| 1 |
General
information |
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1.1 |
Place and date of birth |
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1.2 |
Nationality
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1.3 |
Religion
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1.4 |
Profession
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1.5 |
Education (school / college / university)
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1.6 |
Where were you living in your home country before
you left it?
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| 2 |
Have
you been persecuted because you belong to a religious group,
trade union, political party, political movement
or other organisation? If yes, please answer in your written
statement the following questions! |
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2.1 |
Name of the organisation (mention all names
if
there are various names) |
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2.2 |
What is the purpose of the organisation? |
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2.3 |
Is it legal or banned? |
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2.4 |
When and where did you join the organisation? |
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2.5 |
Have you been trained by the organisation? |
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2.6 |
What did you do for the organisation? How often?
E.g. did you
participate in any campaigns or other activities? |
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2.7 |
Was the organisation watched / under observation
by the police? |
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2.8 |
Were members of the organisation persecuted?
If yes, in which
way? |
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2.9 |
Have they been physically attacked or tortured? |
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2.10 |
Have they been arrested or detained? If yes:
by whom? With or
without trial? What were they accused of? |
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2.11 |
Were they released later? When? Where are they
living now? Could
they give testimony of what happened to you? |
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2.12 |
Do you belong to another organisation? If yes,
answer the questions
2.1. to 2.11. again for this second organisation please! |
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| 3 |
Have you been persecuted because you belong to
a tribe or ethnical group? If yes, please answer in your written
statement the following questions! |
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3.1 |
Name of the tribe or ethnical group (mention
all names if there are various names) |
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3.2 |
Where are the members of this tribe or ethnical
group living? Are they in a minority position at the place where
you were living? |
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3.3 |
Were members of the tribe or ethnical group
persecuted? If yes, in which way?
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3.4 |
Have they been physically attacked or tortured? |
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3.5 |
Have they been arrested or detained? If yes:
by whom? With or without trial? What were they accused of? |
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3.6 |
Were they released later? When? Where are they
living now? Could they give testimony of what happened to you? |
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| 4 |
Have you been persecuted because you have a certain
religion? If yes, please answer in your written statement the
following questions! |
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4.1 |
Name of the religion (mention all names if there
are various names) |
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4.2 |
Where do the members of this religion live? Are
they a minority where you lived? |
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4.3 |
Were members of the religion persecuted? If
yes, in which way?
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4.4 |
Have they been physically attacked or tortured? |
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4.5 |
Have they been arrested or detained? If yes:
by whom? With or without trial? What were they accused of? |
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4.6 |
Were they released later? When? Where do they
live now? Could they give testimony of what happened to you? |
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| 5 |
Have you
been arrested? If yes, please answer in your written statement
the following questions! |
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5.1 |
Who arrested you? The police, a secret service,
the army? |
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5.2 |
Where and when (day / hour)? |
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5.3 |
For what reason? |
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5.4 |
Where there witnesses of your arrest? |
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5.5 |
How long were you arrested? And where?
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5.6 |
Have you been trialed by a court? What was the
sentence? What was the crime you were accused of? |
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5.7 |
Please describe in detail the prison and the
conditions in the prison! (Building, cells, food, guards, other
prisoners) |
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5.8 |
Were other prisoners beaten, tortured or in other
ways badly treated? In
which way? |
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5.9 |
Have you been interrogated? How often? When?
By whom? What were you accused of? What did they expect you
to say? |
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5.10 |
Were you threatened or badly treated? |
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5.11 |
How did you get out of the arrest / the imprisonment?
Please give details if you escaped! |
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5.12 |
Do you know former prisoners who are now living
abroad? Could they give
testimony of what happened to you? |
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5.13 |
Have you been arrested a second or third
time? If yes, please answer again the questions 5.1. to 5.12.
for these arrests! |
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| 6 |
Have you been in other ways
persecuted than by arrests? Or were you threatened to be persecuted?
If yes, please
give details answering the following questions! |
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6.1 |
How often? |
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6.2 |
When? Where? |
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6.3 |
In which way? What might have happened to
you?
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6.4 |
By whom? |
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6.5 |
Why? |
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6.6 |
Are there witnesses? Where are they living now? |
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| 7 |
Were members of your family
or close friends persecuted? If yes, please answer the following
questions! |
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7.1 |
How was he or she persecuted? Was he or she arrested? |
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7.2 |
When and where? |
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7.3 |
Why? What was he or she be accused of? |
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7.4 |
Was he or she beaten, tortured or in other
ways badly treated?
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7.5 |
Where is he or she living now? |
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7.6 |
Were other members of your family or close friends
persecuted? If yes, please answer again to the questions 7.1.
to 7.5. for each of them! |
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| 8 |
How did you flee / travel
from your home country into your asylum country? |
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You might be asked a lot of details in the interview,
if there is to be one in your asylum country. So you better
prepare yourself by writing down step by step what happened
to you when and where. However, no interview should be limited
to these questions. Insist on telling about your persecution. |
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| 9 |
If you have lived in a third
country before entering your asylum country, please describe
why you had to leave from
there. If you have been politically active in the third country,
please give details! Have your activities been noticed by the
authorities of your home country? If yes, how? |
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| 10 |
If you are politically active
in your asylum country, please give details on your activity,
your functions
etc.! Have your activities been noticed by the authorities of
your home country? If yes, how? Can you prove your activities
by witnesses or documents? |
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| 11 |
Have you any documents
or photos referring to what you have written down until now?
Could you get hold
of such documents? |
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| 12 |
Do you wish to get medical
or psychological treatment because of what happened to you?
Have you already
seen a doctor or psychologist for this reason? |