Case Fact Sheet

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DETAILS OF DOCUMENTER
Name of person submitting Case Factsheet*

First NameLast Name
Organization / Affiliation*
Write the full name of your Organization / Affiliation
Date of Submission*

YearMonthDay
Date
Contact Details*

EmailPhone Number
Email*
example@example.com
Phone Number*
Is the documenter submitting this case factsheet as primary data?*

Yes - (Primary data refers to data that are gathered directly from the victim/s, family/ies of the victim/s, member/s of the Indigenous Peoples that were affected.)No
Please provide information on source of data.

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DATA-SHARING AGREEMENT
As the documenter, I understand that Indigenous Peoples Rights International (IPRI) will record the information detailed in this case factsheet in its database. I am submitting this case factsheet with the following restrictions: (tick as preferred)*

The information in this case factsheet can be used by IPRI only in understanding broad trends of criminalization, violence and impunity against Indigenous Peoples but cannot specifically refer to any of the details of this case.The information in this case factsheet can be used by IPRI in understanding broad trends of criminalization, violence and impunity against Indigenous Peoples and can specifically refer to any of the details of this case.
PLACE AND DATE OF INCIDENT
Country of incident*
Subnational location*
(Specify what state, department, county, province etc.)
Other Location Details (1)
(Specify what city or municipality)
Other Location Details (2)
(Specify what town, village, etc.)
Is the case ongoing?

YesNo
Date of Incident*
Start Date of Incident*

YearMonthDay
Date
Time of Incident

Hour Minutes

AM/PM Option
VICTIM PROFILE
Does the case involve individual/s or group/s of people (E.g., an entire village, members of an ethnic community, etc.)?*

Individual - (Choose this category if the name/s of the victim/s is/are known)Group of People - (Choose this category if the name/s of the victims are too many to identify and are not known, e.g., 100 of members of an entire indigenous community or an entire village etc)Both - (Choose this category if the case involves both an Individual and Group of people)
Individual Victim Profile
Name/s (Write Full Name)*
Gender (Write M=Male; F=Female; Z= LGBTQIA+)(If more than one individual, indicate Gender of Individual according to the sequence of Name listed.)
Dependent type (Write WD=with dependents; WOD=without dependents; ND= no data)(If more than one individual, indicate Dependent Type according to the sequence of Name listed.)
Please provide details of dependents. (E.g., children, partner, grandchildren etc.) (List details of dependents according to the sequence of Name listed.)
Name/s of Indigenous Peoples’ group or Ethnic Identity/ies of victim/s (If more than on individual, list Indigenous Peoples’ group or Ethnic Identities according to the sequence of Name listed.)*
Date of Birth (Write YYYY-MM-DD) (If more than one individual, list Date of Birth according to the sequence of Name listed.)
Age Bracket (Write A= 0-14 years old; B= 15-24 years old; C= 25-59 years old; D= 60 years old and above) (If more than one individual, indicate Age Bracket according to sequence of Name listed.)
Role/s of the Victim/s in the Community (The response in this field can be elder, healer or spiritual leader, community organizer, a vocal protester against human rights violations, etc.) (If more than one individual, write Role of the Victim in the Community according to the sequence of Name listed.) This information is meant to capture the victim/s’s involvement in the community and understand why s/he or they was/were the target of human rights violation and/or the impact of the human rights violation against him/her/them to the community or movement.
Group Victim Profile
Name/s of Indigenous Peoples’ group or Ethnic Identity/ies of peoples affected (If more than one Indigenous Peoples' group, list the name of each group.)*
Number of affected people*
Specify if number refers to individuals, families, homes, groups, communities, villages etc. (E.g., 100 families, 250 homes)
Does the number of affected people refer to individuals

YesNo
If no, please provide more information
Write the number of male from the total number of individuals affected:
Write the number of female from the total number of individuals affected:
Write the number of 0-14 years old from the total number of individuals affected:
Write the number of 60 years old and above from the total number of individuals affected:
DETAILS OF INCIDENTS OF HUMAN RIGHTS VIOLATIONS
Categories of Incidents of Human Rights Violations*

Criminalization - defined as the misuse of criminal laws that involves the manipulation of the punitive power of the State and non-state actors in order to control, punish and/or prevent the exercise of the right to defend human rights. It can also occur when state and non-state actors use and misuse their position of power, even without using any laws/policies, to control, punish and/or prevent the exercise of Indigenous Peoples’ right to defend their individual and collective rights (E.g. trumped-up charges, red-tagging, or accusing of individuals/organizations as terrorist groups/as enemy of the State, illegal detention, etc.)KillingOther Type of Human Rights Violation - refers to any other incident of human rights violations that are neither criminalization nor killing, and are linked to the protection and defense of Indigenous Peoples’ on their rights to lands, territories and natural resources, self-government, cultural integrity. (E.g., attacks against life and security (except killings) like torture, enforced disappearance, kidnapping, illegal detention, sexual harassment, violation of collective right to free, prior and informed consent (FPIC), forced eviction, displacement, land grabbing etc.)
Details of Criminalization
Why was/were the victim/s criminalized?*
(E.g., S/he or they are defending their lands from being grabbed. S/he or they are protecting their traditional livelihood of pastoralism or defending their right to self-government, etc.)
Did the victim/s experience any form of harassment or intimidation prior to criminalization?*

YesNoNo information
If yes, please provide more information
What was/were the accusation/s or charge/s filed against the victim/s?*
What was/were the policy/ies or law/s or institutional justification/s used against the victim/s?*
Who put forward the accusation/s or charge/s against the victim/s?

National-level government officialArmed forcesFederal-level government officialIntelligence agency; secret serviceLocal government officialsVigilante groups; death squadsOfficial in the judiciaryGuerrilla armies officialsPrison officialNational or local corporationPoliceTransnational CorporationOther
Please provide more information
Was/were the accusation/s or charge/s against the victim legally or formally filed?*

YesNoNo Information
If yes, where was the case/s filed? (e.g., regional court, military court, supreme court, etc.)*
If no, please provide more information
Status of the incident of criminalization
Is there a decision on the legal or formal accusation/s or charge/s filed against the victim/s?

YesNoNo Information
Please provide more information
Is/Are the victim/s in prison or detention facility?

YesNoNo Information
If no, please provide more information on the current situation of the victim/s—Is/Are s/he/they in hiding? Released on bail? Awaiting court trial? On house arrest? etc.
If yes, please provide more information on their conditions or situation in the prison or detention facility—do they know where is the prison or detention facility located? Are they allowed visitors?
Was/Were there (a) legal case/s filed against the alleged perpetrators on behalf of the victim/s criminalized?

YesNoNo Information
If no, please elaborate on your response (e.g. can you provide probable reasons on why there has been no legal case/s filed against the alleged perpetrators? Etc.)
If yes, please provide further information: Where is/are the case/s filed? Who filed the case? E.g., victim, family of the victim, support organizations, etc.; any other details of the case/s filed, please share.
Where is/are the case/s filed? Who filed the case? E.g., victim, family of the victim, support organization, etc.; any other details of the case/s filed, please share.
Has the State undertaken any action/s to address the incident of criminalization?

YesNoNo Information
If no, please elaborate on your response
If yes, please provide more information on the action/s undertaken, including any relevant results.
Has there been any investigation/s on the incident of criminalization?

YesNoNo Information
If no, please elaborate on your response. (e.g. can you provide probable reasons on why there has been no investigation/s conducted? Or, is the case not yet publicly reported? Etc.)
If yes, please provide additional information on the investigation, including relevant date/s and institutions/ office/s or representative/s involved, e.g., national human rights institutions, United Nations body, etc.
Details of Killing
Why was/were the victim/s killed?*
(E.g., S/he or they are defending their lands from being grabbed. S/he or they are protecting their traditional livelihood of pastoralism or defending their right to self-government, etc.)
How was the killing carried out?*
(E.g., shooting, bombing, resulted from torture, etc.)
Did the victim/s experience any form of harassment or intimidation prior to the killing? E.g. death threats, etc.*

YesNoNo information
If yes, please provide more information.
Is/Are the alleged perpetrator/s known?

YesNo
(Tick as many as applicable)

National-level government officialArmed forcesFederal-level government officialIntelligence agency; secret serviceLocal government officialsVigilante groups; death squadsOfficial in the judiciaryGuerrilla armies officialsPrison officialNational or local corporationPoliceTransnational CorporationOther
Please provide more information
Status of incident of killing
Was/Were there (a) legal case/s filed against the alleged perpetrators on behalf of the victim/s killed?

YesNoNo Information
If no, please elaborate on your response. (e.g. can you provide probable reasons on why there has been no legal case/s filed against the alleged perpetrators? Etc.)
If yes, please provide further information: Where is/are the case/s filed? Who filed the case? E.g., victim, family of the victim, support organizations, etc.; any other details of the case/s filed, please share.
Where is/are the case/s filed? Who filed the case? E.g., victim, family of the victim, support organization, etc.; any other details of the case/s filed, please share.
Has the State undertaken any action/s to address the incident of killing?

YesNoNo Information
If no, please elaborate on your response
If yes, please provide more information on the action/s undertaken, including any relevant results.
Has there been any investigation/s on the incident of killing?

YesNoNo Information
If no, please elaborate on your response. (e.g. can you provide probable reasons on why there has been no investigation/s conducted? Or, is the case not yet publicly reported? Etc.)
If yes, please provide additional information on the investigation, including relevant date/s and institutions/ office/s or representative/s involved, e.g., national human rights institution, United Nations body, etc.
Details of Other Type of Human Rights Violations
What was/were the human rights violation/s? (Tick as many as applicable.)*

Violation of collective right to free, prior and informed consent (FPIC)Land grabbingArbitrary detentionPhysical injury/Beatings/TortureForced displacementForced evictionEnforced disappearanceKidnappingSexual Violence and other forms of gender-based violenceOther
Why did the victim/s suffer from the human rights violation/s?*
(E.g., S/he or they are defending their lands from being grabbed. S/he or they are protecting their traditional livelihood of pastoralism or defending their right to self-government, etc.)
Is/Are the alleged perpetrator/s known?*

YesNo
(Tick as many as applicable)

National-level government officialArmed forcesFederal-level government officialIntelligence agency; secret serviceLocal government officialsVigilante groups; death squadsOfficial in the judiciaryGuerrilla armies officialsPrison officialNational or local corporationPoliceTransnational CorporationOther
Please provide more information
Was/Were there legal case/s filed against the alleged perpetrators on behalf of the victim/s?*

YesNoNo information
If no, please elaborate on your response. (e.g. can you provide probable reasons on why there has been no legal case/s filed against the alleged perpetrators? Etc.)
If yes, please provide further information: Where is/are the case/s filed? Who filed the case? E.g., victim, family of the victim, support organizations, etc.; any other details of the case/s filed, please share.
Please provide details of the legal case against the alleged perpetrator/s
Has the State undertaken any action/s to address the incident of human rights violation/s?

YesNoNo Information
If no, please elaborate on your response
If yes, please provide more information on the action/s undertaken, including any relevant results.
Has there been any investigation/s on the incident of other type of human right violation?

YesNoNo Information
If no, please elaborate on your response. (e.g. can you provide probable reasons on why there has been no investigation/s conducted? Or, is the case not yet publicly reported? Etc.)
If yes, please provide additional information on the investigation, including relevant date/s and institutions/ office/s or representative/s involved, e.g., national human rights institution, United Nations body, etc.
IMPACT/S OF THE INCIDENT/S OF HUMAN RIGHTS VIOLATION
How did the incident/s affect the victim/s and his/her/their family?
(E.g., the family members had to relocate for safety. Or, the family lost a breadwinner, etc.)
How did the incident/s affect the Indigenous Peoples group/s or community/ies and/or organization of the victim/s?
(E.g., disrupted livelihood, culture and tradition, functions of indigenous institutions, community cohesion, cannot access ancestral territories and resources, rituals are affected etc.)
OTHER ACTION/S UNDERTAKEN
Is/Are there any other advocacy and/or action/s undertaken*

YesNoNo Information
Please elaborate on any action/s at national level and indicate the actor who initiated the action/s.
(E.g., community mobilization organized by family and local organization, fund-raising to support lawyers, communication submitted to national/regional human rights institution initiated by local organization and international NGO, etc.)
If no, please provide more information.
DEVELOPMENT PROJECT PROFILE
Is the case related to (a) development project/s?*

YesNoNo Information
If yes, do you have further details on the development project/s?*

YesNo
Type of Development Project

InfrastructureEnergyConservationMiningAgribusinessTourismOther
Name of development project/s
Description of development project/s
(Provide details of the development project/s. E.g, land/surface area of project if known.)
Indicate year of project's start of operation on the country where the incident of human rights violation happened
Source of information on development project

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PARENT COMPANY PROFILE
Do you know if the development project/s has/have a parent company offshore?

YesNo
Country of parent company
Description of parent company
Source of information on parent company

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File Upload

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SOURCE OF FUNDING PROFILE
Do you know if the development project/s is/are linked to any financial institution/s?

YesNo
Type of Funding source/s

State-SponsoredInternational Financial InstitutionsPrivate BanksCommercial BanksPrivate InvestorsPrivate CorporationsOther
Description of Source/s of Funding
Source of information on Funding Source

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File Upload

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We have an updated form!

DETAILS OF DOCUMENTER

DATA-SHARING AGREEMENT

PLACE AND DATE OF INCIDENT

VICTIM PROFILE

Individual Victim Profile

Group Victim Profile

DETAILS OF INCIDENTS OF HUMAN RIGHTS VIOLATIONS

Details of Criminalization

Status of the incident of criminalization

Details of Killing

Status of incident of killing

Details of Other Type of Human Rights Violations

IMPACT/S OF THE INCIDENT/S OF HUMAN RIGHTS VIOLATION

OTHER ACTION/S UNDERTAKEN

DEVELOPMENT PROJECT PROFILE

PARENT COMPANY PROFILE

SOURCE OF FUNDING PROFILE