Housing and Land Rights Violation Case Documentation Form
I.
Date(s) of violation:---/-------/---- (through ---/-------/----)
Time(s) of violation:---/-------/---- (through ---/-------/----)
Date you began this record:--/--/---- Date you completed this record: --/--/----
Type of area: urban
What is the type ofviolation? forced eviction q
confiscation
If other, define theviolation: ------------------------------------------------------
II.A
What is the nameby which the community is commonly known? --------------------------
Does the communityhave another name for themselves? What is it?
Give the preciselocation of the affected group or community:
Address/location:
City/town/village:
District/region:
State/country:
Type of affected area:
informal settlement
What is the community’s total population? | | | | | | |
| | | | | | |
What number and/or proportion of the individuals in the community affected? | | | | | | |
| | | | | | |
How many families in the community? | | | | | | |
| | | | | | |
What number and/or proportion of families affected? | | | | | | |
| | | | | | |
In the community, how many affected people are male? | | | | | | |
| | | | | | |
In the community, how many affected people are female? | | | | | | |
| | | | | |
Also identify the numbersand/or proportions of children, minorities, persons with special needs (medicalconditions, disability, elderly) and those subject to historic discrimination:
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II.B
Full name of owner/tenureholder: -------------------- ------------ --------------
Nationality:---------------- (and citizenship,if different: -------------------)
I.D. number:-------------------- Type of document: -----------
Completeaddress of affected housing unit:
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Type of affected area:
informal settlement
Completecurrent address (if different):
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
Other:
Sex/gender:
Civil status:
Birthdate:
Full name of spouse (ifany): --------------------------- --------------
(Additionalnames, if more than one spouse:
Namesand ages of children: ---------------------- (age)--------
[Copy & paste thissection to add lines as needed.]
Refugee status:
Occupation:
WorkTel: ------ ------ ------
Residents:
Listall residents: -------------------- ---------- (age)----
[Copy & paste thissection to add lines as needed.]
Also identify the numbersand/or proportions of children, minorities, persons with special needs (medicalconditions, disability, elderly) and those subject to historic discrimination:
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Is victim/tenure holder alsothe household provider?
Ifno, give contacts:
Street address:
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communication numbers:
Other:
Ifvictim is not owner, identify owner/landlord:
Fullname: ------------------ ----------
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
Other:
III.
Cause ofloss/damage/destruction: demolition
pollution
Means ofdamage/destruction: bulldozer
Identifytype and origin of destructive means: Brand/company of manufacture: --------------
Model: -------------
Direction of violation(from):
IV.
Status of principalperpetrator:
Identity of principalperpetrator, or immediately responsible public official/officer:
Fullname: --------- --------- ---------- Title: ----------
Armed service branch: -------------------
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Commander/superiorofficer:
Fullname: --------- --------- ---------- Title: ----------
Armed service branch: -------------------
Identity of principalperpetrator, or immediately responsible private party:
Name:----------- ---------- ---------- Title: ----------
Relationship to victim(s),if any: -------------------
[Copy & paste thissection to add lines for more identifiable parties as needed.]
Whoordered the violation (if different from principal perpetrator)?
Full name:-------------------- --------------------------
Nationality (andcitizenship, if different): -------------------
I.D. number:-------------------- Type of document: -----------
Completeaddress:
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
What reasons, if any, havethose responsible (duty holders, violators) given for the violation?
Whogave those reasons?
I.D.number: -------------------- Type of document: -----------
Contactinformation:
Organization:
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
IV.A
Company:
CEO:
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
IV.B
Company:
CEO:
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
IV.C
Company:
CEO:
Streetaddress:
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
V. Documentingconsequences:
Which type of tenurevictim(s) hold:
Groundarea of structure: -----square meters
Floor space of residentialunit: -----square meters
Type of property affected:
If multiplex or multistorystructure, how many storeys? ----- How many units? -----
How many rooms in structure?---- How many roomsaffected? ----
Does the affected housingunit have:
Degree of affect:
Housing Rights Violation “Loss Matrix” | ||||
Type and description of cost/loss | Quantification method | Values/ losses | Long-term values/ losses | Totals |
Victims’ Material Losses | ||||
Structure | | | | |
Walls | Number and mass (in square meters) @ replacement value | | | |
Doorways (frames and doors) | Number (wooden) @ replacement value | | | |
| Number (wooden & glass) @ replacement value | | | |
| Number (metal) @ replacement value | | | |
| Number (metal & glass) @ replacement value | | | |
| Number (other) @ replacement value | | | |
Window frames | Number (wooden frame) @ replacement value | | | |
| Number (metal frame) @ replacement value | | | |
| Number (other) @ replacement value | | | |
Windowpanes | Size and grade @ replacement value | | | |
Roofing | Surface area & material (wooden, shingled) @ replacement value | | | |
| Surface area & material (concrete) @ replacement value | | | |
| Surface area & material (metal) @ replacement value | | | |
| Surface area & material (thatch) @ replacement value | | | |
| Surface area & material (other) @ replacement value | | | |
Infrastructure installations | ||||
Heating & cooling systems | Gas heaters @ replacement value | | | |
| Gas furnace @ replacement value | | | |
| Oil heaters @ replacement value | | | |
| Oil furnace @ replacement value | | | |
| Electric heaters @ replacement value | | | |
| Electric furnace @ replacement value | | | |
| Solar heating units @ replacement value | | | |
| AC units @ replacement value | | | |
| Central AC @ replacement value | | | |
| Gas water heaters @ replacement value | | | |
| Oil water heaters @ replacement value | | | |
| Electric water heaters @ replacement value | | | |
| Solar water heaters @ replacement value | | | |
| Other(s) @ replacement value | | | |
Plumbing | Replacement value pipes, drainage, water-delivery system, sanitation & cost of labor to replace | | | |
Electrical installations | Replacement value of wiring, fixtures & cost of labor to replace | | | |
Other utilities | Replacement values of gas and oil pipelines, fixtures and related installations & cost of labor to replace | | | |
Contents | ||||
Furniture | Number of beds with mattresses by type @ replacement value | | | |
| Number of cabinets by type @ replacement value | | | |
| Vanity & dresser (x number) @ replacement value | | | |
| Shelving | | | |
| Sofas (x number & type) @ replacement value | | | |
| Chairs (x number & type) @ replacement value | | | |
| Tables (x number & type) @ replacement value | | | |
| Carpets (by number, type & size) @ replacement value | | | |
Decor | Inventory by number and type @ replacement value | | | |
Appliances | Television(s) @ replacement value | | | |
| Computer(s) @ replacement value | | | |
| Refrigerator(s) @ replacement value | | | |
| Oven(s) & stove(s) @ replacement value | | | |
| Clothes washer @ replacement value | | | |
| Clothes dryer @ replacement value | | | |
| Sound equipment (recorders, music systems) @ replacement value | | | |
| Other @ replacement value | | | |
Kitchen items | Kitchen appliances @ replacement value | | | |
| Inventory of dishes, cutlery, cooking utensils, pots & pans @ replacement value | | | |
Clothing | Inventory by item and value @ replacement value | | | |
Personal items | Replacement values of books, recordings, memorabilia, collections and all personal items lost | | | |
Plot | Current market values (before violation) | | | |
Plants & vegetation | Houseplants @ replacement value | | | |
| Shrubbery @ replacement value | | | |
Trees | Fruit bearing | | | |
| Ornamental @ replacement value | | | |
| Demarcating land @ replacement value | | | |
Crops | Number of plants @ replacement value | | | |
| Harvest value | | | |
Animals & livestock | ||||
| Household pets @ replacement value | | | |
| Cattle (market value at maturity) | | | |
| Sheep (market value at maturity) | | | |
| Goats (market value at maturity) | | | |
| Poultry (market value at maturity) | | | |
| Other (market value at maturity) | | | |
Vehicles and equipment | ||||
Vehicles | Automobile(s) @ replacement value | | | |
| Utility vehicle(s) @ replacement value | | | |
Equipment | Business & office machines | | | |
| Manufacturing equipment & machines | | | |
| Cultivation and harvest equipment @ replacement value | | | |
| Farm equipment @ replacement value | | | |
Tools | Farming implements @ replacement value | | | |
| Other @ replacement value | | | |
Other | ||||
Collateral damage | @ replacement value | | | |
Utilities infrastructure | @ replacement value | | | |
Business losses | @ replacement value | | | |
Inventory | @ replacement value | | | |
Prospective income | @ replacement value | | | |
Mortgage, other debt penalties | Actual costs | | | |
Lost/decreased wages/income | Actual losses | | | |
Health care | Actual costs | | | |
Interim housing | Actual costs, or equivalent market value for rent for comparable accommodation donated by others | | | |
Bureaucratic and legal fees | Actual costs | | | |
Alternative housing | Actual costs | | | |
Resettlement | Actual costs, including moving, storage, losses in the moving process, transportation and other fees | | | |
Transportation costs | Actual costs as a result of resettlement and additional transport costs to access livelihood and meet social needs | | | |
Subtotals | | | |
Victims’ Nonmaterial Losses | ||
Health | | |
Living space | | |
Reconstruction licensing | | |
Psychological harm | | |
Disintegration of family | | |
Loss of community | | |
Heritage | | |
Environment/ecology | | |
Standing/seniority | | |
Political marginalization | | |
Social marginalization | | |
Further vulnerabilities | | |
Other | | |
Other-than-Victims’ Material Costs | ||
Police | | |
Bulldozers | | |
Lawyers | | |
Army | | |
Other forces | | |
Bureaucratic and personnel costs | | |
Other | | |
Subtotal | | |
Other-than-Victims’ Nonmaterial Costs | ||
Social costs | | |
Civic order | | |
Political legitimacy | | |
Total material costs/losses | |
How does the total of thismaterial loss compare with the victim’s annual household income?
Total losses ¸ annual household income = years of labor & investment |
Was the residence occupiedat the time of the violation? q
Did the perpetrators give warningbefore carrying out the violation? Please describe the circumstances, includingthe period of the warning and the actions of the inhabitants.
Was anyone injured in thecourse or aftermath of the violation? q Yes
IfYes, identify those injured:
Name: ---------- ------------------ Age: ----
Name:---------- --------- --------- Age:---- Relationship to residents:----------
Name:---------- --------- --------- Age:---- Relationship to residents:----------
Name: ---------- ------------------ Age: ----
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Was anyone killed in thecourse or aftermath of the violation?
Name:---------- --------- --------- Age:---- Relationship to residents:----------
Name:---------- --------- --------- Age:---- Relationship to residents:----------
Name: ---------- ------------------ Age: ----
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Wasthis home or property previously subject to violation?
[Copy & paste thissection to add lines as needed.]
Is the present state of thehousing unit(s) suitable for habitation? q Yes
Isthe housing unit(s) presently occupied? q Yes
Name:------- ------ --------- Age:---- Relationship to originalresidents: ----------
Name: ------- --------------- Age: ----
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Otherwise,where are the original inhabitants residing? Briefly describe their circumstancesand tenure in the current residence. Please also indicate if their currenttenure is as renters, guests of friends and/or relatives, living in a camp,owners of another residents, etc.:
VI. Responses
VI.A
Are the victims currentlyreceiving aid from any party? If Yes, is the assistance coming from agovernment body q
Please identify the aidorganization(s) and the type(s) of aid provided.
Organization name:
Contactperson: ----------------- ----------
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
Describe the type ofaid or service provided: ------------------------------------------
[Copy & paste this sectionto add lines for more identifiable parties as needed.]
VI.B
Has any media agencyinvestigated and/or reported on this case? Yes
Name:
Title/position:
Mediaagency: ----------------- ----------
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
[Copy & paste thissection to add lines for additional contact persons, if necessary.]
VI.C
Has a legal case been raisedby, on behalf of the victims? Yes
Are victim(s) involved inthe case as plaintiffs q
Is the dispute beingresolved outside of court? If so, by what method? ----------------------
If you have not raised asuit, are you considering to do so? Yes
If a current case is beforethe courts, please provide some basic details:
Casenumber: -------------- Court:------------- Judicial district:-------------------
Datefiled: --/--/---- Date decided:--/--/---- (Settlement date, if outof court,: --/--/----)
Presidingjudge(s):
(1) ------- ------- --------(2) ------- ------- -------- (3) ------- ------- --------
Fullname of prosecuting attorney:
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone:
Fullname of defense attorney:
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communication numbers:
Resultsof case (if any):
Othercomment:
Has there been an appeal inthe case? Yes q
Would you consider mountingan appeal in this case? Yes q
VII.
Victim/affected person:--------------------------- Date:--/----/----
Other person filing thisform: -----------------------
Relationshipto victim/affected person:
Organization:
Position: ----------------------------
Streetaddress: -----------------------
P.O.Box: -------------
City/town/village:
District/region:
State/country:
Communicationnumbers: Telephone: