de l’ Europe - Council of Europe - Avrupa Konseyi Strasbourg, France
REQUÊTE
APPLICATION
BAÞVURU
présentée en application de l’ article 34 de la Convention europeenne des Droits de l’ Homme,
ainsi que des articles 45 et 47 du Règlement de la Cour
underArticle 34 of the European Convention on Human Rights
and Rules 45 and 47 of the Rules of Court
Avrupa Ýnsan Haklarý Sözleþmesi’nin 34. ve Mahkeme Ýç Tüzüðü’ nün
45 ve 47. maddeleri uyarýnca sunulmuþtur.
IMPORTANT: La présente requête est un document juridique et peut affecter vos droits et obligations.
This application is a formal legal document and may affect your rights and obligations.
Bu baþvuru hukuki bir belgedir ve hak ve yükümlülüklerinizi etkileyebilir.
I- LES PARTIES
THE PARTIES
TARAFLAR
A. LE REQUÉRANT/LA REQUERANTE
THE APPLÝCANT
BAÞVURUCU
(Renseignements à fournir concernant le requérant/la requérante et son/sa represantant(e) éventuel(le)
(Fill in the following details of the applicant and the represantative, If any)
(Baþvurucu ve varsa temsilcisi hakkýnda verilmesi gereken bilgiler)
1. (Nom de familie/ Surname)
Soyadý............................................ ....
2. (Prénom (s)/ First name (s))
Adý............................................... ......
(Sexe: masculin/feminin
Sex: male/female)
Cinsiyeti: erkek/kadýn
3. (Nationalité/Nationality)
Milliyeti......................................... .
4.(Profession/Occupation)
Mesleði........................................... .
5. (Date et lieu naissance/Date and Place of birth)
Doðum tarihi ve yeri .................................................. ......
6.(Domicile/Permanent address)
Ýkametgahý ..................................................
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7. Tel. No.......................................
8. (Adresse actuelle (si diffêrente de 6.)/ Present address (if different from 6.))
Þu anki adresi (6’da belirtilen ikametgahýndan farklý ise) ..........................
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9. (Nom et prénom du/de la représentant(e)/ Name of represantative)
Temsilcinin adý.......................................
10. (Profession du/de la représentant(e)/Occupation of represantative)
Temsilcinin mesleði........................................
11.( Adresse du/de la représentant(e)/ Adress of represantative)
Temsilcinin adresi...................................
12. Tel No................................................ .........
Fax No................................................ ..............
B. LA HAUTE PARTIE CONTRACTANTE
THE HIGH CONTRACTING PARTY
YÜKSEK SÖZLEÞMECÝ TARAF
(Indiquer ci-après le nom de l’ Etat/des Etats contre le(s)quel(s) la requète est dirigée)
(Fill in the name of the State(s) against which the application is directed)
(Aþaðýda baþvurunun hangi devlet aleyhine yöneltildiðini belirtiniz.)
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(*) Si le/la requérant(e) est represanté(e), joindre une procuration signée par le/la requérant(e) en faveur dulde la représentant(e) A form of authority signed by the applicant should be submitted it a reprasentative is appointed.
Eðer baþvurucu temsil ediliyorsa, temsilciyi vekil atayan ve baþvurucunun imzasýný taþýyan bir Yetki Belgesi ekleyiniz.
II- EXPOSÉ DES FAITS
STATEMENT OF THE FACTS
OLAYLARA ÝLÝÞKÝN AÇIKLAMA
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Si nécessaire, continuer sur une feuille séparée
Continue on a separate sheet if necessary
Eðer gerekli görüyorsanýz ayrý bir sayfada devam edebilirsiniz.
III- EXPOSÉ DE LA OU DES VIOLATION(S) DE LA CONVENTION ET/OU DES PROTOCOLES ALLÉGUÉE(S), AINSI QUE DES ARGUMENTS Â L’ APPUI
STATEMENT OF ALLEGED VIOLATION(S) OF THE CONVENTION AND/OR PROTOCOLS AND OF RELEVANT ARGUMENTS
BAÞVURUCU TARAFINDAN ÖNE SÜRÜLEN SÖZLEÞME VE PROTOKOL ÝHLALLERÝ ÝLE ÝDDÝALARIN DAYANAKLARINA ÝLÝÞKÝN AÇIKLAMA
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Si nécessaire, continuer sur une feuille séparée
Continue on a separate sheet if necessary
Eðer gerekli görüyorsanýz ayrý bir sayfada devam edebilirsiniz.
IV- EXPOSÉ RELATIF AUX PRESCRIPTIONS DE L’ ARTICLE 35 § 1 DE LA CONVENTION
STATEMENT RELATIVE TO ARTICLE 35 § 1 OF THE CONVENTION
SÖZLEÞMENÝN 35. MADDESÝNÝN 1. FIKRASINA ÝLÝÞKÝN AÇIKLAMA
Her þikayet için, gerektiðinde ayrý bir sayfa kullanarak, aþaðýda 16’ da 18’ e kadar numaralanmýþ alt bölümlerde istenen bilgileri veriniz)
16. Décision interne définitive (date et-natura de la décision, organe - judiciaire ou autre - l’ ayant rendue)
Final decision (date, court or authority and nature of decision)
Nihai karar (kararýn tarihi, niteliði, Kararý veren merci -adli veya diðer-)
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Si nécessaire, continuer sur une feuille séparée
Continue on a separate sheet if necessary
Eðer gerekli görüyorsanýz ayrý bir sayfada devam edebilirsiniz.
17. Autres décisions (énumérées dans l’ ordre chronologique en indiquant, pour chaque décision, sa date, sa nature et l’ organe -judiciaire ou autre- l’ ayant rendue)
Other decisions (list in chronological order, giving date, court or authority and nature of decision for each of them)
Diðer kararlar (tarih sýrasýna göre her kararýn tarihi, niteliði ve kararý veren merci -adli veya diðer- belirtilmelidir.)
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Si nécessaire, continuer sur une feuille séparée
Continue on a separate sheet if necessary
Eðer gerekli görüyorsanýz ayrý bir sayfada devam edebilirsiniz.
18. Dipos(i)ez-vous d’ un recours que vous n’ avez pas exercé? Si oui, lequel et pour quel motif n’a-t-il pas été exercé?
Is there or was there any other appeal or other remedy available to you which you have not used.
If so, explain why you have not used it.
Baþvurmadýðýnýz baþka bir çözüm yolu var mý? Eðer varsa, nedir ve neden bu yola baþvurulmadý?
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Si nécessaire, continuer sur une feuille séparée
Continue on a separate sheet if necessary
Eðer gerekli görüyorsanýz ayrý bir sayfada devam edebilirsiniz.
V- EXPOSÉ DE L’ OBJET DE LA REQUÈTE ET PRÉTENTIONS PROVISOIRES POUR UNE SATISFACTION EQUITABLE
STATEMENT OF THE OBJECT OF THE APPLICATION AND PROVISIONAL CLAIMS FOR JUST SATISFACION
BAÞVURUNUN AMACINA VE HAKKANÝYETE UYGUN TATMÝN TALEPLERÝNE ÝLÝÞKÝN AÇIKLAMA
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Si nécessaire, continuer sur une feuille séparée
Continue on a separate sheet if necessary
Eðer gerekli görüyorsanýz ayrý bir sayfada devam edebilirsiniz.
VI- AUTRES INSTANCES INTERNATIONALES TRAITANT OU AYANT TRAITÉ L’ AFFAIRE
STATEMENT CONCERNING OTHER INTERNATIONAL PROCEEDINGS
DÝÐER ULUSLARARASI MAKAMLAR ÖNÜNDEKÝ USULLERE ÝLÝÞKÝN AÇIKLAMA
20. Avez-vous soumis à une autre instance internationale d’enquéte ou de règlement les griefs énoncés dans la présente requète? Si oui, fournir des indications détalilées à ce sujet.
Have you submitted the above complaints to any other procedure of international investigation or settlement? If so, give full details.
Bu baþvurunuzdaki þikayetlerinizi baþka bir uluslararasý makama sundunuz mu?
Eðer sunduysanýz, bu konuda ayrýntýlý bilgi veriniz.
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Si nécessaire, continuer sur une feuille séparée
Continue on a separate sheet if necessary
Eðer gerekli görüyorsanýz ayrý bir sayfada devam edebilirsiniz.
VII- PIÈCES ANNEXÉES (PAS D’ ORIGINAUX, UNIQUEMENT DES COPIES)
LIST OF DOCUMENTS (NO ORIGINAL ONLY PHOTOCOPIES)
BELGELER LÝSTESÝ (BELGELERÝN ASLI DEÐÝL SADECE ÖRNEKLERÝ )
(Voir chapitre VII de la note explicative, joindre copie de toutes les décisions mentionnées sous ch. V et VI ci-dessus. Se procurer, au besoin, les copies nécessaires, et, en cas d’impossibilité, expliquer pourquoi ceiles-ci ne peuvent pas ètre obtenuès. Ces documents ne vous seront pes retcurnès.)
(Include copies of all decisions refered to in Parts IV and VI above. If you do not have copies, you should obtain them. If you cannot obtain them, explain why not. No documents will be returned to you.)
(Yukardaki IV ve VI. alt bölümlerde belirtilen bütün kararlarýn örneðini ekleyiniz. Eðer bu belgeler elinizde yoksa temin ediniz. Eðer temin edemiyorsanýz bunun nedenini açýklayýnýz. Gönderdiðiniz belgeler size geri verilmeyecektir.)
21.
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VIII- DÉCLARATION ET SIGNATURE
DECLARATION AND SIGNATURE
BÝLDÝRÝM VE ÝMZA
22. Je déclare en toute conscience et loyauté que les renseignements qui figurent sur la présente formule de requète sont exacts.
I hereby declare that, to the best of my knowledge and belief, the information I have given in the present application form is correct.
Bu baþvuru formunda vermiþ olduðum bilgilerin doðru olduðunu bilgim ve inancým
dahilinde beyan ederim.
Lieu/Place /Yer............................................... .........................
Date/Date /Tarih............................................. .........................
(Signature du/de la requérant(e) ou du/de la représentant(e))
(Signature of the appilcant or of the representative)
(Baþvurucunun veya temsilcinin imzasý)
Konu: AÝHM'ne Bireysel Baþvuru Örnek Dilekçe (Okunma sayýsý 143 defa)
Gösterim: 466 -